An ancient disease that claims human lives even today, Rabies appears in myth and folklore as much as it incites fear and terror. An illness which targets the brain, it is for all intents and purposes, a 100% fatal disease. When we lose control of our brain, we lose the very thing that makes us uniquely human. This condition, transferred from one to another by a deadly bite, likely gave birth to creatures of folklore such as vampires and werewolves, who ceased to be human, once infected. Getting the rabies vaccine for humans through pre-exposure prophylaxis (PrEP) is especially important for expats living in Asia due to the higher risk of rabies exposure in many Asian countries. Rabies is a deadly viral disease that is transmitted through the bite or scratch of an infected animal, most commonly dogs. Here's why getting the rabies vaccine PrEP is crucial for expats in Asia:

1. High Rabies Incidence: Many Asian countries, particularly in rural areas, have a high incidence of rabies in stray and domestic animals. Expats might be at risk due to increased exposure to unfamiliar animals. In many rural Asian settings, public health surveillance methods cannot be counted on to provide real-time, accurate data on animal rabies. The incidence of rabies among animals, therefore, may be much higher than the official statistics.

2. Limited Access to Healthcare: Some remote areas might lack proper healthcare facilities. If someone is exposed to rabies, getting timely and appropriate medical care (post-exposure prophylaxis, or PEP) might be difficult. This is commonly encountered in remote explorations, safaris, hikes and getaways, where even the most basic medical care and medications may be unavailable. PrEP provides a proactive safeguard in such situations. Rabies Immune Globulin (RIG) - pre-formed antibodies sometimes referred to as ‘serum’ by laypeople - is typically in short supply in rural Asia. RIG is an essential life-saving treatment for those exposed to rabies but without PrEP.

3. Unfamiliarity with Local Animals: Expats might not be familiar with the behavior of local animals, making it harder to judge if an animal is potentially rabid. PrEP acts as a preventive measure, reducing the risk even if the bite is from an animal that might not appear visibly sick. Furthermore, even animals vaccinated against rabies may not have developed protective immunity due to vaccines being inappropriately handled, transported and stored.

4. Long Incubation Period: Rabies has a relatively long incubation period, meaning symptoms might not manifest until weeks or months after exposure. By the time symptoms appear, it is almost always fatal. PrEP provides a window of protection, allowing individuals more time to seek medical help.

5. Potential Delay in Treatment: If an exposure occurs, there might be delays in receiving appropriate medical treatment, especially if the incident happens in a remote area. PrEP provides immediate protection until proper medical care can be administered.

6. Occupational Risks: Some expats might have jobs that involve regular contact with animals (such as veterinarians, researchers, or animal rescue workers), increasing their risk of exposure. PrEP is highly recommended for individuals with such occupations.

Each year, almost 60,000 people die of rabies worldwide. Almost half of these deaths occur in Southeast Asia. PrEP offers a proactive and potentially life-saving measure against this deadly disease which is considered uniformly fatal. Exposure with a potentially rabid animal, may not show any symptoms, needs immediate medical attention to assess the risk of exposure and the need for post-exposure treatment.