Rabies vaccine in Southeast Asia. Is it necessary ? (2)

Let’s go back to the question. Is it necessary to get rabies vaccine before travel in Southeast Asia? As in any vaccine; we have to consider the risk of getting the diseases and the cost/side-effect of vaccine. Benefit of vaccines should clearly outweight the cost and side-effect of vaccine. In that case we’ll recommend the vaccine.

So we’ll come to the most important question. We, all, know that we might get rabies only when we are bitten/licked by animal. So what it the chance for someone to get bitten/licked during travel. Difficult to say? Yes, that’s right. Risk for any individual is not equal. But according to previous researches we have some information;

  • In 1994; a survey in general traveler in Thailand found that the risk of being bitten and being licked were 1.3% and 8.9% respectively, in an average stay of 17 days.
  • Our recent survey (2009) in Khao San Road, we found that 0.7% of backpackers were bitten and 3.6% of backpackers were licked during their trip (average duration of travel = 30 days).

So, are the risk of being bitten high or low in your point of view? Some may say it is high so I would like to get vaccine; while some may say it is low risk for me to be bitten so I will not get the vaccine. By the way, many factors should also be considered such as duration of travel, exact destination, availability of medical care in the destination, traveler’s preference, activity during travel, budget, etc. So it is recommended to have a formal consultation/discussion with your travel doctor in this issue.

For us, we usually consider pre-exposure rabies vaccine in travelers who 
       – will travel in a rural or remote area where standard medical care is not available
       – have high risk activities including cycling, backpacking etc
       – have longer duration of stay (more than 2 wks)

Reference:

  1. Phanuphak P, Ubolyam S, Sirivichayakul S. Should travelers in rabies endemic areas receive pre-exposure rabies immunization? Ann Med Interne (Paris) 1994; 145(6):409-11.
  2. Piyaphanee W, Shantavasinkul P, Phumratanaprapin W, et al. Rabies exposure risk among foreign backpackers in Southeast Asia. Am J Trop Med Hyg. 2010 Jun;82(6):1168-71.

3 comments to Rabies vaccine in Southeast Asia. Is it necessary ? (2)

  • Steve Wilke

    In late November 2019 I was bitten on the back of the leg by a dog with unknown vaccination history in a tribal village. The wound was washed immediately and within an hour I was being treated at a hospital in Chiang Rai. There I received 6 or so equine immunoglobulin shots around the wound plus two more in the buttocks plus a vaccine shot in the arm. This was followed at intervals by 4 rabies vaccine shots. On May 31, 2020 I was nipped in the lip by my small 16 year old blind dog whose last rabies vaccination was on May 3 2019. He receives shots annually and does not run loose outside the compound. The small lip wound which drew some blood was washed thoroughly and betadine applied. With this history are more shots required for me.I have been under the impression that the above vaccine scenario would afford protection for some years. Appreciate your advice.

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