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Dog bite in Thailand - a word of Warning


kristophon

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hi.. I have been meaning to write this post for a while because I feel it may come of use to folk somewhere down the line

Back in early 2015 I was training for a half marathon running in a local village. I am experienced cyclist but, at the time, was not an experienced runner. While I was running through the village there were a group of dogs barking up ahead. I kept an eye on them but I didn`t hear or see one of the dogs that crept up behind and bit me on the back of my left leg just above my ankle. Obviously my immediate thought was... 'bugga'...

I waved the snarling dog off and had a closer look. 2 puncture wounds that were bleeding but the cuts didn`t seem that deep. My honest thoughts at the time were, 'iy, thats not too bad'.. walked back to a local shop and cleaned the wounds up with tissue and water and carried on with my run.

when I got home I told the wife what had happened and she said straight away that I had to go to the local hospital to get injections for rabies & tetanus!... I thought.. 'eee thats a bit over the top. they are only small cuts, no need for all that'... but the wife kept on saying YOU HAVE TO GO, you have to go!....so I started to think... 'hmm.. better off save than sorry'

so off we went to the hospital and sure enough the doctor said i would have to have these injections. its almost a year ago so I forget exactly how many their were but it was alot. some small injections around the wound areas, a few in the bum, and another few in both arms. big needles they were as well so not a pleasant experience. I then had to go back the following week and again after a month had passed for the same same. it did seem at the time alot of bother over nothing much but I`m very glad now that I did follow the wifes advise.

a couple of months ago a farang husband of a friend of my wifes was bitten by a dog on Koh Samui where he used to run a couple of bars with his wife. i had only met him on a few occasions. he seemed like a good bloke. one of the few decent folk you meet in this place. he was only in his early 60`s, not a big drinker and in pretty good health.

unfortunately he, like myself, didn`t think it was a big deal, but unlike myself he decided not to follow the advise of his wife and would not go to hospital for the injections. 3 weeks later the wounds had turned green and his leg was swollen and finally he decided to go to hospital. but it was too late. 1 week later he was dead. I`m still not sure exactly what killed him. whether it was rabies or tetanus or just plain ganggreen so have all the injections the doctor advises.

so i`m writing the post as a warning to anyone who gets bitten by a dog in Thailand (or for that matter anywhere in the world)

do not hesitate no matter how small the bite. the size of the wound is irrelevant. once that bacteria from that dogs mouth is in

your system GO STRAIGHT TO HOSPITAL AND GET THE INJECTIONS FOR EVERYTHING ASAP

also if you are running in villages or anywhere outside of your house, always take some kind of stick with you. of course there are no garrantees u won`t get bit but as you run the stick swishing around will put dogs off (unless they are particularly vicious). Cycling wise, I have clocked up many miles and have realised that so long as you keep going and keep pedaling, the dogs can get close but they are never able to time a bite while you are moving. again, there are no garrantees but my advise is don`t panic, keep moving and keep pedaling.

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Sage advice!

Rancid wretched creatures.

The amount of bites and rta's they cause is staggering year on year.

They should all be culled humanely on a national scale as most lead horrific lives, covered in mange & starving.

I sometimes stop on my bike and use the bike as defence to stop myself getting bitten.

P.S. I am a massive dog lover but these are vermin in my eyes.

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Thank you. Very important advice. Thailand/SE Asia is not Europe/US etc. Diseases and infections here whether they are as bad as Rabies or not MUST be taken seriously. The speed at which infections/bacteria can take hold is simply not the same.

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Sage advice!

Rancid wretched creatures.

The amount of bites and rta's they cause is staggering year on year.

They should all be culled humanely on a national scale as most lead horrific lives, covered in mange & starving.

I sometimes stop on my bike and use the bike as defence to stop myself getting bitten.

P.S. I am a massive dog lover but these are vermin in my eyes.

Should at least have a gov funded castration scheme going. Our local temple took in a stray - Doberman cross. It's a mean, snarling dog. 2 years and it still hasn't chilled out. Haven't taken my son to the temple since. Mai pen rai, farang bah! etc.

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It would be nice if we had a phonenumber from the government which we can call to report agressive dogs.

Also would be nice if we can report to which owner they belong (in case we know that) or who feeds them.

Even better would be if the government just gets them all off the streets. They also come into moobaans where children play or people have dogs in their own fenced garden.

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Possible to get pre-exposure rabies vaccine which will decrease the number of injections needed if bitten.

Besides rabies, animal bites carry bacteria that can cause very serious infections, likely what happened in the case of the poster's friend who lost a limb.

About 2 years ago my cat, in a jealous rage because i had taken an injured kitten into the household, slept up on my bed and sank her teeth into my arm, deeply. I was half asleep when it happened and didn't feel like getting up, so foolishly did not wash it or apply antiseptic until the next morning. It was almost Xmas and I was very busy during the day preparing for Xmas dinner and didn't really notice what was happening on my arm until I happened to glance into a mirror and saw a whopping cellulitis on that arm, bright red and very hot to the touch. Had to rush to hospital. Luckily in my case caught it in time.

Brucella

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Thank you [emoji120] I love running long distances and look forward to long runs as I travel around here but after reading this much changes . Maybe carry a little can of mace/pepper spray for protection ? post-202056-14585413103211_thumb.jpg

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Sticks work well and simply waving them as a threat often gets the message across. Tossing a stone likewise. Thai soi dogs are used to being hit with sticks and having stones thrown at them but might not know what the spray is...plus they have to already be pretty close to spray them whereas the stick wave/stone throw works from a distance, which is where you want to keep them.

The most important thing is to not feel fear, they literally smell it. if you start to feel apprehensive, try to switch it to anger, which they can also sense. They will attack if they sense fear and flee if they sense anger.

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Thank you [emoji120] I love running long distances and look forward to long runs as I travel around here but after reading this much changes . Maybe carry a little can of mace/pepper spray for protection ? attachicon.gifImageUploadedByThaivisa Connect1458541309.738156.jpg

yeah not sure about the pepper spray... if you are close enough to use it you are probably already bitten.. the stick works best. the thais beat them regularly with sticks so they know to stay away if u have a stick (generally speaking)...

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I was bitten by our neighbors dog about two years ago and had the rabies series of I think 5 shots plus tetanus. After being bit I was told you have 24 hours to start the series. Total costs was around B6000.

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I think the dogs are pissed off in the heat... just had a near miss with a couple of local psycho mutts. First real threat of a bite in years... bending for a large stone did the job, gave me long enough to find a stick. I might just take them on and show I'm the alpha round here.. next time they get too close (lab size dogs)

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Possible to get pre-exposure rabies vaccine which will decrease the number of injections needed if bitten.

Besides rabies, animal bites carry bacteria that can cause very serious infections, likely what happened in the case of the poster's friend who lost a limb.

About 2 years ago my cat, in a jealous rage because i had taken an injured kitten into the household, slept up on my bed and sank her teeth into my arm, deeply. I was half asleep when it happened and didn't feel like getting up, so foolishly did not wash it or apply antiseptic until the next morning. It was almost Xmas and I was very busy during the day preparing for Xmas dinner and didn't really notice what was happening on my arm until I happened to glance into a mirror and saw a whopping cellulitis on that arm, bright red and very hot to the touch. Had to rush to hospital. Luckily in my case caught it in time.

Brucella

Years ago, I was in my HMO's "Urgent Care" center. My turn came up and just as I was about to enter, a guy was rushed in in holding his hand...so swollen it looked like he was wearing an inflated rubber glove. The Dr. took one look: "Cat bite?" he asked...Yup.

He took the guy right in and later when he saw me, he apologized for taking him out of turn but explained to me that cat bites are among the worst...this guy's was only 3 hours old. Apparently, the teeth are so sharp and smooth that they "self-seal"...usually don't even bleed so the bacteria is trapped inside a perfect incubator.

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Sounds very familiar.

Only after I got a small bite from a soi dog, and I had to take all the series of rabies and tetanus shots, I found out that foreign travel agencies advice travelers to get 2 preventive rabies shots before traveling in Asia.

India is #1 in rabies infections...and Thailand?...#2.

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There is no suspicion of rabies in the event of such bites?

The symptoms described are unrelated to rabies as that would manifest only much later. It is however possible to get rabies from a cat. Whether or not rabies vaccine is indicated after a cat bite depends on the same factors as for a dog bite: whether or not the animal is known to have vaccinated and whether the bite was unprovoked/unexplained. I suspect most people with cat bites are bitten by their own pets, just as I was....unlike dogs cats WILL bite the hand that feeds them, if they are sufficiently angry with the person.

The ER doc who treated me (Thailand) asked all the right questions to determine whether I needed rabies shots but had a little trouble understanding the replies. The part about it was my own pet cat and she's fully vaccinated, he got. It was the circumstance of the bite that had him very puzzled.. Him: "she just jumped on you and bit you while you were sleeping?" (Thinking sounds like possibly rabid behavior). Me: "yes , but it's OK, she had a reason..." and then the story of the new kitten and my cat's jealousy. He was rather dubious (clearly not a cat owner) but eventually took my word for it that the bite was perfectly normal healthy cat behavior.

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Such unnecessary panic.

Tetanus: Sorry dearies, but you should all have your boosters no less than every 10 years. You are more likely to need it for the basic scratches and scrapes you get around Thailand.

Rabies: Depends on the region. Likelihood of infection in Krabi, Hua Hiin etc. is close to zero, if not zero Rabies is a reportable infection. In the 10 year period of 2003 to 2012 there were 186 confirmed cases of rabies transmission between animals and humans. During that period, a large scale preventative vaccination program took place. The result was that the numbers declined significantly over time. The last year of reporting data released shows only 4 cases of rabies. All of the cases were in border areas or zones known for the trafficking in dogs for human consumption. (Northeastern Thailand.) There is no need for worry or fear.

You are more likely to die from dengue than a dog bite. 105 people were confirmed dead in Thailand from dengue in 2015. I believe that the rabies number for 2015 is none (data release pending). Yet people go out without their deet and they wear shorts and t shirts.

That being said, I used to be vaccinated for rabies so that I would only need a reduced number of injections subsequent to exposure. I used the Pasteur European version.

According to a 2014 study from a clinician who treats rabies exposure ,

In conclusion, WHO rabies postexposure management guidelines were not followed at a major teaching and referral hospital in a rabies endemic country. The agreement rate in clinical practice with WHO guidelines was only 26.9% in this retrospective

study. We believe that this is not unique and reflects the general situation throughout this region. More intensive physician training at all levels in management of potential rabies exposures is urgently needed.

Citation: Asian Biomedicine Vol. 8 No. 3 June 2014; 393 - 397

Yuwares Sittichanbuncha, Chalermpon Chairat, Kittisak Sawanyawisuth

Emergency Medicine Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10700, Department of Medicine, Faculty of Medicine, Khon Kaen University, cResearch and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand

I do respect the authors as it is a fascinating read. However, I would say it does show that the Thai approach of common sense is the cost effective approach. The results back it up. The likelihood of 1 or 2 deaths per annum doesn't justify the expenditure of millions of baht for vaccine for the hundreds of thousands of people who suffer dog and cat bites every year.

Edited by geriatrickid
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I would be very hesitant to suggest to anyone that they shrug off a dog bite and not get treatment.

Thailand does not always follow WHO guidelines to the letter but they DO always give the vaccine...it is the immunoglobulin part that is often skipped. And Thai people are pretty well informed about the risk and quick to seek treatment. So the number of rabies deaths has to be put in the context of most bites receiving post-exposure course of vaccine.

Whatever campaigns there may have been in isolated localities, the overwhelming majority of street/stray dogs in Thailand have NOT been vaccinated.

I have seen someone die of rabies. It is a truly horrible death and well worth not taking even the smallest risk of undergoing.

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The OP's (and others') advice should be heeded. Dog bites are a very serious thing in Southeast Asia; don't mess around. Tetanus and Rabies are not the only diseases you need to worry about; 10 years ago, a dear friend who lived in Cambodia was bitten by a friend's dog while playing with it; she ignored the bite. A week later, she and her unborn child were dead from a blood infection.

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It would be nice if we had a phonenumber from the government which we can call to report agressive dogs.

Also would be nice if we can report to which owner they belong (in case we know that) or who feeds them.

Even better would be if the government just gets them all off the streets. They also come into moobaans where children play or people have dogs in their own fenced garden.

Some local governments do have units that deal with stray dogs. I've seen them a few times near my house. They've got a blow gun and take the stunned dogs away. Not sure whey they are taken, but I've seen this a few times.

Many of these dogs are strays that are fed by the locals. The locals thinking they are doing a good thing when in reality they are making things worse. Spay and neuter would be a much better thing to do....

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Just want to add a couple of things on your Good Advice.

Rabies can come from any animal, including humans, so your advice should follow any animal bite. My daughter got bitten at the Petting Zoo by a Goat and even though these animals are vaccinated against Rabies, the doctors still gave her the shots. Needless to say that Goat probably didn't have a long life even if he did not have Rabies as I am pretty sure I saw him on the Food Cart the next day.

The other thing is that there is no cure for Rabies once it spreads to your Nervous System. It is not even 100% effective even when you get your shots right away. If you get it and it spreads you will die a horrible death. So don't take a chance.

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I was walking across Tha Pae Gate back in early '90s and got bit by a monkey who was performing 'tricks'. The chain leash was longer than I thought and the bugger caught my hand and bit it. No blood.

I don't like monkeys anymore. Can't be trusted.

For dogs, I use the stick or stones approach, as others pointed out.

For dogs in my neighborhood who I see regularly, I make friends with them by giving them food. After that they recognize me and people with me and I am granted passage.

What those dogs do not know is that I am the one who has water balloons at the ready on my balcony and for fun and target practice lob them at the pack down below if they are making noise at night. This is very entertaining and extremely effective. I have never hit one. But when that water explodes nearby, they all lose interest in anything and disappear for a long while.

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Thank you [emoji120] I love running long distances and look forward to long runs as I travel around here but after reading this much changes . Maybe carry a little can of mace/pepper spray for protection ? attachicon.gifImageUploadedByThaivisa Connect1458541309.738156.jpg

I love that idea!

Can you still get it legally in Thailand?

I'm not sure about legality and personally it would not bother about it if there was a need. It was available from roadside vendors down Sukhumvit a year or two ago so might be worth checking if you are in BKK. I have never bought any yet but after reading this maybe I will as it is not always convenient to carry a big stick.

However if the legality does worry you there is a "criminal identification spray alternative" but you might have to have it sent from the UK or US. It is a dye which would be useful in identifying the dog for later disposal and it appears to result in temporary blinding. I'm sure you will find it on the web.

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