Attacked By Monkey

[Globalguppy]

Rang Hill.

I've been there loads of times, to watch the monkeys and enjoy the scenery of the mountain. If I have a friend from out of town I bring them there and we sometimes give them treats, fruits or unsalted nuts. I've never had a problem until today.

I do what I'd normally do and feed them, giving attention to the big alpha males as much as the younger and more week ones. Anyway as I was feeding some younger ones a large alpha male came from behind and bit me on the leg. Twice. I calmly dropped the food once I noticed a waterfall of blood flowing down my leg. I tied my leg in a tourniquet and I got on my bike and drove to Phuket International hospital.

I've had my full round of rabies shots in Thailand at the end of 2007 along with all other shots you need when traveling SE Asia. Today I received a booster, and tetunus shot. The main bite wound is large and deep to the bone. And because it's a wild monkey, and rabies is an issue, they can't sew me up for 2 weeks.

Today they just cleaned it out, gave me local anesthetic and morphine, and pennicilin. The bill was nearly 8,000 baht.

I have to go in for more rabies shots. They told me it would be 25,000 baht. I also need to go in everyday for two weeks to have it cleaned out. I don't know how much that will be.

The question is this. Is it possible to go somewhere that will give me the same great treatment, for cheaper? Do I really need the recommended 5 bottles of rabies shots if I already had my preventative rabies shots? I know that my health comes first. I need advice. Also curious as to why it bit me. Jealousy? Trying to keep the pecking order in order?

I'm a volunteer for both Soi Dog Foundation and P.A.W.S. I know by dealing with these animals that I put myself at risk and feel like a complete idiot for not having health insurance. I'm American and I'm just used to never having it.

I'm in a lot of pain and I already feel stupid enough for putting myself in this situation. So please, no lectures, just kind and informative advice as always.

Thank you.

[Somtamnication]

Wow, I feel for you.

The price for the rabies shot is way overboard. The treatment is crucial, though I have no idea if the rabies shots are good only for a short time or longer, since you had them in 2007.

Mission Hospital or Wachira deal with rabies quite a bit. And far cheaper. And under rated as hospitals.

I know nothing else, nor how to treat your pain and also worries. I wish you the best!!!!!!!!

[g00dgirl]

I would be much more concerned for types of viruses that this monkey can carry similar to HIV or Herpes, and I would think its most important to get the same kind of shots that rape victims or injured police get when they have been exposed to HIV infected people.

SIV and STLV, This is the simian counterpart to HIV and HTLV

simian herpes virus is another one

[wasabi]

I'm not sure if the price of the shots is overpriced. You should need two more shots if you were already vaccinated one now and one more three days later. I too got bit by a monkey but had never been vaccinated so I had to have the full course of 5 Verorab shots plus Immunoglobin. The cost was about 30,000 Baht, so maybe you could find it somewhere slightly cheaper but the monkey's most likely to bite are the ones who may have rabies so maybe better safe than sorry and take as much as they recommend? Rabies is one of the most painful ways to die. I would just write it off as a loss and try not to get bitten again.

I used to think the monkeys were so cute and fun to play with until I got bitten. After that a friend told me. "Monkey's are not your friend." I have to agree they are vicious little beasts best left alone.

I did find this linke that says you need two shots http://www.vaccineinformation.org/rabies/qandavax.asp

Edited April 15, 2009 by wasabi

[MisterMan]

Sorry about the bite.. I have had a few from a certain gibbon in this island.. however has had his shots.

About 6 years ago I was bit by a dog as I was on my motorbike. I was going slow and he came out and bit my ar$e.

I first went to the hospital at Patong and it was about 700 ? for the rabbies and tetanus. the first round. As I was a dive instructor at the time on my way to Similans I realized I would not be around for the 2nd round.

So I went to DR Wattana on the Beach road in Patong on soi....WATTANA .. south of Starbuck/Hagan Daas and I paid 500 for each shot and got it to go!

Yep syringes and rabbies vaccination in a small little styrofoam take home box with an ice pack...

UBELIEVABLE how much you paid at PIH. I wonder how they come up with the prices. Should have a Thai person call and ask how much......

So I recomend Patong Hospital or Dr Wattana!!!!

[harrry]

To the OP. As this is a pretty severe problem it may be best to ask a mod if they can move the topic to the medical forum where there are some people who can give reliable advice. Hope things work out.

[JetsetBkk]

I've heard other stories about the monkeys on Rang Hill biting people. The ones on Khao Toe Sae are much more friendly.

[marcus]

I was bitten by a dog 6 years ago, and had my shot's in a local "clinic" - not a private hospital. I remember the cost was not more as a couple of 100 baht/shot.

If I remember well, there is a "Gibbon Resque Project" in Phuket. Maybe they can inform you better about the dangers of monkey bites.

A very well known institute is the Institute of Tropical Medicine in Antwerp. I doubt they will be happy if too many farang from Thailand mail them for advise, but you might be lucky if you mail them a picture of your wound and provide them the name of the brand of the shot you already had.

You should read this text from their site. It contains the following alarming phrase : "The problem in developing countries is that vaccines are often of a lower quality since they are prepared on the basis of animal brains and the correct immoglobulins are not available. In the event of a suspect bite the traveller may decide to leave home at once; or to try and obtain the vaccine or immoglobulins with the help of the travel insurance company or the Embassy."

Good luck !

[Jimjim]

I think you should keep the monkey behavior questions and monkey bite treatment questions separate and in different threads. Perhaps the monkey behavior question can be in the Thai sub-forum In Case You're Stupid Enough to Feed Wild Animals in Thailand; Here's What To Do.

But 25000 baht sounds like too much for just shots.

[BigSnake]

See a medical doctor NOW!! This no place for medical advice. GOOD LUCK!!

[namoo]

See a medical doctor NOW!! This no place for medical advice. GOOD LUCK!!

Chill. Read again he has already seen a doctor..

[Globalguppy]

I would be much more concerned for types of viruses that this monkey can carry similar to HIV or Herpes, and I would think its most important to get the same kind of shots that rape victims or injured police get when they have been exposed to HIV infected people.

SIV and STLV, This is the simian counterpart to HIV and HTLV

simian herpes virus is another one

How common is this? The doctor did not mention anything about it yesterday. I didn't think about it either, but since you posted it I didn't get a wink of sleep last night.

I'm going into the hospital right now for the first follow up cleaning. Yesterday I was on morphine so it was hard to look up anymore of the great information you all provided for me.

Thanks everyone again for being informative and kind. I'll update things when I get back. And see what's up with these prices.

[wasabi]

One other thing. I had considered getting this shots in the USA before I came here and the cost was going to be about 20,000 Baht which didn't include the immunogloblin. I would rather pay more to make sure I'm receiving the best vaccine than save money, though of course no one wants to be ripped off.

Edited April 16, 2009 by wasabi

[Gary A]

It sounds like you are doing all you can do and thanks for the warning message. It's surprising to me that this type of thing doesn't happen more often. feeding the monkeys, tigers, elephants and other wild creatures is a dangerous practice even though it seems like fun. They are still wild animals and should be treated as such.

[Sheryl]

IF what you had before was the human diploid vaccine fopr prevention (and not the immunoglobulin given after a bite) then you do not need the multiple injections you describe them as having recommeneded -- but need to be 100% sure that this is hwat you previously had.

If so, all you need is abooster right away 9which tyou have presumably had) and then again 3 days later. The 5 shot course is for unvaccinated people. I am not sure why they are recommending it for you, unless it is as a precuation because you do not have a record of your prioprt immunization.

As for cost, certainly it will be less at a government hospital or non-profit private, or for that matter at a private hospital that caters mainly to Thais. How much cheaper, can't say.

regarding SIV, STLV, there are no medications to take (the post-exposure prophylaxis regimen used against HIV does not apply for simian viruses) and I have not heard of anyone becoming ill from these. The "s" stands for "simian"meaning monkey/ape family, just like the "H"in HIV stands for "human". Viruses that cause disease in one species usually need to mutate befopre they are capable of infecting an entirely different species. I would not worry about this. the main concern is rabies. You are in a good position having already been vaccinated, just need 2 boosters for complete protection.

[bina]

most monkeys get human disease, but not vice versa; just hep b...

tetanus

the wounds are open not cause of rabies but because most bite wounds are never ever sewn shut... too much anaerobic bacteria...

u should be getting antibiotics (i always got cephalaxin for all the bites ive gotten)... must get wound cleaned out, and bite wounds are super painful and take a long time to heal, plus secondary infection of tissue...

rabies u like sheryl says need a booster not a whole new series

i've worked with monkeys and hate them intensely and yes probably made the mistake of feeding the lower downs and not the alpha or one of the medium alphas but monkeys ARE unpredictable in action; u could have squatted down incorectly, or smiled showing teeth or a million other small cues that he got that u didnts...

bina

israel

[Globalguppy]

Thanks everyone for all of your replies and concerns.

It's strange, EVERYONE I've talked to about this has either been bitten or knows someone who has been bitten. Crazy, with all the years I've worked with stray dogs I've never heard such crazy stories.

Yes, now I know, monkeys are unpredictable. I learned just yesterday that it's the recent change in weather that has them all cranky and depressed.

Luckily I don't have to receive that set of rabies shots. I received one more yesterday when I went in for the daily cleaning and it was only like 600 baht.

Oh the cleaning. I'm supposed to go in an hour. I'm dreading it. It's torture time. They cut open the bandages (no pain killers, no local anesthetics) and they poke, prod, clean, and cut away the infection. All I get is a towel to scream into. I've lost my voice since. Yesterday was the most infected. I feel like throwing up just thinking about it. I really have to tell myself, it's either 2 weeks of torture or a lifetime of some other illness or no leg. The big wound does not even hurt as much as that singular tooth puncture right to the bone. They have to shove that hole with gauze and when they do that I see stars.

Ok wish me luck. Today is day 5 with only 9 days left.

[khun_j]

"no pain killers, no local anesthetics"

why can´t they give any? if there is no medical reason, i´d sure tell them i need local anesthetics prior to the cleaning!

wish you all the best - i hate cute monkeys and know now why...

[WorldwideALOHA]

Just a quick note. The original prices that were quoted are way out of line for someone who has already had the preexposure jabs. Even those are relatively inexpensive. RabiPur is the one given at Bumrungrad in Bkk.

Sounds like the current treatment is driving you bananas...hang in there. If you feel the urge to groom your nurse, just roll with it. It's a natural simian urge...

Hope you fell better soon!

Aloha

[DanBlack]

My wife was bitten on the ass by (probably) the same monkey. She went through the rabies deal at Wachira hospital for about 1000 Bt total.

I heard of a few other people getting bitten up there and they now have warning signs .

I think that's one mean monkey

[Macx]

Sorry to hear about your woes.

Nothing to add regarding the rabies, but I'd like to empathize by noting that I too had to go to the hospital for staph infection caused by insect bites. The first time I went to a very good private hospital in Trang. Had the wound cleaned, injected antibiotics and so on everyday for a week. Total cost 1,200 baht, medicine, as well as being treated by a real doctor.

Second time, I went to Bangkok Phuket International hospital. They took me to the ER room. A nurse cleaned the wound but somehow "pushed" (as I was later told) the infection deeper into the wound. He put me on antibiotics. Three days later, the wound was worse and a real doctor was called in clean and "operate" the wound. And, yes, this time it went all the way to the bone. Local anesthesia, but OMG it was painful. And of course, I had to go back daily for a full week, and then every other day for another week. Total time nearly 3 weeks. Total cost including the idiot nurse's mistake: 16,000 baht.

Be careful.

Best of luck.

[TerryLH]

"You are in a good position having already been vaccinated, just need 2 boosters for complete protection."

It used to be that not everyone built up an immunity from taking vaccinations.

A 'titer' test can be taken to see if your vaccinations 'took'.

My personal experience is based on info from many years ago. I guess that nowadays the vaccines are better, but if it was me I wouldn't count on vaccinations from several years ago without a test to see if there is some immunity built up.

I understand the Red Cross in BKK also treat bite victims, and at a low cost to the patient.

[Globalguppy]

So I decided to quit Phuket Intl' hospital and go to Bangkok Hospital instead for a second opinion.

What a difference!!! Thank the heavens I did!

The staff was so friendly. The doctor picked up on something within the first minuet that the other doctor had not seen for a whole week. It turns out the two bites are connected. He loaded me up with local anesthetics, cut a path from one wound to the other (totally infected, green, yellow, grey mess), and cleaned it all out. Now the wound is huge, however it's pink and healthy. I was so worried about amputation and said that it may have been a possibility if it had never been found.

He also told me that I didn't need any other vaccinations than the other ones I already had. And he also said that the two week time period was not necessary before stitching me up.. He said three days max and I'm good to go. They bandaged me so good. No leaks. Can you believe that my wound was actually sticking out from the job they did at the other hospital? Unbelievable.

With minor surgery, meds, latest anit biotic technology put directly on the wound (Phuket Intl' just used gauze and Betadine) and everything else, it cost half the price of Phuket Intl' the first day I arrived.

He actually made me feel better about the wound, seeing how clean it was, and how professional and smart he was (is). He also had wonderful bedside manner.

I almost can't wait to go back tomorrow! Ok that may be pushing it =) I'm just so happy to have found such a wonderful doctor and staff!!!

Also, the doctor said that this may be the same monkey that has been attacking everyone else. Apparently it's got a signature walk! I wouldn't have known since he jumped me from behind. Oi, not even a fair fight! Although I have a feeling that if I had it in me to hit an animal that it would have just mauled me death. That's why I just gave him the rest of the nuts and walked away. Still bitter

[gregchambers]

Christ what a harrowing tale, I have always been wary of wandering around amongst monkeys - Thai girls think it is fun time., though I used to take a delight in feeding the smaller monkeys whilst the big one glowered. Great news that you changed hospital and found a good doctor and are on the mend.

[Globalguppy]

Christ what a harrowing tale, I have always been wary of wandering around amongst monkeys - Thai girls think it is fun time., though I used to take a delight in feeding the smaller monkeys whilst the big one glowered. Great news that you changed hospital and found a good doctor and are on the mend.

Thank you. On Day 11 (yesterday) I was finally able to get stitched up. It used to be a fun time to go up there and feed them, especially with some of the local volunteers and monks. But now that I know how emotional and dangerous they are, I won't be going back. It's too bad, but it won't keep me from loving all animals. It'll just give me a new found respect and knowledge for these particular ones.

BEFORE- http://www.flickr.com/photos/27543190@N02/3470941562/

AFTER- http://www.flickr.com/photos/27543190@N02/3482749201/

[dabest]

I was bit by a dog in Phuket about 9 years ago

I became very concerned

The nurse who I first went to recommended rabies shots sure just to make sure

but later I met an educated and English speaking Thai Vet and he said there had not been a rabies case detected in Phuket for 9 years and if an animal can eat it is not able to transmit the disease period

so I went back later with some nice food for this dog and it ate it easily

needless to say

I didn’t do anything more and had no problem afterwards

Shots and such are something I am extremely careful with as they have caused incredible suffering for me in the past

Edited April 28, 2009 by dabest

[FBN]

The approach of the nurse was correct.

Rabies is a fatal disease and this is part of the proper and routine management of any animal bite.

Rabies is endemic in Thailand and the vet's comment is irresponsibe.

Going back to feed a dog that has bit you may also not be the best thing to do..

If you found that the dog could not eat, and therefore, according to this particularly flawed logic, had rabies, it would have been too late to start your own prophylaxis.