I was playing with my dog when he was a pup and he gave me a nip, it didn't even to appear to have broken the skin at the time but it must have because it constantly breaks out then scabs up, even six or seven years later.

It's no big deal, just like a couple of small pimples but I wondered if this was usual with dog bites?

Very unusual. The most likely in this situation is that some foreign material is embedded on that location; this is the more usual body response that would explain what you have. This may have been related to the "nip" but perhaps some other injury occurred in the same spot later?

Detailed examination of the area by a dermatologist when the rash or reaction is visible would probably be the next step..

One or two countries where I have lived have a large population of loose unconstrained dogs running around the streets. Is this the case in Thailand? I am not there yet but my reason for concern is, would it be wise to get tetanus and rabies vaccinations before leaving Europe for Thailand? (I am a hard-core walker) Hope that someone out there can give us the benefit of their experience on this issue. Thanks,- S.

One or two countries where I have lived have a large population of loose unconstrained dogs running around the streets. Is this the case in Thailand? I am not there yet but my reason for concern is, would it be wise to get tetanus and rabies vaccinations before leaving Europe for Thailand? (I am a hard-core walker) Hope that someone out there can give us the benefit of their experience on this issue. Thanks,- S.

Bangkok has a large number of stray dogs and rabies is endemic. For stays longer than a month and high exposure risk, such as hiking and walking, rabies vaccination would be recommended. Getting post-exposure treatment within 24h after a bite, in case you are not vaccinated, can be a problem in rural areas of Thailand as vaccines may not be readily available and, due to the frequency of injections required in such an event, it can really ruin your day...

Travel to Thailand currently due to the flooding, should be really well researched and planned..

"...would it be wise to get tetanus and rabies vaccinations before leaving Europe for Thailand?"

I think tetanus vacc's are good for 10 years. Good to keep it up wherever you are.

Rabies vacc's, as a general rule, couldn't hurt, but you may not build up a titer that would do you any good if bitten.

Not sure about the newer vaccinations, but in the past not everyone had a titer that was much of a protection. On the down side, a vaccination might make you feel safer than you really would be in case you were bitten.

If you are going to live a village life, probably worthwhile.

I've never seen rabies around Chiang Rai but believe it occurs.

There was certainly a lot around when I lived in the Philippines.

Everyone should keep their tetanus vaccinations up to date regardless of where they live but I've never bothered with rabies.

Rabies is present everywhere in Thailand.

I strongly recommend the vaccine.

It is a series of 3 injections over a month, possibly this is what TerryLH meant about not building up enough titer? As I otherwise don't know why he said that.

Even if you are planning to come in less than a month's time you could start the series and then complete it in Thailand.

But I wouldn't advise coming to Bangkok within a month given the flood situation. Chiang Mai, Phuket etc fine.

"It is a series of 3 injections over a month, possibly this is what TerryLH meant about not building up enough titer? As I otherwise don't know why he said that."

As i understand it, titer (titration) is a measurement that can tell you how well a vaccination has built up antibodies to help fight rabies.

Not everyone used to build up a titer high enough to be effective. You'll only know that, though, if you are vaccinated and then tested.

My personal/professional experience is from years ago.

I don't have any recent experience with newer versions of the vaccine, which I presume, from S's comments, have better results.

T

Early vaccination (pre-exposure prophylaxis) for rabies does not by itself give protection against rabies.

It only simplifies the management of any subsequent exposure and thus necessitates fewer doses of rabies vaccine.

Human Rabies Immuno Globin (HRIG) will also not be required.

HRIG is expensive and often difficult to obtain in Thailand.

sanuk