Rabies is rare – but when symptoms appear, the disease is almost always fatal. Children are particularly at risk when traveling because they touch animals more often and sometimes do not immediately report bites or scratches.
A stray dog, a cat at the temple or a monkey in the park: In many countries, contact with animals is part of everyday life – and when traveling it often happens faster than expected. According to the WHO Tens of thousands of people die from rabies every year, and a large proportion of those affected are children. The risk is particularly high in many regions of Asia and Africa because dogs are the most common source of infection there. The Pharmaceutical newspaper reports that travel doctors therefore often urgently recommend rabies vaccination for children on long-distance journeys – also because modern vaccines are approved from the first day of life.
Why children are at higher risk when traveling
Children are more vulnerable for several reasons:
- Proximity to animals: Children are more likely to pet dogs, cats or monkeys – and animals sometimes react more unpredictably to children.
- Bites are missed: Small scratches or leakage contacts are not always recognized as “relevant” or reported immediately.
- Bite sites are often higher on the body: In smaller children, bites are more likely to land on the hands, arms or face – areas where doctors pay particular attention.
The WHO also emphasizes that once the virus reaches the central nervous system and symptoms appear, rabies is fatal in virtually 100% of cases. That’s exactly why speed counts in every possible exposure.
When it makes sense to get vaccinated before traveling
Preventive vaccination (pre-exposure prophylaxis, PrEP) is particularly considered if:
- You are traveling with children to countries with a relevant prevalence of rabies (especially in parts of Asia and Africa).
- a longer stay, tour, backpacking or “adventure vacation” is planned
- You are traveling away from large cities where medical care or rabies immune globulin may be difficult to obtain.
Important: The specific recommendation belongs in a travel medical consultation because the destination region, type of travel and age of the child are crucial.
This is how the rabies vaccination typically works for children
In Germany, the Pharmazeutische Zeitung (with reference to STIKO information) continues to describe a schedule with three doses on days 0, 7 and 21 or 28 (e.g. with Rabipur or Verorab) for primary immunization.
The Paul Ehrlich Institute also states that approved rabies vaccines can be used from birth. For comparison: In the USA, the CDC now recommends a 2-dose PrEP regimen (at least 7 days apart) for travelers (depending on risk). This is a different national approach, but shows that schemes can vary by country.
What changes the advance vaccination in an emergency
The big practical advantage of PrEP is that if there is a risky contact in the country you are traveling to, follow-up treatment is usually necessary easier.
The CDC describes for children after possible exposure:
- without PrEP: wound cleaning, additional immunoglobulin + vaccination series (several doses)
- with PrEP: typically only 2 vaccine doses after exposure (days 0 and 3)
The central principle is similar internationally: advance vaccination reduces dependence on immunoglobulin – and that is exactly the bottleneck in many travel countries.
What you should teach children before traveling
Regardless of the vaccination, the following applies:
- No petting of street dogs/cats, no “cute puppy” photos with physical contact.
- Do not feed monkeys and keep your distance (monkey = high risk of bites/scratches in tourist hotspots).
- Do not touch bats – even small bites can be relevant.
If it happens: What you should do immediately if you are bitten, scratched or licked
The WHO recommends that the first step be to immediately wash the wound thoroughly (water + soap), followed by medical care as quickly as possible – and, depending on the level of exposure, vaccination and, if necessary, immunoglobulin.
Important: Scratches or saliva contact with injured skin/mucous membranes can also be relevant. If in doubt, always have this assessed by a doctor.
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