Temple Dog Bite - Rabies Vaccine

[weka]

The wife got bitten by a dog that lives at our temple. It broke the skin in two places on her ankle.

We immediately went to the hospital and got 5 jabs - 2 shoulders, 1 bum, 2 in the puncture wounds. She also got the little booklet advising about further jabs on days 3, 7 14 and another. We did jab 3 today and will definitely administer the rest of the treatment.

The dog that did it, (and probably has a shortened lifespan if Thai justice is carried out) is behaving normally - we see it each day.

My question is, do we need to worry about any further complications? Does the Verorab vaccine cover all eventualities from a bite? (if indeed the dog has rabies)

It's shocking how deadly dog bites can be over here and I wonder about people here that can't afford verorab or don't get treated

Edited April 18, 2014 by weka

[isanbirder]

I've been bitten twice by dogs in Thailand (both times in Chiangmai). I had the first three rabies jabs (out of five), and was told that the remainder were not necessary if the dog which bit you was still behaving normally. In one case I didn't know, so had the other two jabs; in the other case, I saw the dog daily (and knew the owner), and it was behaving normally, so I stopped having the jabs.

[bina]

found more frequently and cheaper in thailand than in 'western ' countries

[notmyself]

and probably has a shortened lifespan if Thai justice is carried out

What does that mean?

[Bkungbank]

How long does the vaccination last in the body after first bite then second bite later 6 months , do we need to a new jab for have antibody already?

[advancebooking]

Theres heaps of info in this link:

http://www.thaivisa.com/forum/topic/705918-rabies-question/

There is mention of a flow chart diagram on a health website. If you find that you will find an answer to your question

[ezzra]

and probably has a shortened lifespan if Thai justice is carried out

What does that mean?

I think he meant that a biting dog or rabid dog would have been put to sleep fairly

quickly in 1st world countries.. even a suspicion of being rabid would be enough...

[Doznotdiz]

I was bitten in Chiang Mai 4 years ago and tried to find the dog again. After searching for a week I called the doctor and they opened the surgery just for me to have the first Verorab jab. I then had 4 more to complete the course. I believe that you are covered for a year only when you have the full course. I was bitten again in Chiang Mai 6 months ago and went to the hospital emergency where I had two booster shots a week apart. I think that the shots are well tolerated because they only contain the dead virus and no other additives or preservatives.

[Thailandgayguy]

They just careless I guess. I don't think they can't afford it because one jab cost only less than 500 THB ($15 Including hospital+doctor fee)

[weka]

They just careless I guess. I don't think they can't afford it because one jab cost only less than 500 THB ($15 Including hospital+doctor fee)

Possibly only 500 baht in some places.

It was Songkran and the local clinic closed so the nearby hospital, after checking our daily Insurance limit was 9000 baht came up with a bill of 8975 for the first treatment - lucky it was just under the limit eh?

Thanks for the info folks

Moral of the story, get Verorab for dog bites and shop around if you can

[techboy]

and probably has a shortened lifespan if Thai justice is carried out

What does that mean?

Maybe he's gonna bite the dawg?

[weka]

and probably has a shortened lifespan if Thai justice is carried out

What does that mean?

It means that there is a pretty pissed off Thai family annoyed that people are getting bitten in a public place. A pack of dogs circling and she was bitten from behind.

Do I have to spell it out? The people in the community want to kill the dog

The temple monks said they couldn't do anything and gave 500 baht for taxis to the hospital. Do what you like to the dog

The woman who feeds them daily said she couldn't do anything.

The local government when asked to remove the dogs said they couldn't do anything. Do what you like to the dog

So what next? How do you remove this danger from the community?

Edited April 21, 2014 by weka

[ClutchClark]

You have made the local community...you have done your part.

I just left a thorough post on treatment for rabies in another thread. Try a search "Red Cross Rabies Unit" or "Snake Farm".

After 2 weeks of observation on the dog determines it is not displaying any syptoms of rabies then you can stop vaccinations.

If you have had 3 vaccinations then the next time you are bitten you will only need 2 vaccinations as a previous poster indicated.

You paid quite alot for your initial treatment. This probably indicates you received HRIG immunoglobulin rather than cheaper ERIG.

The shots at wound and in rump were immunoglobulin. The shots in each deltoid were one vaccine and one Tetanus.

BTW, about 80% of bites are from dogs sneaking up from behind.

Cheers

[johninbkk71]

If dogs still around find a local vet who can run a rabies check, but the dog needs to be dead. You'll need to catch the dog, put it down , don't damage the skull or neck area. Or ask the vet to do it.

[ClutchClark]

I was bitten in Chiang Mai 4 years ago and tried to find the dog again. After searching for a week I called the doctor and they opened the surgery just for me to have the first Verorab jab. I then had 4 more to complete the course. I believe that you are covered for a year only when you have the full course. I was bitten again in Chiang Mai 6 months ago and went to the hospital emergency where I had two booster shots a week apart. I think that the shots are well tolerated because they only contain the dead virus and no other additives or preservatives.

Your information is not correct and should be ignored.

You waited a week for your first shot.

If the dog had rabies then you would have died a very horrible death because you must begin treatment within 72 hours of exposure--the sooner the better.

You are lucky.

[ClutchClark]

If dogs still around find a local vet who can run a rabies check, but the dog needs to be dead. You'll need to catch the dog, put it down , don't damage the skull or neck area. Or ask the vet to do it.

Please ignore this advice.

This is not only unnecessary but places you at risk of another bite.

You are currently receiving the most aggressive form of treatment you can--immunoglobulin. Even if they were to perform a necropsy on the animal it would not provide any advantage to your circumstance. All that is necessary now is observe the dogs behavior for first two weeks and if it is not manifesting behavior or is dead then it was not rabid.

If dog is fine after 2 weeks then you can stop vaccinations after #4 @ week 2.

If dog cannot be located or is dead then continue full series including shot #5 at 4 weeks.

They used to kill dogs back in the days of the old medication and required numerous and expensive and painful shots in your stomach because a negative necropsy meant you could stop the treatment early.

[maswov]

I've been bitten twice by dogs in Thailand (both times in Chiangmai). I had the first three rabies jabs (out of five), and was told that the remainder were not necessary if the dog which bit you was still behaving normally. In one case I didn't know, so had the other two jabs; in the other case, I saw the dog daily (and knew the owner), and it was behaving normally, so I stopped having the jabs.

That was bad advice. The shots directly into the wound(s) is what kills the active rabies if any. That needs to be done within 24 or it will be ineffective. The series of shots is the vaccine to prevent infection, just like what is done to dogs when puppies. The series needs to be complete to be effective as well, and if the dog did have rabies it would be dead by the time the series is complete.

[dotx]

Killing the dog would actually be stupid. Better to keep an eye on it to see if he's showing any signs of rabies.

[thepool]

Factual information on rabies and post exposure treatment

here

http://www.cdc.gov/rabies/

[ClutchClark]

That was bad advice. The shots directly into the wound(s) is what kills the active rabies if any. That needs to be done within 24 or it will be ineffective. The series of shots is the vaccine to prevent infection, just like what is done to dogs when puppies. The series needs to be complete to be effective as well, and if the dog did have rabies it would be dead by the time the series is complete.

Maswov, the advice you just provided is partially incorrect and could result in death.

Immunglobulin and Vaccinations are two seperate courses of treatment and they both treat the current rabies virus exposure. They can be beneficial if administered within 72 hours, but the sooner the better.

The shots at the wound & buttocks are called immunoglobulin (either ERIG or HRIG) and they give your own body a "boost" in antibodies until you are manufacturing your own. The immunoglobulin slows down the virus--and is the reason it is injected at the wound--but it is not enough without the added vaccinations.

The vaccination series is still necessary for the bite because it takes your body about 7-10 days of vaccines before you are manufacturing your own antibodies at full efficacy.

It is the combination of the two treatments that kill the virus.

Edited April 21, 2014 by ClutchClark

[johninbkk71]

It was only a suggestion. My cousin got bit in India 2 years ago it's what happen there.I know that the test on the dead dog could be inconclusive,sorry I should have added tell your wife to keep taking the shots. Better safe than sorry. The only treatment for rabies is pretty bad and not 100% and as far as I know only attempted in some hospitals in the US. Might be wrong.

[ClutchClark]

It was only a suggestion. My cousin got bit in India 2 years ago it's what happen there.I know that the test on the dead dog could be inconclusive,sorry I should have added tell your wife to keep taking the shots. Better safe than sorry. The only treatment for rabies is pretty bad and not 100% and as far as I know only attempted in some hospitals in the US. Might be wrong.

Johnny, the old treatment was bad--the new RIG treatment is much easier and 100% effective if administered in first 72 hours.. Ofcourse, much depends on the experience level of the person administering the shots.

Treatment is slightly different in the US compared to much of the 3rd World due to cost considerations.

Actually, if a person needs post-exposure treatment then BKK is the best option anywhere on the globe and its a reasonable price.

Every ex-pat or traveller should really get the pre-exposure vaccination series. It costs 450 each for 3-part series (total 1,350 Bt) at Red Cross Rabies Unit/Travel Clinic in the building next to the Snake Farm.

Rabies is endemic here and the strain found in dogs is a more virulent strain than that found in bats.

Cheers

Edited April 21, 2014 by ClutchClark

[johninbkk71]

Killing the dog would actually be stupid. Better to keep an eye on it to see if he's showing any signs of rabies.

I only made a suggestion based on personal experience. The incubation period for rabies can be up to 8 weeks. I did neglect to say keeping taking the shots.

Also, stray dogs in Thailand can be skittish, snappy it's their nature like all dogs.

Anyway hope you learn some manners when commenting and don't worry OP the docs are taking the best route.

[shaurene]

and probably has a shortened lifespan if Thai justice is carried out

What does that mean?

Means what is say, some Thais poss the family will end it's life.

[johninbkk71]

It was only a suggestion. My cousin got bit in India 2 years ago it's what happen there.I know that the test on the dead dog could be inconclusive,sorry I should have added tell your wife to keep taking the shots. Better safe than sorry. The only treatment for rabies is pretty bad and not 100% and as far as I know only attempted in some hospitals in the US. Might be wrong.

Johnny, the old treatment was bad--the new RIG treatment is much easier and 100% effective if administered in first 72 hours.. Ofcourse, much depends on the experience level of the person administering the shots.

Treatment is slightly different in the US compared to much of the 3rd World due to cost considerations.

Actually, if a person needs post-exposure treatment then BKK is the best option anywhere on the globe and its a reasonable price.

Every ex-pat or traveller should really get the pre-exposure vaccination series. It costs 450 each for 3-part series (total 1,350 Bt) at Red Cross Rabies Unit/Travel Clinic in the building next to the Snake Farm.

Rabies is endemic here and the strain found in dogs is a more virulent strain than that found in bats.

Cheers

Thanks for the advice I don't travel much these days going off old advice. I'll keep it in mind. I did hear the old treatment is still done in some parts of Thailand so a few jabs might be worth me getting over my dislike of needles.

[ClutchClark]

Killing the dog would actually be stupid. Better to keep an eye on it to see if he's showing any signs of rabies.

I only made a suggestion based on personal experience. The incubation period for rabies can be up to 8 weeks. I did neglect to say keeping taking the shots.

Also, stray dogs in Thailand can be skittish, snappy it's their nature like all dogs.

Anyway hope you learn some manners when commenting and don't worry OP the docs are taking the best route.

Johnny, The reason that poster might be impolite is because we are discussing something that kills with amazing efficiency and wrong information can result in a very painful death.

This topic should be left alone unless you deal with this stuff all the time. I started a foundation some years back that helps to manage dogs in Underdeveloped countries so this subject is critical for the safety of my staff.

As for "8 weeks", that is a possibility for humans but with dogs its different and I will include quotes easily verified from this point forward:

"... The incubation period in dogs is not 10 days, but rather ranges from 10 days to one year, and is usually between 3 and 12 weeks. Dogs that have bitten people are required to be confined and observed for 10 days following the bite in order to insure that the dog is not at the end of its incubation period, which is the only time that the animal can infect people through bites or contact with saliva."

Cheers

Edited April 21, 2014 by ClutchClark

[ClutchClark]

It was only a suggestion. My cousin got bit in India 2 years ago it's what happen there.I know that the test on the dead dog could be inconclusive,sorry I should have added tell your wife to keep taking the shots. Better safe than sorry. The only treatment for rabies is pretty bad and not 100% and as far as I know only attempted in some hospitals in the US. Might be wrong.

Johnny, the old treatment was bad--the new RIG treatment is much easier and 100% effective if administered in first 72 hours.. Ofcourse, much depends on the experience level of the person administering the shots.

Treatment is slightly different in the US compared to much of the 3rd World due to cost considerations.

Actually, if a person needs post-exposure treatment then BKK is the best option anywhere on the globe and its a reasonable price.

Every ex-pat or traveller should really get the pre-exposure vaccination series. It costs 450 each for 3-part series (total 1,350 Bt) at Red Cross Rabies Unit/Travel Clinic in the building next to the Snake Farm.

Rabies is endemic here and the strain found in dogs is a more virulent strain than that found in bats.

Cheers

Thanks for the advice I don't travel much these days going off old advice. I'll keep it in mind. I did hear the old treatment is still done in some parts of Thailand so a few jabs might be worth me getting over my dislike of needles.

Johnny,

I figured you'd been around the block a time or teo because your advice was spot on if you were "old school".

Luckily, medicines have improved and Thailand has kept pace with those improvements since rabies is so prevalent here. You should really consider going to the red Cross Rabies Unit in the same complex as the Snake Farm. They are very good. The building is about 80 years old but in far better condition and much better maintained to hygienic standards than most local hospital ER's.

Cheers

[johninbkk71]

It was only a suggestion. My cousin got bit in India 2 years ago it's what happen there.I know that the test on the dead dog could be inconclusive,sorry I should have added tell your wife to keep taking the shots. Better safe than sorry. The only treatment for rabies is pretty bad and not 100% and as far as I know only attempted in some hospitals in the US. Might be wrong.

Johnny, the old treatment was bad--the new RIG treatment is much easier and 100% effective if administered in first 72 hours.. Ofcourse, much depends on the experience level of the person administering the shots.

Treatment is slightly different in the US compared to much of the 3rd World due to cost considerations.

Actually, if a person needs post-exposure treatment then BKK is the best option anywhere on the globe and its a reasonable price.

Every ex-pat or traveller should really get the pre-exposure vaccination series. It costs 450 each for 3-part series (total 1,350 Bt) at Red Cross Rabies Unit/Travel Clinic in the building next to the Snake Farm.

Rabies is endemic here and the strain found in dogs is a more virulent strain than that found in bats.

Cheers

Thanks for the advice I don't travel much these days going off old advice. I'll keep it in mind. I did hear the old treatment is still done in some parts of Thailand so a few jabs might be worth me getting over my dislike of needles.

Johnny,

I figured you'd been around the block a time or teo because your advice was spot on if you were "old school".

Luckily, medicines have improved and Thailand has kept pace with those improvements since rabies is so prevalent here. You should really consider going to the red Cross Rabies Unit in the same complex as the Snake Farm. They are very good. The building is about 80 years old but in far better condition and much better maintained to hygienic standards than most local hospital ER's.

Cheers

Ok fair enough it's been a long time since I've been on the road and yes my bad call. Dogs are more likely to develop rabies quicker than some animals. heck, I now thanks to: http://www.americanhumane.org/animals/adoption-pet-care/safety/rabies-facts-prevention.html that some animals it can be years.

Promise I'll think next time before posting a statement, a question would have been better to determine if it was appropriate.

I will now bow out. OP this guys right I'm sure and I'm off to the snake farm.

[dotpoom]

found more frequently and cheaper in thailand than in 'western ' countries

What is ......."found more frequently and cheaper in thailand than in 'western ' countries" ?

[Suradit69]

and probably has a shortened lifespan if Thai justice is carried out

What does that mean?

I think he meant that a biting dog or rabid dog would have been put to sleep fairly

quickly in 1st world countries.. even a suspicion of being rabid would be enough...

"I think he meant that a biting dog or rabid dog would have been put to sleep fairly

quickly in 1st world countries.. even a suspicion of being rabid would be enough."

That's you definition of "Thai justice."?? Rather strange to apply Thai justice in the exalted first world countries , but this is Thai Visa so anything is possible.

And no, a dog that bites someone even in the exalted first world countries would not necessarily be euthanized (even amongst the very few of them alleged to employ Thai justice). Depends on local laws and the circumstances, but generally the dog owner is held financially liable. A dog that is known/considered to be dangerous might be seized or ordered to be put down. Really depends on local laws and the individual case.

Certainly a dog or any other animal that is believed to be rabid would be put down even in not first world Thailand.

If you feel you are at risk, at least in the short term while travelling, it might be best to get rabies vaccination ( or "jabs," which is the more primitive term used in certain parts of the self-describe first world) as a preventative measure.

Edited April 21, 2014 by Suradit69