Posted by soQQuadro on 19/8/2009 at 07:40
I was wondering if it's possible to get the epathitis A & B and Thypoid shots somewhere in Bangkok.
#1 soQQuadro has been a member since 3/8/2009. Posts: 28
Posted by somtam2000 on 19/8/2009 at 08:21 admin
Yes you can. Bangkok Adventist Hospital (Mission Hosp.) has a small clinic just off Khao San Road which does vaccinations and other traveller orientated care.
#2 somtam2000 has been a member since 21/1/2004. Location: Indonesia. Posts: 8,062
Posted by soQQuadro on 19/8/2009 at 10:28
thanks heaps. do u think is alright/ safe to head there?
#3 soQQuadro has been a member since 3/8/2009. Posts: 28
Posted by soQQuadro on 19/8/2009 at 10:52
I just had a look. sure will be stupid of us tho, as many shots are done in a period of time. so don't know how efficient this can be. thinkingthinking......
#4 soQQuadro has been a member since 3/8/2009. Posts: 28
Posted by somtam2000 on 19/8/2009 at 11:04 admin
The clinic looked fine to me -- I didn't get any jabs, but the nurse was chatty and seemed to know her stuff. Good English spoken.
#5 somtam2000 has been a member since 21/1/2004. Location: Indonesia. Posts: 8,062
Posted by soQQuadro on 19/8/2009 at 11:22
ok,if we decide to leave here with no vaccination whatsoever we might consider that clinic,as we are staying near KSR and will be pretty close.
#6 soQQuadro has been a member since 3/8/2009. Posts: 28
Posted by travellerwill on 19/8/2009 at 16:46
I had a lot jabs done at BAH a couple of years ago. Very professional and much cheaper than having them at home.
#7 travellerwill has been a member since 19/8/2009. Posts: 3
Posted by jojow25 on 16/9/2009 at 05:12
Hey. My Gf and I are booked into the Bangkok International Hospital so that when we arrive we go to get our vaccinations for Rabies and Typhoid. This costs as follows:
755 THB Rabies
760 THB Typhoid
Plus 500-800THB Doctors Fee
I was just quoted by a doc in NZ $140 NZD for just the rabies one.
And also $49 for the Typhoid. He said Tyhpoid should be the least of my worries and that Rabies was a rare one for people to have before going to Asia??? I am now so confused. But we leave in two weeks for Thailand, Laos, Cambodia, Vietnam for 4 months so no time for farting around!!
Hope that helps
#8 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by busylizzy on 16/9/2009 at 11:31
With respect to rabies - you actually need 3 shots, one each on Day 1, Day 7 and Day 21 (I think). Travel Doctor in Tauranga (NZ) quoted NZ$150 per shot. Just letting you know in case you wanted it and were only planning on staying for a few days. And I'm not sure that there is any point in only getting the first one.
Also - the nurse today told me about one of their patients who just returned this week after getting minor dog bite. He didn't have the pre-trip vaccinations, so now he's getting the whole set of 5, which is a LOT more expensive, including the immunoglobin shots that you need (or whatever they are called). I guess it just goes to show that it can happen..... bugger!
Hep A requires 2 shots, and Hep B requires 3 shots (spread out over a few weeks as well).
#9 busylizzy has been a member since 31/12/2007. Location: New Zealand. Posts: 2,152
Posted by Rufus on 16/9/2009 at 12:07
Why on earth do you want injections for rabies? Heb A/B and typhoid is all you need. If you want top notch service, go to Bumrungrad, but really any doctor/clinic/hospital ought to be able to give you these.
#10 Rufus has been a member since 22/4/2007. Location: Laos. Posts: 978
Posted by Nokka on 16/9/2009 at 15:46
Rabies has me a bit confused also. I am up to date with all the obvious jabs due to previous travels, but the travel nurse suggested the rabies shots this time. £110 in the UK, which clearly isn't cheap.
I'm unsure which way to go. As we will be away for 4 months, often in rural areas, its possible to get bitten. But, if you are bitten, you still have a period to get to a hospital or clinic and get a different shot as an antidote. Its unlikely we'll be more than 24 hours from a clinic.
Busy Lizzie suggests this is a lot more expensive (in Asia ?), but does anyone know if that is the only downside, or are there other health issues as well ?
#11 Nokka has been a member since 6/4/2009. Location: United Kingdom. Posts: 259
Posted by busylizzy on 16/9/2009 at 16:12
I am not advocating getting a rabies vaccination one way or another - I'm a big believer in doing your own research, and making an informed decision about what is best for you in terms of what level of risk is applicable to you.
Based on my understanding, you can get rabies from dog or monkey bites. You can also 'inhale it' from bats (bat dust maybe?!). So when you explore various temples that are overrun with monkeys and exploring caves where the bats live - you are in theory at risk. If you don't get treatment, death is the most likely outcome.
If you get bitten, you need to get immediate treatment. You also need an injection of immune globulin that provides rapid short-term prevention treatment. I was told by the Travel Doctor that it's difficult to get in Asia - and you would most likely need to go urgently to Bangkok to get this. And it's about $1000 a pop. This is not needed if you have had the vaccinations.
The vaccination is very expensive in NZ - I have no idea on costs in Asia.
As I said, I'm not suggesting you get the vaccination, and I'm not suggesting you don't. Just understand the implications of treatment in both cases. And weigh up the likelihood of being exposed to bats, dogs and monkeys. If you're blobbing on a beach in Southern Thailand, you're probably pretty safe. I also understand that many expats live in Asia and don't bother with the vaccinations, and they're (usually!) OK.
I've struggled with this decision myself! Just do your research and make an informed decision.
#12 busylizzy has been a member since 31/12/2007. Location: New Zealand. Posts: 2,152
Posted by somtam2000 on 16/9/2009 at 16:15 admin
The main reasons I never bothered with rabies is:
a) I'm petrified of monkeys and don't go anywhere near them
b) It's my understanding, even if you have the vaccine, you need further shots anyway after being bitten -- so I don't really see the point -- the vaccine gives you more time to get the extra shots you need, but unless you're walking barefoot through the Kalahari, chances are you'll be able to get to a hospital within the prescribed period.
#13 somtam2000 has been a member since 21/1/2004. Location: Indonesia. Posts: 8,062
Posted by mattocmd on 16/9/2009 at 22:36
A few years ago I thought about the same thing.
You might want to contact a doctor first anyway. Some of the shots take a while to kick in so you want to make sure they would be effective for when you need them to be.
#14 mattocmd has been a member since 13/6/2007. Location: United States. Posts: 367
Posted by Rufus on 17/9/2009 at 07:19
You can't "inhale" rabies. You can get it if you get bitten by a bat or eat bat faeces. I guess you are unlikely to do that.
#15 Rufus has been a member since 22/4/2007. Location: Laos. Posts: 978
Posted by jojow25 on 17/9/2009 at 14:15
Thanks for your replies.
Once we arrive in bangkok - I go to get my vaccines the day after. Then we spend two weeks in the South - yes, on a beach on the islands where the WHO says there is a very low risk. So this gives us two weeks to get the vaccine into our system. I have sent the hospital an email to ask whether I will be getting three rabies jabs in one go or whther I will be getting one - in which case I will not bother getting one if I have to have others too after being bitten. The reason I wanted Rabies is because out of all of the diseases - this is the one you are most likely to die from. Of course I won't be conudling with monkeys and sniffing bat dust - but the risks are there- even the WHO states that there is a high risk in Ankor Wat temple ara! SO I am thinking now - Rabies, Typhoid, Hep A. No Antimalrials - but to buy Malarone when I am there (I beloieve this can be used once fever has set in to treat it?) and also to take Vitamin B1 throughout my stay, cover with trousers at dusk, slap on the Deet and use citronella preparations on my clothes.
Oh - I am lesbian... does this mean that I don't need the Hep B? Apparently it is minaly spread through backpackers via sexual intercourse... I am taking my partner with me - so no need for the exchange of other bodily fluids other than between ourselves... and I don't intend on eating food contaminated with faeces, neither do I intend to swim in water other than the ocean...anyone any views on this?
#16 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by Nokka on 17/9/2009 at 16:01
I've had the hep b jab in the past and it seemed a bit of a no-brainer to me at the time. Can't remember all the details, but I believe you can also get it if the tiniest drop of infected blood reaches you. In South East Asia this may be medical treatment if you have an accident, for example. I believe hep B is incredibly contagious.
I'm still pondering the rabies jab. However, Mrs Nokka is keen we should get it, so that will probably be that :) Her point is that we do spend quite a lot of time in rural areas and do come across dogs quite frequently. Plus we are away 4 months this time. In India a couple of years ago, we pondered the jab and decided against. However, stray dogs were everywhere and how sure can you be that they won't suddenly turn on you ? It appears to be the case that you do need extra jabs after being bitten even if you have had the pre-departure jabs, but you have a longer period to get them. I would feel pretty silly having to get back to B'kok really quickly if I'd been bitten. Untreated, rabies ends in death.
Finally, on Malarone; my understanding is that malarone isn't available at all in SEA. You'll need to take some from the UK.
#17 Nokka has been a member since 6/4/2009. Location: United Kingdom. Posts: 259
Posted by jojow25 on 17/9/2009 at 16:43
Thanks for letting me know that it isn't available in SEA. I didn't realise.
With the rabies - does anyone know if there is informaiton somewhere which will show how many dogs in SEA are actually infected with Rabies - or is every dog infected with rabies - surely not?
Just recieved a reply from the Bangkok hospital - they say we have to have 3 jabs for Rabies - as BusyLizzy says above on day 1, 7 and 21 - but theres no way we will be able to have day 7 and 21 as we won't be returning to Bangkok until February! Sooo confused and frustrated with this it's making me dizzy! Is there a vaccination for dizziness???
#18 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by jojow25 on 17/9/2009 at 16:44
Oh and for informaitons sake - The Bangkok International MEdical Centre - at the hospital, have a deal on for all vaccinations required - it's around $254 NZD:
#19 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by Nokka on 17/9/2009 at 18:48
No, not all dogs have rabies in SEA. However, if you are confronted by some mangy, scabby looking thing how can you tell ?
Let's be fair here, its unlikely you'll get rabies. If you get bitten by a dog, its probable that the dog doesn't have rabies. But what are you gonna do if you are bitten ? You're going to have to get it checked out pretty smartish, which may or may not be convenient, depending where you are.
What you are buying is an insurance policy. Whether you consider the premium is worth paying is up to. My concern sometimes is that budget travellers make their decisions based purely on price.
Oh, by the way, you mention above that you don't intend to eat faeces. Unfortuantely, many cases of food poisoning are due to the food preparer not washing their hands properly after using the toilet. Or indeed those horrible poo flies landing on food. Nice, huh.
#20 Nokka has been a member since 6/4/2009. Location: United Kingdom. Posts: 259
Posted by jojow25 on 18/9/2009 at 05:57
Ok fair point.
I read in Wikipedia (and referenced by the Australian government health authority):
Treatment after exposure, known as post-exposure prophylaxis or “P.E.P.”, is highly successful in preventing the disease if administered promptly, generally within ten days of infection.
So even if you do or don't get the pre exposure jab - as long as you get the shots within 10 days - it is treatable. I was told it was half an hour to get the shots after exposure??
And I wonder if the liklihood of a dog being infected, a dog biting me, and me getting rabies, is the same as catching Mengingitis in the West?
#21 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by jojow25 on 18/9/2009 at 08:28
OK so I will answer my own hypothetical question... it seems that there are 15,000 (WHO)deaths from Meningitis worldwide each year - and there are 31,000 (WHO) deaths from Rabies in SE Asia alone. Most deaths (30 - 60% are of children who have been bitten by dogs who ae under the age of 15. I'm not sure if that comforts me... arrgghhh.
Anyone know anyone or have you been bitten by a dog before ? Would ove to hear from you.
I am just going to go away and have a good time and not think about this anymore. Ignorance is bliss. And if I live, i will return to the forum after my trip to let you know that I did not die from rabies.
#22 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by sidewinder on 21/9/2009 at 07:38
Interesting thread...mainly because I got bitten by a dog in Thailand this summer (in Koh Chang)
I was offered the jabs before I left the UK but as you had to pay extra I just thought I'd "stay away from them". That was before I knew that islands like Koh Chang and Ko Samet have ridiculous amounts of stray dogs, a minority of which are pretty aggressive.
Anyway, the day after it happened, I went to the Koh Chang government hospital (mainly because neither I nor the guesthouse owner would be able to afford the international clinic) and got shots of the rabies & tetanus vaccines, and given a card showing when I had to go back for subsequent shots.
What worried me a bit was that I had no injection in the bite (which from talking to people, seems to be the common method?) and I certainly didnt get the other shot being discussed here. They didnt even bother dressing it!
Tetanus didnt bother me since Id already had that
So after that I went to 2 different cheap clinics in Bangkok (before realising there is one down Soi Rambutri), and then the hospital in Phi Phi for the final one. Minor annoyance but not bad, and only cost around 600-800B per shot. And as I'm not dead I can only assume I didnt have rabies :)
#23 sidewinder has been a member since 11/4/2009. Location: United Kingdom. Posts: 57
Posted by worldnomad on 21/9/2009 at 19:56
Just a couple points regarding rabies and dogs for future information:
- published estimates show 20-30% of Soi dogs in Thailand have rabies. Over 50% show antibodies which means it is still a pervasive problem. Don't go petting soi or temple dogs.
- If you do get bitten and you can't capture the dog / animal then you need to get the rabies shots. They can't wait and test you to see if you need the shots. If you do develop rabies then you are toast.
- If you do get bitten, wash it immediately (within minutes) with soap and water if possible. This cuts down on your chances of getting it.
If in your trip you think you will be interacting with animals, or caving then it is probably a good idea.
Just FYI: I was bitten - just walking near Chatuchak market when a small dog came out from under a table and attacked me. She didn't have an owner but apparently had a litter of puppies nearby and thought I got too close. I did get the rabies shots.
#24 worldnomad has been a member since 29/10/2005. Posts: 5
Posted by jojow25 on 22/9/2009 at 00:26
I read 10% of dogs had rabies in Thailand... I read this on a travel clinic site for Auckland. See how messed up the information is?
The thing is, I could get bitten by a rabid dog in Frnace - but I would never have thought of getting a jab for France?
Since I now know I can get treatment post exposure - we will be taking our chances. I will return to let you know if I am rabid.
Thanks guys for your posts. :o)
#25 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by jojow25 on 23/9/2009 at 10:16
Ok, so I had an adult moment, went to the Travel Doctor CLinic in Christchurch, NZ and got our jabs. This is what I got and the advice they gave us:
We were advised that we should use anti malarials 2 days before entering a moderate - high risk area (areas she stated were southern laos, borders between thailand and mynamar and also cambodia - most of, she said the cost of vietnam was completely safe so anywhere inland would be more risk).
We were advised to get our jabs for Rabies from Bangkok - at the Travel Clinic at the BNH Hospital -9/1 Convent Road, Silom. As they will be cheaper than in NZ and also this is a place she can guarentee that the immuno globin stuff would be kosher and good quality (which is what you get in your first jab).
* one travel kit (complete with anitbiotics, rehydration sachest, throaties, ant acid tabs, bandages, antiseptics, plasters etc and even thrush medication) $115 NZD
* Doxcycyline - for Malaria - $4 per week - we bought 6 weeks worth - and contrary to popular belief, we did not need to start taking these weeks before our trip... just two days prioir to entering a troubled area, during our time there and for 4 weeks after. So $48 for anti malarials - a lot cheaper than i thought.
* We were advised Tetanus, which cost just $15 for one shot which will last 10 years.
* Hep A and Typhoid - combined as one injection - $150 - will last me lifetime for Typhoid and just have to get another Hep A in 6-12 months for lifetime immunity.
* and because I was born in the UK and am over 23, I had to have MMR - which hurts like hell by the way - this was $20.
In total around $300 per person including the consultation fee.
I now feel secure in the knowledge that I am covered for most things that are a problem in the areas we are going to. I have realised how important it is to visit a professional and not rely on internet info as some of it could be outdated and not from credible sources. The WHO and CDC are the most likley places you will find unbiased and up to date info if you want to make an informed decision. It's not so much about the 'countries' that is important when making your decision about the risks- it's more about the 'areas' within those countries that you intend on travelling too as each will have varying degrees of risk.
So I now feel relieved. And my arm hurts :o( Hope this info is helpful to people. :o)
#26 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by jojow25 on 23/9/2009 at 10:17
oh and we were not advised Hep B as we are lesbian and do not intend on swapping body fluids with locals... the doctor said it also wasn't as common as hep A.
#27 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by Rufus on 23/9/2009 at 10:36
"We were advised that we should use anti malarials 2 days before entering a moderate - high risk area (areas she stated were southern laos, borders between thailand and mynamar and also cambodia - most of, she said the cost of vietnam was completely safe so anywhere inland would be more risk)."
Just curious: what are the qualifications of those who advised you? Are they specialists in tropical medicine? Have they been in these areas recently, or did they get second hand information from a website. If the latter, then the information is relatively useless to say the least.
#28 Rufus has been a member since 22/4/2007. Location: Laos. Posts: 978
Posted by somtam2000 on 23/9/2009 at 10:42 admin
Thanks for that -- useful information -- cheers.
#29 somtam2000 has been a member since 21/1/2004. Location: Indonesia. Posts: 8,062
Posted by jojow25 on 23/9/2009 at 13:23
It was a tropical medicine specialist in Christchurch, NZ: http://www.traveldoctor.co.nz/
What makes you say the info is useless?
#30 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by jojow25 on 23/9/2009 at 13:24
She said she followed the WHO reccommendations?
#31 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by jojow25 on 23/9/2009 at 13:32
Oh and about the Rabies vaccination - the doctor told us that in all cases, whether you have had the first shots or not, you have to get your other jabs within 24 hours of exposure. Having the first three shots makes it more likely that it will save you money and time to get only 2 and not 5 after exposure. Also - she said that it was important that the first shot you get whether before or after exposure, is a good quality immuno globin - which you can't always get outside of Thailand as its a blood product and either is not available or can be contaminated. We have decided to get the first 3 jabs in Bangkok as even the doc said it was expensive in NZ and that she would only recommend we get them in Thailand as their medical care, an esp the centres she recommended to us, is good and they will more likely have this product. I did read that you had 10 days to get attention straight after exposure - but upon looking again, the info was from a journal which was 10 years old. Things change I guess as medicine advances... hope this helps.
#32 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by Nokka on 23/9/2009 at 15:48
Thanks for the info, Jojow.
Will this not mean you have to keep going back to Bangkok for your 2nd and 3rd rabies shots ? Anyway, let us know how you get on and what it costs you.
#33 Nokka has been a member since 6/4/2009. Location: United Kingdom. Posts: 259
Posted by jojow25 on 23/9/2009 at 16:11
Nokka - No - we will get them in Phuket most probably and then in Chiang Mai. We have already been quoted 755 Thai baht / dose plus 700 for Consultation fee at Bangkok Hospital Medical Center
2 Soi Soonvijai 7, New Petchburi Rd and have made an appoibtment for when we arrive. They have been excellent at answering queries we have had regarding the jabs and have been very quick at replying via email.
#34 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
Posted by soQQuadro on 24/9/2009 at 10:56
Oh!!! you people mentioned about three different clinics/ hospitals...
I haven't consulted a doctor yet and I leave in less than a month..
Is it possible to get a single shot for the Hep A??
I think I'll go for that one near KSR.
#35 soQQuadro has been a member since 3/8/2009. Posts: 28
Posted by jojow25 on 24/9/2009 at 13:35
The single Hep A shot is possible - not sure about in thailand - assume they have it - and it will cover you for 6 months - if you have another in 6 months - it will last a lifetime.
#36 jojow25 has been a member since 9/9/2009. Location: United Kingdom. Posts: 29
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