|
Rabies: the facts you need to know |
|
|
consider for all travellers (especially children) even if the duration is short to rabies endemic countries and higher risk activities eg cycling, trekking, local homestays, runners, caving and 'of the beaten' travel. - rabies is almost always fatal if untreated and ~10% of strays in Thailand are rabid
- our clinic advises and manages approximately 2 travellers per month with accidental animal bites; rabies is a risk wherever dogs are allowed to roam free
- Bali & Bolivia is currently having a major outbreak and all travellers are advised to be immunised
- immunisation route may be ID - intradermal or IM - intramuscular for 'peace of mind'.
- dosing schedules and route of administration vary (ID vs IM : pros and cons).
- ID route is a series of 3 doses and costs $75 per dose, followed by a blood test to check for rabies virus neutralising antibodies (and a booster in a year for long term immunity).
- there are other schedule options for travellers who cannot do the 3 dose series.
- preferably make your own antibodies in New Zealand, so if ever you are bitten (dog, monkey, cat, bat ), you will need two vaccinations after the animal bite, but you will never need any human rabies immunoglobulin ie. a blood product injected into the bite wound.
- if you are bitten and unimmunised ie. no antibodies, this is almost certainly a trip ruining experience, as you have to stop what you are doing and travel to a centre where the post-exposure therapy is available; and request human rabies immune globulin HRIG which needs to be injected into the bite wound and try to time 5 rabies vaccinations required on days 0, 3, 7, 14, and 28 around one's remaining travels.
- All bites and scratches should be immediately flushed out , washed and then disinfected. Doing so can enable efficient elimination of the rabies virus at the infection site.
- In summary, the aim of getting your own rabies antibodies boostable before travel is to prevent uncertainty, eliminating the need for blood products ie. human rabies immune globulin which is difficult if not impossible to obtain in many developing countries, reducing the need for post bite vaccines from 5 shots to 2 shots, reducing the post bite treatment period from 28 days to 3 days and allows for a delay in treatment.
|
