This is risky. Rabies. Are you at risk?

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1 This is risky. Rabies Are you at risk?

2 Are you at risk of rabies? You are at risk if you are in contact with potentially rabid animals: t Laboratory workers, veterinarians t Animal control workers, animal handlers, wildlife workers t Cave explorers (spelunkers) t Hunters or trappers in high-risk areas t Any person whose activities bring them into frequent contact with rabies virus or rabid bats, skunks, foxes and dogs t Any child who may not understand the need to stay away from animals or to report any bite or If you travel or plan to travel to high risk areas, i.e., where rabies is common and where adequate and safe medical treatment may not be accessible. Know your risks, know where you go. Know the facts about rabies.

3 DISCOVERING UNKNOWN PLACES CAN BE SO EXCITING DISCOVERING YOU VE BEEN EXPOSED TO RABIES IS NOT. Pre- Exposure Did you know that t Dogs for example, are the major transmitter of rabies to humans in Asia and Africa t Many countries do not have effective dog rabies control programs therefore increasing your risks of getting rabies when travelling abroad

4 Rabies occurrences No risk Low risk Medium risk High risk Not stated HAVE YOU CONSIDERED TRAVEL TO AREAS SUCH AS THAILAND, BRAZIL, CHINA, VIETNAM, INDIA, CUBA, MEXICO, SOUTH AFRICA OR ASIA? These represent only some of the areas where rabies remains endemic (common). Adapted from World Health Organization (WHO), Map by VECTOR WORLD MAP.com. Version 2.2. Copyright 2009, Graphics Factory CC.

5 The risk is yours The risk of acquiring a disease, such as rabies, depends on several factors. They include some of the following: t your age t your itinerary, duration and style of travel (first class or adventure) t your immunization status t your anticipated travel activities (animal contact ) t your current health status and the local disease situation, i.e., where rabies is common. It is strongly recommended that your travel plans include contacting a travel clinic or a physician 6 weeks before departure. Based on your individual risk assessment, a healthcare professional can determine your need for immunizations and/or preventative medication and advise you on precautions to avoid disease. If you are a parent Assess your Risks Know that young children, who may not understand the need to stay away from animals or to report any bite, should be offered pre-exposure immunization when travelling to places where rabies is common.

6 Did you know that t World Health Organization reports indicate that more deaths occur worldwide from rabies than from other common infections such as dengue fever, polio, meningococcal meningitis or Japanese encephalitis t Pre-exposure immunization does not eliminate the need for careful wound management and post-exposure immunization but simplifies post-exposure prophylaxis in populations at risk such as travellers to high-risk areas If travel is in your plans, ask your doctor about the risk of rabies and RabAvert *, the rabies vaccine trusted worldwide.

7 In Canada... t Wildlife rabies has become well established t Rabies is mostly found in bats and in wild meat-eating animals such as skunks, raccoons and foxes Post- Exposure

8 Occurrence of Rabies in Countries Rabies endemicity in North America 2008 Rabies occurrences Low risk Medium risk High risk Adapted from the World Health Organization (WHO), Map by VECTOR WORLD MAP.com. Version 2.2. Copyright 2009, Graphics Factory CC.

9 Did you know that rabies is present in Canada? In spite of large numbers of animal rabies in Canada, human rabies is a rare disease due largely to excellent prevention and control programs. Did you know that t Transmission of rabies can occur from minor or even unrecognized bat bites t Though bat rabies is most common in Canada, other animal species such as skunks and foxes may also be rabid

10 If you find a bat in your home or cottage, you should know that t Over half of North American human rabies reported in the past 20 years were bat rabies t Rabies post-exposure prophylaxis should be considered for any physical contact with bats when bites or mucous membrane contacts cannot be excluded

11 If you think you have been exposed to any animal that may carry rabies SEE A DOCTOR IMMEDIATELY t Appropriate rabies post-exposure treatment is effective, but must be administered quickly t Once acute symptoms of the disease show up, rabies is almost always fatal Ask your doctor about the risk of rabies and about RabAvert *, the rabies vaccine trusted worldwide.

12 What is rabies?

13 Rabies is a viral infection of animals that can be transmitted to humans. It is caused by a virus of the Rhabdoviridae family, which attacks the central nervous system and eventually affects the brain. The virus is usually found in the saliva of an infected animal. Rabies is almost always fatal once symptoms occur. Rabies a deadly disease t Rabies is a deadly disease that can be passed on to humans by: Bites Scratches Licks on broken skin or mucous membranes (e.g., eyes, mouth) t Treatment should be prompt following rabies exposure as rabies has one of the highest fatality rates of all viral infections t Worldwide, approximately 55,000 people die of rabies every year Rabies Information

14 Testing and Treatment It is very important to act quickly if an individual thinks they may have been exposed to rabies. Treatment for rabies is effective, but only if an individual begins treatment early. Immediately following an exposure (bite, lick or scratch) to a suspected rabies carrier, one should: t Vigorously wash and flush the wound or point of contact with soap and water and apply alcohol or iodine, if available t Seek medical attention for post-exposure vaccination and, if necessary, wound care Exposure Incubation period Prodrome Encephalitic stage/ Brainstem dysfunction Coma and death Clinical stage Dormant Period Symptoms Appear Acute Stage General stages of rabies Fever Headache General feeling of being unwell Muscle pains Fatigue Loss of appetite Nausea and vomiting Sore throat Cough Pain or numbness at bite site Agitation Excitation Confusion Hallucinations Seizures Muscle spasms Hydrophobia Excess salivation Usually due to respiratory failure Usual duration days 1-4 days 3-10 days

15 Recommended by the National Advisory Committee on Immunization (NACI) The NACI, Canadian committee, charged with preventing infectious diseases recommends that individuals who have a high risk of being exposed to rabies receive: t Rabies vaccination t Booster vaccination when necessary The Committee to Advise on Tropical Medicine and Travel (CATMAT) also recommends immunization Rabies vaccination be considered for travellers: t With a significant risk of exposure to rabies t Travelling to a location where rabies is present, and adequate and safe post-exposure measures may not be available If you believe you may be at risk, ask your doctor what kind of rabies protection you might need! Know your risks, know where you go. Know the facts about rabies.

16 Help protect yourself against rabies talk to your physician about RabAvert * t RabAvert* is one of the world s most widely distributed rabies vaccines t RabAvert* vaccination can help if taken: Before exposure to rabies (pre-exposure vaccination or booster dose) or After exposure to rabies with prompt and appropriate additional medical treatment Though RabAvert* has an excellent safety and tolerability profile, the most commonly occurring adverse reactions are: injection-site reactions, such as injection-site redness, swelling and pain; flu-like symptoms, such as fatigue, fever, headache, muscle pain and general discomfort; abdominal pain, joint pain, dizziness, lymph node swelling, nausea, and rash. History of severe allergic reaction to the vaccine or any of the vaccine components, including the container, constitutes a contraindication to pre-exposure vaccination with this vaccine. For more details or specific information, precautions and contraindications, please inquire with your physician or travel clinic healthcare professional. As with any rabies vaccine, vaccination with RabAvert* may not protect 100% of susceptible individuals. If you have or think you have been exposed to any animal that may carry rabies SEE A DOCTOR IMMEDIATELY t Appropriate rabies post-exposure treatment is effective, but only if provided early t Once acute symptoms of the disease show up, rabies is almost always fatal RabAvert* Drug Identification Number (DIN): * RabAvert is a registered trademark. Product Monograph available on request. Printed in Canada RAB Exp: 02/2014 Novartis Pharmaceuticals Canada Inc RabAvert* may be covered by your private health insurance plan. Please check your individual coverage.

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