Rabies vaccine in Southeast Asia. Is it necessary? (1)

Well, it depends…..before we will answer the above question. Let’s begin with some practical knowledge of rabies:

1. Rabies is a zoonotic disease (animal borne); you may get rabies when you are bitten/licked by infected animals.

2. It is a fatal disease with no effective treatment available. Once a patient develops symptoms; he/she will eventually die. So it is an untreatable disease.

3. In Thailand and Southeast Asia, dogs and cats are the most important vector for rabies. Unfortunately, there are many stray dogs in many parts of Southeast Asia.

4. Not all stray dogs are rabid. According to the survey in 2004, only 0.03% of stray dogs in Bangkok carry rabies virus. In general, rabid animals will have some bizzare behaviours (may looked crazy or dump). Unfortunately even normal-looking animal may carry rabies virus also.

5. Whenever you are bitten or licked, please clean the wound with soap and water as much as possible. Good cleansing clearly reduce the chance to get infection. After that, you should seek for medical care immediately. The doctor will give a post-exposure vaccination/treatment.

6. If someone never get any vaccination against rabies and are bitten. He/She must have the post-exposure treatment immediately. The treatment include Immunoglobulin and a series of rabies vaccine (5 shots). But if someone have already complete pre-exposure vaccine (3 shots). He/She will require only 2 doses of vaccine (Day 0 and Day 3). Immunoglobulin is not necessary.

7. The major factor that we have to consider is the availability of medical care in the destination. Let’s imagine, if you never get pre-exposure vaccine, and you are bitten. You have to find the medical service that equipped with vaccine and immunoglobulin. Unfortunately, immunoglobulin is available in the major cities in Southeast Asia only. So in some cases, they may have to interrupt their trip and fly to Bangkok to get the treatment.

8. The advantages of getting rabies vaccine before travel included you will have some protection which could give you some peace of mind, and you are not required to get immunoglobulin when you are bitten. However, you still need to get 2 shot of rabies vaccine.

(continue in part2)

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