Is there a rabies booster?

[silver sea]

Last July, I was bitten by a feral dog. I went to the local government hospital in Nathon, here on Samui.

As it was a wild dog, they injected the wound five times with what I think was a fast acting, emergency protection. They then gave me a further four injections, two in each shoulder.

In order to complete the treatment, I had to return another four times to the hospital for an injection in my shoulder.

The whole exercise, including my gasoline, cost me about 5000 Baht. From memory, the emergency injections were the largest part of the fees.

I got bitten again last February by another soi dog. It was a very old dog that nobody loved. It was a very hot day, and so it was in a foul mood. Fortunately, for me, it was so old that its teeth had been ground down flat. It was like being bitten by a dog that had taken its dentures out.

My hand was sore but the skin was not broken and so there was no blood. To be on the safe side though, I went to the clinic near where I live and saw the doctor. She confirmed my belief that I didn't need to go to the hospital again. She said that the injections were effective for twelve months.

As the 12 months protection will be expiring in a few weeks can I return to the hospital and ask for a booster? I do a lot of walking. I am not afraid of dogs, but they can be very aggressive so I don't doubt there will be further trouble. Paying for boosters would, I assume, be a lot cheaper than waiting for the 12 months to expire, and then, if I am bitten, having to start all over again.

I would add that my tetanus jabs are up to date.

Thanks for any advice that you can give.

[sirocco]

You should walk around with a placard around his neck to the attention of dogs

thank you not to bite me, it's already done

[ClutchClark]

Without actually knowing the name of the medications provided to you any response is simply speculation and could be misleading and when it comes to exposure to the Rabies virus you want to be certain. You need to talk to the hospital that treated you.

Typical treatment for exposure depends on whether you have had the vaccine series or not. If a patient has never had a vaccine before, then treatment of dogbite involves a large quantity of immuno-globulin injected at both the wound and the remainder in a large muscular region (typically the buttocks).

Seperate from that shot series, the patient is started on a Rabies vaccination program and there are different schedules or regimens for this but each includes a series of shots administered over a roughly one-month period.

A tetanus booster is typically provided as well.

If a person has already been provided a vaccination series then they have anti-bodies in their system, and any future exposure to Rabies is treated with ONLY vaccine. The initial immuno-globulin is NOT re-administered because it could actually thwart the bodies effort to fight the Rabies virus.

However, a booster of vaccine is provided (typically 2 shots over a series of days) when any re-exposure occurs (i.e. future dogbites).

The only recommendation is that you speak to the hospital that treated you after the first dog bite. It is typical that they provide you a vaccination card that lists all of the shots you have received. Any and every time you are bitten by a dog or even exposed to its saliva (even if no puncture has occured) you need to seek medical treatment as soon as after the bite as possible. The wound needs to be thoroughly scrubbed with soap and water and an iodine type solution applied. Even if the medical staff suggests no vaccine is necessary, I personally would request a vaccine booster.

[silver sea]

I have just remembered that after the first bite, the nurse did give me some injections in my buttocks as well. I am afraid that as you get older your memory begins to fade. I think that I had 14 injections in all on that occasion. As I say, I then had to return a further four times for an injection in my shoulder.

Anyway, thank you ClutchClark for your helpful response. Much appreciated.

[Sheryl]

Yes, if/when bitten again you will need only 2 injections. No need to get them now.

[TerryLH]

"If a person has already been provided a vaccination series then they have anti-bodies in their system,..."

It used to be that not everyone built up a titer after getting a series. You'd have to be tested to determine how much, if any, protection you have.