Travel Clinic

Main Menu

logo TP updated



  • Any mammal can get rabies (wild + domestic) and infect humans; the animal may appear well even with the virus in saliva
  • Consider for all travellers for peace of mind (especially children) even if the duration is short to rabies endemic countries and higher risk activities eg cycling, trekking, local homestays, runners, caving and 'off the beaten' travel.
  • Rabies is almost always fatal if untreated and ~10% of strays in Thailand are rabid
  • Two travellers per annum die of rabies & Bali has a bite rate of as high as 5%
  • Our clinic advises and manages approximately 2+ travellers per month with accidental animal bites; rabies is a risk wherever dogs are allowed to roam free
  • New Zealand does not have any rabies, however Australia has rabies
  • Immunisation route may be ID - intradermal or IM - intramuscular
  • Dosing schedules and route of administration vary (ID vs IM : pros and cons).
  • ID is the most popular route: is a series of 3 separate doses over a few weeks (see picture below for clinical response); at a reduced cost of $75 per dose, followed by a blood test if clinically necessary to check for rabies virus neutralising antibodies (and a booster in a year for long term immunity).
  • ID rabies is offered daily at dedicated travel clinics and you do not need to 'gather' other travelling companions (as it's not cost effective or feasible at non travel clinics)
  • ID rabies is safe, low cost and effective (only if done with the correct expertise)
  • There are other schedule options 'off label' or accelerated schedules for travellers who cannot do the 3 dose series (over approximately 0,7, 21 -28 days)
  • Preferably make your own antibodies by immunisation in New Zealand, so if ever you are bitten, scratched or licked by a dog, monkey, cat, bat, you will need only two rabies vaccinations (which is easily obtainable) on days 0 & 3 after the animal bite, but you will never need any human rabies immunoglobulin ie. a blood product injected into the bite wound.
  • If you are scratched, bitten or licked and unimmunised ie. no antibodies, this is almost certainly a trip ruining experience as the treatment is a lot more dramatic! You have to stop what you are doing and travel to a centre where the appropriate post-exposure therapy is available; and request human rabies immune globulin HRIG which needs to be injected into the bite wound to prevent early entry of the rabies virus into nerve endings, then try to time 5 x rabies vaccinations required on days 0, 3, 7, 14, and 28 around your remaining travels.
  • All bites, scratches and licks should be immediately flushed out, washed and then disinfected. Doing so can enable efficient elimination of the rabies virus at the infection site.

 

In summarythe advantages of getting your own rabies antibodies before travel is to reduce the urgency, trip disruption and complexity of treatment
  • to prevent uncertainty and 'ruining' this trip and future holidays !
  • totally eliminating the need for blood products ie. human rabies immune globulin which is difficult if not impossible to obtain in many developing countries 
  • reducing the need for post bite vaccines from 5 to 2 shots
  • reducing the post bite treatment period from 28 days to 3 days
  • and allows for a delay in treatment 

rabies ID x 3 1

 

 
 

© 2017 Travel Clinic North Shore, Auckland, New Zealand. Please read our Website Terms.