Rabies question....

[ghworker2010]

On Monday evening I was bitten by one of those posh fluffy small dogs in a shop in isaan. It nipped me when I went to pat the little bugger. My vaccination history for rabies is something along the lines of:

- jan 2006 in the uk- had the 3 to 5 vaccines for rabies prevention

- In 2011 I might have had a few more preventative vaccines in oz

- Dec 2012 I had one on the 27th and another on the 30th in Chonbury after being bitten by a beach dog.

After Monday night I remembered the vaccines I'd had in Chonbury in dec 2012 and thus thought my anti-body count would be sufficient to grant me immunity from the dreaded disease.

It was a small nip that drew blood and I immediately poured at least a litre of water over the small cut.

Now its thursday night and a friend has made me paranoid... Ive been researching on the net and its says:

Vaccination after an exposure

Anyone who has been bitten by an animal, or who otherwise may have been exposed to rabies, should clean the wound and see a doctor immediately. The doctor will determine if they need to be vaccinated.

A person who is exposed and has never been vaccinated against rabies should get 4 doses of rabies vaccine - one dose right away, and additional doses on the 3rd, 7th, and 14th days. They should also get another shot called Rabies Immune Globulin at the same time as the first dose.

A person who has been previously vaccinated should get 2 doses of rabies vaccine - one right away and another on the 3rd day. Rabies Immune Globulin is not needed.

Previously Vaccinated Persons

Previously vaccinated persons are those with a history of preexposure vaccination with HDCV, PCECV, or rabies vaccine adsorbed (RVA); prior PEP with HDCV, PCECV or RVA, or previous vaccination with any other type of rabies vaccine and a documented history of antibody response to prior vaccination. Previously vaccinated persons should receive two vaccine doses, (1-mL of PCECV or HDCV administered IM in the deltoid on days 0 and 3 only). Administration of HRIG is unnecessary, and HRIG should not be administered to previously vaccinated persons to avoid possible inhibition of the relative strength or rapidity of an expected anamnestic response. Local wound care remains an important part of rabies PEP for any previously vaccinated persons.

___________________

This issue is that its been 3 days since the bite and Ive done nothing. Should I go and get a vaccine again???

I also read on another post that:

''A dog can pass on rabies only when the virus reaches the brain...at the same time, it infects the saliva..hence it can transmit it via bites.

Once this happens the dog will die within a week or so and also exhibit very outward signs ...confusion,anger,loss of co-ordination.

If you don't want to get vaccinated and have daily access to the dog, keep an eye on him for a few days.

If no signs of rabies are present ,don't have the vaccines.

If yes, do it asap.

You have several days grace as the virus takes some time to incubate.

The rabies vaccine is a nasty mofo....

Keeping an eye on the dog" is not useful. Rabies vaccine (the immune globuline), to be effective needs to be administered within 24h.

Calculating odds of getting rabies is not useful either; you are dealing with an extremely serious condition that carries a 100% fatality rate and involves dying in a most unpleasant manner''

_______________

I checked the posh dog today and its acting normal.

I thus think the risk is LOW and that Ive previously had 2 vaccines in late 2012.

Do you think I would be ok to not bother going to the hospital and getting another vaccine??

One last piece of useful info that I read was a diagram entitled ''Rabies Post-Exposure Prophylaxis (PEP) Protocol for People

Exposed to Animals''

Que 1 asked if person was bitten

yes

que 2: was the animal a dog, cat or feral animal

yes

que 3: was the animal captured- or can it be located for 10 day observation?

yes

que 4: did the animal exhibit abnormal behavour or die within a 10 day period

no

the flow diagram indicates ''NO PEP necessary''

_______________________________

I was bitten on monday night and its now friday by the time you read this. Should I bother with a post exposure vaccine

thanks for your opinion!

[olddoc]

You have already delayed a decision.

However , given the previous vaccination history coupled with the fact hat the animal was not feral would appear to mitigate risk.

It is now a decision you have to make ---- no one here can advise for/or against vaccination

Edited February 20, 2014 by olddoc

[Sheryl]

Unless you are able to ascertain for certain that the dog has been vaccinated for rabies (as all dogs should be), then better safe than sorry, see a doctor and get the vaccine.

As you know who owns the dog, should be possible to ask to see vaccination card?

[ghworker2010]

I went to see the posh dog and its owner today and the dog was displaying normal behaviour. She said that the dog is only 6 months old and that its already had a rabies vaccine and that their friend is a vet who gave it.

Thus based on the fact that the dog only nipped me and that I washed it with water immediately and that that I had 2 booster vaccines in dec 2012- and that the dog is not a feral at the train station. I will not get another rabies shot for myself. Hopefully Im making the correct decision.

[Showbags]

Is it true that any warm blooded animal can carry it with no symptoms and pass it on ?

I was always of the belief that if an animal had it, then it showed and behaved as such and died at some stage....not carried it around forever and a day.

Anyway...take a photo of yourself in the morning immediately after waking up and if you flick through them after a week and notice changes...please post them here.

[davidst01]

This is on Wikipedia:

Vaccination after exposure, PEP, is highly successful in preventing the disease if administered promptly, in general within 6 days of infection. Begun with little or no delay, PEP is 100% effective against rabies.^[11] In the case of significant delay in administering PEP, the treatment still has a chance of success.^[15]

^{Thus in OP's case its still within the 6 day timeframe of post exposure. Get to a hospital and get the PEP shot just to be safe. Your mad if you dont... why take the risk.}

^{I also read that if the bite was unprovoked then its likely the animal is rabid. Read the CDC website for more info}

^{I think the moderator should include this topic on the daily tv.com email that is sent to everyone. Rabies is a serious disease and the more farang that are educated and aware of this problem the better.}

[TerryLH]

"Keeping an eye on the dog" is not useful. Rabies vaccine (the immune globuline), to be effective needs to be administered within 24h."

Actually it's very useful to 'keep an eye on the dog'. If the dog had rabies when you got bitten, it will be dead in 10 days. If it dies, you can still get the series of shots and be okay.

"I also read that if the bite was unprovoked then its likely the animal is rabid."

Likely? In this case the dog was provoked. What an animal thinks is provocation might not be the same as what you would consider it to be.

It's owner known. Vaccination history known. The OP knows where the dog is at and should be able to check to see if it's alive after 10 days. It's usually not the 'posh fluffy small dogs in a shop' that you need to be overly concerned about.

"Que 1 asked if person was bitten

yes

que 2: was the animal a dog, cat or feral animal

yes

que 3: was the animal captured- or can it be located for 10 day observation?

yes

que 4: did the animal exhibit abnormal behavour or die within a 10 day period

no

the flow diagram indicates ''NO PEP necessary''"

[Sheryl]

The "just nipped" part is meaningless, especially as it drew blood.

If I were you I would politely ask to see the vaccination card (use the excuse of needing to verify the date and type of vaccine given). Remember that Thais tend to give the answer they think you want to hear rather than necessarily what is true, and do not see anything wrong with doing so.

If truly vaccinated then together with the fact that it is not feral and acting normally, I would personally probably not bother, but it is ultimately your choice. As you have previously been vaccinated you'd only need 2 injections and that would surely be the safest route. Would definitely do it if you cannot find proof of the rabies vaccination.

[olddoc]

Its a pity no links were provided to the on line advise which was accessed.

This advise would not appear to correlate well with the advise given by the WHO or indeed with any other professional protocol.

[Showbags]

I still wanna know about the dormant thingy ?

[olddoc]

<script type='text/javascript'>window.mod_pagespeed_start = Number(new Date());</script>

I still wanna know about the dormant thingy ?

Look here

http://www.who.int/mediacentre/factsheets/fs099/en/

[bina]

rabies in grazing animals like antelopes can be up to 6 months dormant; some mammals are more 'receptive' to rabies: bats, canines but cats and rabbits and horses and donkeys can all get and pass on rabies.

once again, a dog, a known house dog, that the owner most likely paid lots of money to own, will most likely have been vaccinated, and even if not yet, most likely not a carrier. most puppies at the age of 6 months nip and chew and if had to run to get an injection for every nip i would be covered in puncture wounds. we are rabies rampant here. we have foxes and jackals who are identified as rabies active, and foxes and jackals do come in to our kibbutz. last year a group of our larger dogs managed to grab and kill a rabid fox.

that said, a large majority of our feral cats are not vaccinated as they cannot be caught. we used to use the oral meat injected with serum method but it was deemed not efficient as not just wild animals ate the meat, but all the roaming owned dogs and cats as well.

a few years ago a soldier here died of rabies due to a scratch by an unknown animal that apparently ran in to him while he was sleeping in an 'open' army camp (outdoor sleeping).

a dog that acts normal, biting u on purpose or as a puppy, or most likely healthy. a dog acting wierd, a fox approaching or standing and staring and not moving when threatened, random biting, those would make me more suspicious than a small shitzu type that nipped me in play.

that said, it s your own life. not mine.

[FBN]

Have a blood test done to determine your level of antibodies. If adequate no need for immediate booster. As Sheryl suggested, ask the owner if the dog had been vaccinated.

[ghworker2010]

I went back to the owner of the dog today at the shop and she said that she didnt have a certificate or proof that the dog had its rabies shot.

I looked at the dog and it was really quiet. It had a bandage around one of its legs. I asked what this was for and she said that it had been at the vet on a drip because it had diahorrea. I asked if there were any other symptoms and she said no.

I decided to go and have a rabies shot after seeing the dog.

At the govt' hospital the nurse went to the fridge and pulled out the vile for the rabies shot. He then went back to the fridge and bought back 2 small glass things containing liquid and he snapped the top off both of them. He then opened up a syringe and needle and drained out the rabies vaccine and then did not bother to mix it with the 2 little liquid thingies that he had opened. Was he supposed to mix that vaccine with the 2 other viles that he opened? Que for Sheryl

[Showbags]

^ are you sure it was rabies vaccine ?

I've read some of the thai hospitals do experimental stuff on farang when they enter..

Edited February 22, 2014 by Showbags

[Sheryl]

If it comes as a powder to be reconstituted then there would be an accompanying vial of sterile water or saline to mix it with. but if the nurse failed to mix it it would not have been possible to draw it into the syringe. Possibly it was already reconstituted (or a type that does not require mixing) and he realized this only after having also pulled out the solvent.

I wouldn't worry about that.

Re the dog, if she has no certificate then as I suspected the dog has NOT been vaccinated. Thais really do tend to give the answer they think you want rather than a truthful one and it would have been obvious to her that you wanted to hear the dog was vaccinated.

[Kitsune]

Just go to the doctor asap it's only a shot

The more you wait the harder it will be for the vaccine to work against rabies.

Also you have to consider your own immune system, some people are more resistant than others.

There is only one case of survival :One girl in the US survived rabies out of millions who died in horrible painful death.

Not the best way to go

[ghworker2010]

Today I went to the shop to see the dog and the owner said that it had died. They said it had bad diahorrea and I asked if there were any other symptoms. My thai is limited and thus could not work out if there were any.

Needless to say I will go tomorrow and get the 2nd PEP shot!

Moral to the story is go and get the rabies shots if you are ever bitten by a dog.

[olddoc]

The dog most likely contacted a Parvovirus infection.

The owner was probably negligent in obtaining any vaccination for the animal.

NB Parvovirus which affects dogs is not pathogenic in humans !

[Rimmer]

Inflammatory troll post removed

[bina]

diahrea = parvo... very very prevalant and a major dog (but not contagious to himan) killer.... and if it was a puppy, then 99% its was parvo... that is the age when they havent gotten the vaccines for puppy diseases and immunity from the dam is no longer, and not being a small baby is allowed out to run around and gets infected.

and some places dont vaccinate for rabies until between 3=6 months...

dogs with rabies die convulsing, in terrible pain, full of slobber and look very ill. a puppy with diahrea and on a drip didnt have rabies.

[ghworker2010]

diahrea = parvo... very very prevalant and a major dog (but not contagious to himan) killer.... and if it was a puppy, then 99% its was parvo... that is the age when they havent gotten the vaccines for puppy diseases and immunity from the dam is no longer, and not being a small baby is allowed out to run around and gets infected.

and some places dont vaccinate for rabies until between 3=6 months...

dogs with rabies die convulsing, in terrible pain, full of slobber and look very ill. a puppy with diahrea and on a drip didnt have rabies.

As its been said above ''Thais really do tend to give the answer they think you want rather than a truthful one and it would have been obvious to her that you wanted to hear the dog was vaccinated.''

It would be hard to ascertain exactly what the truth is about the dog and if it was just diahorrea. Who knows what it died of

The point is that its best to get the 2 post exposure PEPs as its better to be safe.

[Sheryl]

Most likely the dog died of parvo and almost certainly it had never been vaccinated. While the reported symptoms leading to death sound like parvo rather than rabies, cannot rule out early stages ofrabies as well and in any event dog was never vaccinated.

[Showbags]

What about the relationship of the dog dying after biting the OP ??

[Sheryl]

I don't understand the question.?

[olddoc]

"What about the relationship of the dog dying after biting the OP ??"

What exactly is being asked ?

A completely befuddled post.

[Showbags]

I don't understand the question.?

Dog bites man.

Dog dies.

Everyone asks for dogs vaccination records.

Anyone ask for the Mans ?

Dog not always culprit, sometimes victim.

Dog mans best friend after all.

[Sheryl]

I am not aware of any mechanism through which a dog biting a person would cause the dog to become ill and die of a diarrheal illness.

[Robby nz]

When I was bitten recently they gave me a course of anti tet as well as the rabies.

[olddoc]

Robby nz

Standard, routine, good practice.