By Sarah Kohl, M.D., Pediatric Alliance — Chartiers/McMurray Division
Why are children and teens traveling abroad more susceptible to rabies?
Should you worry about rabies if you travel abroad with children or adolescents? Yes. For a variety of reasons, children and adolescents are more likely to get bit by animals than adults. This makes them more likely to contract rabies. The biggest problem is that you cannot tell which animals have rabies: some are aggressive while others are hyper-friendly. Thus, any animal bite is a serious matter.
Dogs spread most of the rabies in the world, but any animal with fur can transmit rabies. Prevention and proper bite wound care is essential since rabies is always fatal once the symptoms start. Sadly over 200 people die each day of rabies with 40% of cases under age 15, mostly in Asia and Africa. Take note however: rabies is present everywhere the world. 
Parents traveling with young children to India and other at-risk countries must be vigilant. Children are far more likely to be bitten due to their small size and proximity to dogs when playing. They are also less likely to report a bite to their family. Remember, children are confused by the need for cautious behaviors around animals when abroad. This is understandable because when at home in the USA kids freely play with dogs and other pets.
Teens and young adults visiting family or studying abroad are also at risk, especially in Asia and Africa. Many have grown up in the USA and are used to pets being well vaccinated. The natural inclination when coming across a dog is, “Aww, how cute… let me just pet you,” especially if the adolescent is a wee bit homesick and misses cuddling with his or her own pets. Puppies tied-up, and town dogs looking for attention, are irresistible but often bite when approached.
A bite, even a small nip on the hand, now becomes a race against the clock to locate proper rabies treatment, particularly in a country which may have limited medical care. The biggest problem is locating immune globulin (IG) in addition to rabies vaccine. IG can be in short supply or non-existent in many countries.
Parents traveling with small children or adolescents for extended periods of time often choose to protect their children with 3 simple rabies shots prior to departure. This makes treatment of a bite abroad quite a bit simpler. You can ask your doctor for details. Unfortunately, the cost of the vaccine is not covered by most insurance plans, but the peace of mind it brings is priceless.
I recommend travelers purchase travel health insurance to offset the cost of medical treatment while traveling abroad. The policies are very affordable and cover the cost of evacuation, if needed, to a treatment center where immune globulin is available.
If you are taking your children abroad, be sure to discuss with them the importance of staying away from all animals and to report to you any bites, even the small ones. If bitten, wash the wound for 15 minutes with soap and water, apply antiseptic and seek medical care immediately.
*September 28, 2014 is World Rabies Day. Visit website here.
CDC info on rabies here.
Read more travel tips from Dr. Kohl here.