Health and safety forum
Rabies is it worth it?
19th April, 2010
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going to be all over South East Asia this summer,
should i get the Rabies Jabs? i here it only gives you an extra 24 hours to get to a hospital if you are bitten etc...
the cost of the injection isn't really an issue for me.... but to be honest i really really really hate getting injections and the rabies one is a course of three!!
so as long as i'm carful (no patting street dogs/ no playing with monkeys) do i really need it?
#1 Posted: 4/5/2011 - 23:25
For me, it was the cost AND the needles that meant I didn't get the rabies vaccination. I was advised that as long as you're never more than half a day away from good medical care, and you're not going to be exposing yourself to unneccesary risk, then you'll probably be fine without it... and I guess the travel nurse was right, because I don't have rabies...!
I guess what you need to ask yourself is:
1) Are you going to be going to areas where it will be difficult for you to get medical attention?
2) Are you the sort of person thats going to want to touch the (stray) puppies or feed the wild monkies?
If you answer 'no' to both, then you'll probably be fine! And if you do get bitten, get to the hospital that bit faster!
#2 Posted: 5/5/2011 - 03:29
Is it worth it? It will be if you are bitten. What are the chances of being bitten? Probably pretty slim.
Avoid dogs, avoid monkeys, avoid bats - and you will most likely be fine. But it's a risk and one that you have to make an informed decision on. If you don't care about the cost, then get it for the peace of mind. They are only little injections and don't hurt at all. The thought of them is worse than the actual injection.
Maybe do a bit of google search to see where there are any current outbreaks and take that into consideration - but also take it with a grain of salt. For example, there has been a recent outbreak in Bali (ie a year or so ago, presumably still ongoing) but it's pretty much localised to one village area in the NW corner of the island, last I heard, in an area not typically visited by tourists.
If I were you, I would perhaps be more concerned about getting Hep A and B if anything, and make sure your tetanus is up to date. Then go and buy some mozzie repellant to reduce the risk of dengue fever.
#3 Posted: 5/5/2011 - 04:51
I think it depends where you are going. We got shots earlier in the year for the whole family), but primarily because there is a bit of a rabies problem here in Bali (over 200 dead now), there's random dogs on the beach and we were worried about the kids.
If I was heading elsewhere in Asia I wouldn't worry about it.
#4 Posted: 5/5/2011 - 08:04
How many jabs do you get? I for one stay the hell away from the cute monkeys. One is cute and then mamma or poppa monkey get upset. I have seen it. So pics are good enough for me, no petting. I have had a couple of bad experiences with stray dogs, but in general the dogs wagging their tails hanging around the locals are usually fed by them and not "dangerous" if treated kindly. Now surprising dogs who are guarding their territory at night almost got me in serious trouble. But after all my SE ASia trvaels I still probably wouldn't get rabies shots if it means I still need to go to the doc for more shots if bitten. As was said, get that Hep stuff and a tetanus booster. Watch the mozzies and maybe a typhoid shot.
AND DON"T FORGET TRAVEL INSURANCE....that is the one that screws people the most.
#5 Posted: 5/5/2011 - 11:42
Hey Somtam - 200 dead? Wow! Is it now spreading to other parts of Bali?
Hamish - you need to get 3 injections. They are little ones. (Look - Somtam's young kids managed, I'm sure you can too!) I'll post some info below from a NZ medical website. I am not trying to be alarmist, and I'm not advocating getting the injections one way or another. But I do believe in making informed decisions after weighing up the risks. Your comments indicate you aren't overly informed about rabies and what's involved if you are bittn.
WHAT IS THE TREATMENT?
Once symptoms develop, death is inevitable in all cases. There is no cure. Treatment consists of first aid management to the initial wound and then and vaccine administered promptly following exposure, and before symptoms develop. This vaccine may have to be given together with a specialised human immunoglobulin immunisation at the first visit following exposure to rabies.
First Aid Management:
Vigorously wash and flush the wound site with soap and water, OR detergent OR water alone. This is important.Apply either ethanol OR tincture or aqueous solution of iodine.Seek the advice of local medical authorities, informing them of any vaccine you have already had.If possible, take the name and address of the owner of the animal or get the local police to trace the animal urgently.If possible, try and find out if the animal is healthy and if vaccinated against rabies.
There are two vaccine administration regimes depending on whether the person has had pre-exposure immunisation ( see Vaccination below ).
If patient has been previously vaccinated with 3 pre-exposure vaccine doses
• 2 further doses are needed on days 0 and 3 after the exposure
• Dose is 1 standard intramuscular dose
• Postpone suturing of the wound
• Begin anti-tetanus and anti-biotic therapy
• No rabies immmunoglobulin is needed.
If patient has NOT been previously vaccinated before exposure
• Full course of 5 vaccine doses plus Rabies Immunoglobulin (RIG) is needed as soon as possible
• Both the vaccine and RIG can be very difficult to obtain in many developing countries.
• Even if they are available they may be very expensive.
From what I understand the Rabies Immunoglobulin injection is particularly awful - I think it needs to go directly into the wound.
Again, I'm not trying to be alarmist. But just make sure you have valid reasons for getting, or not getting, the vaccinations.
#6 Posted: 5/5/2011 - 15:51
19th April, 2010
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thanks for all the info and advise guys! i'm still covered for hep A, B, and Typhoid from my last trip, tetanus is something i didn't even think about, so i'll look into that!
and i'm still weighing up the idea of the rabies jabs
@busylizzie "(Look - Somtam's young kids managed, I'm sure you can too!)" ha very true, i guess im just being a wimp, I've had my fair share of injections in the past.
#7 Posted: 5/5/2011 - 17:56
"i here it only gives you an extra 24 hours to get to a hospital if you are bitten etc... "
That's not entirely true. The time you have depends on where the exposure occurs on your body. Head and neck exposure requires treatment much sooner than when exposure occurs, for example, on the arms or legs. This is because the virus has to travel to the brain in order to manifest itself, and that can take up to a month. For head and neck exposures, one can be good for up to a week, but it's better to begin treatment not much later than 24 hours after exposure.
Also, with regards to costs, the vaccine and RIG are significantly less expensive in SEA than they are here in Canada. WAY less.
The RIG is supposed to be administered into the place of exposure, but this rarely happens. Most of the time it is given in the area of exposure.
The 5 shots of vaccine have to be given over the period of 28 days (Day 0, 3, 7, 14 and 28) which means you have to stick around or continue with the shots in a different place. If the series is not completed, the process will fail. We deal with people who have been bitten overseas, received the RIG and the first 2 or 3 shots of vaccine, then provide them with the remainders.
I've never gone for the pre-exposure shots. I don't think they're necessary unless one is going into a very, VERY remote area that is endemic.
#8 Posted: 5/5/2011 - 21:30
I was bitten by a bat several years ago, on my right leg, and received the full five shots. Thank heavens, no longer done in the stomach, but alternating shoulders. Also was given the immuoglobulin injection. As Bizzylizzy said, it had to go in near (though not at) the location of the bite. For me, it wasn't as painful as the actual rabies vaccine jabs, but because it was done on my leg, it was uncomfortably close to the leg bone.
My understanding about the vaccine is that, even if, like me, you've had the full round of injections, additional are required if you are exposed again (bitten, that is). Two more, as noted by others. But I also understand it doesn't have to happen immediately, especially if bitten on an extremity. In other words, not necessarily within 24 hours. Still, if bitten, or you think you were somehow exposed, I wouldn't dawdle on my way to proper medical care.
#9 Posted: 6/5/2011 - 20:56
19th July, 2012
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So if i dont have rabies injections and say i got bitten in a remote area. how long would i need to get to hospital.
i will be travelling in asia for 3 months but have no idea where we are going yet. i no we will be going up north and over to fiji, singapore and i was going to go bali but im not sure yet.
Would you advise me to get them, there jut so expensive
please help lol
#10 Posted: 19/7/2012 - 10:24
The easy answer to how long is, "as soon as possible." Which doesn't help much, I realize.
Depends on where on your body you are bitten. If on a toe or finger, the rabies will take longer to become mortal, so to speak.
I am no authority, and suggest you do some research on legitimate sites such as worldrabiesday dot com, cdc dot gov / rabies / or who dot int / topics / rabies / en . It's not to be trifled with, as I'm sure you know. Personally, I would not wait more than one week, but even that could be too long if you are, say, bitten on the neck or chest.
#11 Posted: 19/7/2012 - 11:23
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