What is rabies?

Rabies is a disease caused by a lyssavirus. There are 18 known types of lyssaviruses and it is likely that all of them cause rabies. Most people who contract a lyssavirus infection get the virus by being bitten or scratched by an infected dog. Sometimes the infection comes from a different mammal, such as a cat, fox, raccoon or bat. Infected animals can transmit the virus before they become ill.

What are the symptoms of rabies?

If you are treated before you have any symptoms of rabies, treatment can prevent you from becoming ill. Once symptoms appear, rabies always leads to death. It is important to start treatment as soon as possible after contact with an animal that may have rabies.

Rabies starts with symptoms that are often seen in other diseases, such as chills, fever, feeling ill, loss of appetite, nausea, vomiting and headache. The bite or scratch may be itchy and painful.

This is followed by neurological symptoms, such as cramps, problems with swallowing and drooling, irritability or paralysis. Rabies always eventually leads to coma, and then to death.

The time between exposure (through a bite, scratch or lick) and illness is usually 20 to 90 days.

How does rabies spread?

Most people who are exposed to rabies get the lyssavirus by being bitten, scratched or licked by an infected dog in another country. Rabies can also be caused by being bitten, scratched or licked by some other infected animal (often predators such as cats, foxes or raccoons), or by bats (also in the Netherlands). 

Another risk in the Netherlands comes from unvaccinated dogs and cats brought here from abroad. Are you planning to bring a dog or other pet from a different country to the Netherlands? The website of the Netherlands Food and Consumer Product Safety Authority explains the rules for bringing pets into the Netherlands.

A few species of bats found in the Netherlands can also have a lyssavirus infection. That is why there is a minimal risk of catching rabies after contact with bats. Bats almost never bite humans, but if you are bitten by a bat, call a doctor right away. The doctor can decide if you need rabies treatment.

Lyssaviruses are not transmitted to humans through urine, stool (poop) or blood.

Who has a higher risk of rabies?

Some people have a higher risk of getting rabies. This is often because they have more contact with animals. Examples include:

• People who work with bats.
• Travellers in regions where rabies is common.
• Children. Animal bites are more likely for children.

How can I prevent rabies?

The main recommendation for preventing rabies is to avoid any contact with a lyssavirus:

• Do not touch animals (including dogs and cats) in countries where rabies is found (information in Dutch). Do not pet them, and do not feed them. Keep a close watch to make sure children do not pet or feed animals either.
• Do not touch any bats. Not in other countries, and not in the Netherlands.
• Do not touch dead or diseased animals, especially not with your bare hands.

There is a vaccination that protects against the most common and well-known lyssaviruses. It is intended for people in risk groups, such as people who work with bats and travellers in high-risk regions. The vaccination series consists of 2 injections with an interval of 1 week.

You can consult a travellers’ advice centre and vaccination clinic to see if you would benefit from vaccination against rabies. The National Coordination Centre for Travellers’ Health Advice (LCR) lists addresses of travellers’ advice centres and vaccination clinics. The LCR website also has travel advisories for various countries. 

Even if you were vaccinated before exposure, you still need to be treated for rabies if you have had contact with a lyssavirus. If you have been vaccinated against rabies, treatment is easier and almost always available in other countries. People who work with bats can contact the Municipal Public Health Service (GGD) if they have been bitten by a bat.

I found a bat. What should I do now?

Do not touch the bat with your bare hands. 

A bat bit me. What should I do?

If you have been bitten, scratched or licked by a bat, call your GP right away. See the section on treatment for rabies below to read about what else you can do. 

If the bat does not fly away, you should also contact the Netherlands Food and Consumer Product Authority (NVWA) by calling 0900-0388. They can decide if the bat needs to be picked up to test it for rabies. 

Is there any treatment for rabies?

Did a bat scratch or bite you? Or did an animal bite, scratch or lick you in a country where rabies is found? (This only applies to mammals.) Follow these steps:

• Wash the wound for 15 minutes with soap and running water.
• Then disinfect the wound with iodine or 70% alcohol.
• Go to a doctor ASAP (within 24 hours).

Are you travelling abroad? Contact your travel insurance helpline ASAP. The treatment for rabies consists of multiple vaccinations against lyssaviruses, and sometimes also includes antibody injections. This keeps the virus from entering your central nervous system and making you ill. You may need to go back to the Netherlands right away for treatment. Your travel insurance policy states if you are covered for these costs. The costs may be deducted from your insurance excess.

How common is rabies?

According to the World Health Organization (WHO), rabies is found in more than 150 countries. An estimated 59,000 people die from rabies every year. Most patients get rabies by being bitten or scratched by an infected dog. 

In the past 40 years, five people have died from rabies in the Netherlands. All those patients contracted the disease in another country. There is a minimal risk of infection in the Netherlands if you are bitten or scratched by a dog brought here from another country, or by a bat. There has never been a confirmed lyssavirus infection in the Netherlands caused by a bat, but there have been a few cases in Europe.