Rabies

For Australian Cyclists travelling and touring OS

Rabies

Postby Meditator » Tue Mar 27, 2012 8:06 pm

I've done a few cycle tours through india which has a high incidence of rabies. Other south east asian countries also have a high incidence of rabies. Its an issue in central and i think also south america. The dogs in turkey are very aggressive, also in Nepal. I'm not too sure about rabies in africa. Look it up yourself if you are going there.

If you are going to any of these countries or if you are doing long cycle tours then you MUST seriously consider getting vaccinated against rabies. I know its expensive to get them done in Australia. You can easily pay over $300 for the three shots.

If you decide NOT to get the shots, and many opt against them, then you owe it yourself to fully understand the treatment process after a dog/monkey/cow whatever bite before you leave home. The most important part of the treatment program maybe what you do straight after you've been bitten. So do your research thoroughly before you leave home.

I am not going to go over the details again. I have written it up many times already on the thorntree lonelyplanet forum. You can do your own research.

Look at the world health organisation website. Look at lots of websites about the treatment program. know the first aid. Understand the importance and issues of the RIG shot. Mainly how rare (but essential) it is after youv'e been bitten, which is perhaps the main reason to get the vaccine before leaving home or on arrival in any other country.

I spent a month researching before i decided to get the shots. I wouldn't have spent so long but because of the expense, one is looking for any solution.

In the end, here are three ways to get the costs down. I opted for 1 and 2 and got the cost reduced by 50%.

1. if you have private health insurance you will get a rebate on the cost of the shots
2. buy the shots from a discount chemist. It will knock about $30 off the retail price.
3. Do not get your shots done through a travel clinic. Try to find someone who bulk bills
4. You can always start the series of shots in any other country you go to. Just make sure they use a new needle.

Getting the vaccines buys you peace of mind. It also means if you do get bitten, you won't have to fly home, or you won't have to bugger up your itinerary trying to get somewhere far away so that you can get the treatment you need.

I am posting this now because a cyclist just reported being bitten by a dog in turkey. I have also advised a woman who was bitten by a fox in central america. She double checked my opinion against a global expert and went ahead and changed country in order to find the shots. Very stressful period. But YOU MUST UNDERSTAND, if you get bitten by a rabid animal and do not get adequate treatment, YOU WILL DIE. It is much easier to get proper treatment if you have already had been vaccinated.

I have never heard of any cyclist dying of rabies on a tour but it could have happened. I have read about a uk woman on a two week holiday in Goa, India who died after a puppy nipped her on the ankle. So do your research and consider things seriously. This woman died because she didn't know anything about rabies except about as much as you know. She never got treatment. By the time it was worked out what had happened, she was almost or already dead. If that woman had known to wash her wound properly, she might not have died. If she had known that a puppy bite could kill her, she would have gone straight for treatment after being bitten. She could have lived. But she was ignorant.

It seems that a good proportion of cycling tourists are ignorant about rabies, the risks and the difficulties of getting treatment. Do you homework and stay alive.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

by BNA » Tue Mar 27, 2012 8:28 pm

BNA
 

Re: Rabies

Postby il padrone » Tue Mar 27, 2012 8:28 pm

Thanks for that. Very useful information.

The WHO site has a map of rabies-free jurisdictions and shows all of western Europe and Scandinavia as rabies-free. I'm planning to tour Europe next year. Is this information correct as far as you understand? I had thought there was still some rabies in European countries.
Riding bikes in traffic - what seems dangerous is usually safe; what seems safe is often more dangerous.
User avatar
il padrone
 
Posts: 18410
Joined: Mon Apr 07, 2008 11:57 pm
Location: Heading for home.

Re: Rabies

Postby Meditator » Tue Mar 27, 2012 10:20 pm

I have no idea but i would trust what the WHO says in that regard. I think if there was any rabies in europe it is probably amongst the wild animals more likely than the dog community but i'd go with what they tell you on WHO. (and then i suppose if a wild animal bit a dog, there'd be a problem but it seems there's been no incidents for a long time so i suspect that what the europe info is about.)

I did my first lost of research in 2007. I haven't gone into it deeply since then but i know enough to know the situation with the RIG shot hasn't changed so much. And that none of the rest of my information has significantly changed - otherwise i'd have been told.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby polishbiker » Thu Mar 29, 2012 2:52 pm

Good reminder there Mediator.

for anyone who is curious:

I just checked with 1 clinic in Perth and each shot is either 117$ or 50$, depending on which one you need, google says the cheaper one is actually more effective.

3 shots needed, 1 week apart in between first one and second one, third one about 4 weeks later - thats what i was told.
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby Meditator » Sat Mar 31, 2012 6:25 pm

Polish can you tell me more about the $50 one, i' haven't heard of any that cheap. Give us a link if you can.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby polishbiker » Mon Apr 09, 2012 12:21 pm

Hey,

The prices i quoted were given to me by a Travel Doctor clinic in CBD.
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby Meditator » Mon Apr 09, 2012 7:13 pm

I don't think there is actually any different vaccine given. But what the cheaper shot may refer to is when a whole vaccine is shared between a few people. This can be done when the shot is injected into the skin and not into the muscle. It is not recommended by the AMA for GPs since its apparently very difficult to do properly. As the vaccine can't be saved, the two or three people who share the shot have to have them all done at the same time. So it can work for a couple.

If you were to go this route, you should really get a titre done before you leave to make sure you have enough antibodies in your blood, ie that you are indeed protected. I would do that if i had the shots done by anyone who does it this way all the time and there wouldn't be too many of those. So if you were to go this route, i would also ask the doctor how many times he had done this method of vaccination.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby Meditator » Mon Apr 09, 2012 7:15 pm

hang on a minute, just rereading your previous post, you said that google said the cheaper one is more effective. So go on tell me more about it is. I am not asking about the price i want to know what this cheaper shot is. Can you at least provide the link so we know for sure what you are talking about.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby polishbiker » Wed Apr 11, 2012 11:20 am

Have a looksy, unless i misunderstood it!

http://www.who.int/immunization/topics/rabies/en/index.html
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby Meditator » Wed Apr 11, 2012 6:50 pm

Yeah you have understood something polish.

Basically there is only type of vaccination in common use these days and that is the cell culture one. The difference in price is using the same vaccine. As i said, i am sure that the cheaper vaccine is cheaper because it is shared between two or three people.

And it is the more expensive choice on offer in Australia that is widely considered by medics to be the most effective option. You may wish to clarify this with a doctor again if you are not convinced by my explanation.

But you can also do as i just did to double check your info. I googled about nerve tissue and cell culture vaccines. You will see that the nerve tissue one is not much in use anywhere now. And i can assure you that the other one is still over $100 per shot if you take the whole shot.

The way to get it cheaper is to
a) buy it through a discount chemist. You have to phone them up in advance to make sure they have it in stock. You pick it up yourself and drive straight over to the doctor because the shot can't be kept out of the fridge.
b) if you have medibank private health insurance or other health insurance you will get a rebate for part of the cost.
c) choose a doctor who bulk bills to administer the shots or a nurse

So when i had my shots done i got the total cost down from around $300 to about $150.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby polishbiker » Wed Apr 18, 2012 5:55 pm

ok, just got my first shot and while memory is fresh:

there are 2 types of shots, the clinic i went to is the only one that does the 'second type', cant rememebr what it was called (meidcal therm) as this method is still in development but basically its a series of 3 shots, 1, second one 2 weeks later and third one 4 weeks later.

once you go through 3 shots of the second less common method you get your blood tested to see if it worked, if not you get another shot.

main difference between the two:

first one more common - 3 shots and you are done in 4 weeks.
second one less common - 3 shots (1 month all together) then you wait 2 to 4 weeks to check the blood, if not 100% you get another shot and wait another 2 to 4 weeks and check the blood again.

so at the end of the day its money vs time, ~350$ vs ~250$
350$ - 4 weeks
250$ - up to 12 weeks.
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby Meditator » Wed Apr 18, 2012 11:28 pm

polish that's still a bit vague. When you go back next time, can you ask for the names of both vaccines?

I am inclined to think that you are being given partial doses and not a different vaccine. (the clinic will make more money this way). Which is ok if the person can administer it properly. And if not well you will have a follow up shot if the titre shows your antibodies levels are too low.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby polishbiker » Thu Apr 19, 2012 12:28 am

from what i understood it is the same vaccine but it can be injected into your body in 2 different ways, directly into the muscle or under the skin, the process that takes longer is the one that goes under your skin, maybe its a different size portion.

*by saying 2 types of shots i meant 2 methods, not different vaccines*

i am getting 3 shots directly into the muscle (arm) which means you are immune after 3 shots, no follow ups needed.
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby Meditator » Thu Apr 19, 2012 7:20 pm

That's precisely what i've been talking about polish. If you read back you will see that i've referred to it already. But note it is not "better" than the other. In fact it can be less better, hence the need for the titre test to make sure you have enough antibodies.

So you are saving a little bit of money (while the travel doctor makes a better profit). He shouldn't charge you if you have to have a fourth shot because his poor technique would be the only reason you need it, no other reason. Hopefully for you, it goes well and you don't need another.

Because he is a travel doctor, he should get a reasonable amount of practice at this and hopefully his technique is ok but here in qld they prefer doctors don't do it.

Make sure you get that titre test.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby Crittski » Thu Apr 19, 2012 8:07 pm

I would take a different tact, and see a travel medicine expert after consulting my mate who is an infectious diseases specialist! Not sur ewhy you would be recommending someone not visit a doctor who has made it their work to manage travel medicine, but good luck to you, your googlefu skills may just save you a small amount of money...
Last edited by Crittski on Fri Apr 20, 2012 9:39 am, edited 1 time in total.
Santa Cruz Blur TRc XTR
Volagi Liscio Ultegra
Crittski
 
Posts: 391
Joined: Sat Oct 02, 2010 7:06 am

Re: Rabies

Postby polishbiker » Fri Apr 20, 2012 8:39 am

I am getting 3 shots and thats all is needed (no follow ups), did not want to go for the 'uncommon' method, would rather pay a bit more and be 100% sure i have the antibodies in me.
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby petie » Sat Apr 21, 2012 9:01 am

I'm pretty sure you still need a booster shot if you do get bitten by a rabid animal even if you have already had the vaccine....
petie
 
Posts: 499
Joined: Sun Feb 07, 2010 1:16 pm
Location: The Ice rink, bring skates

Re: Rabies

Postby polishbiker » Sat Apr 21, 2012 11:37 am

Correct.
polishbiker
 
Posts: 311
Joined: Sat Oct 02, 2010 10:18 am

Re: Rabies

Postby Meditator » Sat Apr 21, 2012 10:17 pm

INdeed you do Petie but you don't need to ruin your trip trying to hunt down the rare immunoglobulin shot that gives you protection for the first 10 days while the vaccine is starting to take effect. That's the reason why those at risk should have rabies vaccines before being bitten. If it wasn't for that shot, it really wouldn't matter much at all whether one had pre-bite vaccines.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby petie » Sun Apr 22, 2012 10:42 am

Is the booster easier to get? Having never really investigated I just assumed that both would be hard to obtain in places that rabies is a problem? Interested to know as I am about to travel...
petie
 
Posts: 499
Joined: Sun Feb 07, 2010 1:16 pm
Location: The Ice rink, bring skates

Re: Rabies

Postby Meditator » Sun Apr 22, 2012 12:37 pm

Petie the booster shot is the same as the vaccine. There are only two types of shot you need to know about one is the rabies vaccine and the other is the immunoglobulin shot. The only time you would need the latter is if you hadn't been vaccinated before you were you bitten.

Where are you going and for how long?

Generally the term booster is only used if you need to make sure you are covered after two or three years of having the vaccine course or treatment. Any shots given after a bite are usually called treatment not booster. If you understand where i'm coming from.

The vaccine generally lasts about 2-3 years and if you are going to a rabies type country after this amount of time, its worth getting a titre done so your gp can determine whether you should have the booster shot at which time you only need one. I didn't need to have it after two years.

The vaccine is easy to get in any country i believe regardless of where you are. You shouldn't have to travel very far to start treatment if you need it but you should start it as soon as possible.

There is generally a world shortage of the IG shot and i can't remember why. Its probably hard to make but you can get this shot in very major cities of most countries. If you are in india you'd probably expect to have to travel to mumbai, delhi, and probably bangalore calcutta. ie very major cities. It seems tricky to find in central american countries. I know one person who had to change countries to find it and that meant travelling a day or two by bus. IT was a stressful incident.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby J Quinton » Sat Apr 28, 2012 1:30 pm

Was talking to a bloke this morning who said he got rabies in southern france.
J Quinton
 
Posts: 213
Joined: Fri Jan 06, 2012 6:52 pm

Re: Rabies

Postby Meditator » Sat Apr 28, 2012 6:42 pm

If he got rabies, he would have died. Did he mean he'd been bitten by a dog that was rabid. Was he sure that the dog was rabid (how did he know) or was it just that a dog bit him. Lots of people exaggerate.
Meditator
 
Posts: 283
Joined: Sat Feb 11, 2012 12:57 pm
Location: North of Cairns

Re: Rabies

Postby the_real_jimbob » Fri Sep 27, 2013 1:53 am

Meditator wrote:It seems that a good proportion of cycling tourists are ignorant about rabies, the risks and the difficulties of getting treatment. Do you homework and stay alive.


Sorry to dig up another old thread but here's my experience. I got bitten in Thailand and went to get the rabies vaccine from a private hospital after advice from a local GP. The system they had was 5 shots over 28 days and about $20 per shot. Since many people in Thailand make $10 per day, that's still expensive. Shots on day 1, day 3, day 7, day 14 and day 28. Each shot gives you a better chance of fighting against virus before it gets to your brain.

It travels through your nervous system to your brain, then you're stuffed. So getting bitten on the ankle potentially gives you more time for your body to build up resistance (with the vaccine) than getting bitten on the neck.

There's also another type of shot they give you if they're certain the animal has rabies and you got bitten in a high risk area, like the neck. But then there's potential side effects from that. They would not give me that one and said I would have to be admitted to hospital for that one.

If you get rabies there is a procedure that may save you BUT it's a medical emergency and you'd have to be in a hospotial that knows what they are doing, and even if you survive you may have long term injuries. From everything I read though, if you get rabies you die an extremely agonising death. Which is quite concerning to read after being bitten by a dog and the doctors say to go get a rabies vaccine.

Not all dogs foam at the mouth when they get it either, although that seems to be the most known symptom.

Luckily in Aus we don't have it but it's all over SE Asia, there's lots of feral dogs that don't get vacinised from it, and dogs love to chase cyclists.

But a bite can cause other problems, hospital also wanted to know my tetanus status and gave a course of antibiotics.
the_real_jimbob
 
Posts: 17
Joined: Sat Sep 21, 2013 11:31 pm


Return to Touring Overseas

Who is online

Users browsing this forum: No registered users



Popular Bike Shops
Torpedo 7 Torpedo7 AU
Ground Effect Ground Effect NZ
Chain Reaction Cycles CRC UK
Wiggle Wiggle UK
Ebay Ebay AU

“Bicycles BNA Twitter
“Bicycles BNA Facebook
“Google+ BNA Google+
“Bicycles BNA Newsletter

> FREE BNA Stickers
> BNA Cycling Kit