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Rabies Vaccinations

  • Rabies is viral Infection transmitted by animal bites, scratching or Licking where saliva coming in contact with broken skin or into the mouth or eyes
  • Most common animals concerned are Dogs, Cats, Bats, Monkeys other animals such as Squirrel, Raccoons, Fox and Wolf may also carry Rabies.
  • Any animal bites are automatically considered rabies bite as it is difficult to judge the nature of the stray or wilderness of the animals
  • Rabies present in most of the countries around the world and only a few countries are free of Rabies
  • Around 45 to 50000 people die every year from rabies, mostly in the developing and under develop countries
  • If untreated unfortunately Rabies once contracted carry 100% mortality rate

Rabies vaccination strongly recommended for travellers travelling for long time back packing, repatriates, business people travelling and working for long time, community workers , VFRs (visiting friends and relatives) visiting for long times. and more so for children who are more exposed to animal bites due to their inquisitiveness to the animals.

  • Pre exposure rabies vaccination is course three injection administered 0,7 and 21 days
  • Rabies vaccination taken as pre exposure regime prior to travel has got good protection
  • Unfortunately rabies vaccinations are expensive

If you are unable to take pre exposure vaccination it is strongly recommended to follow post exposure rabies vaccination regime without fail (it is better to talk to Travel doctor during consultation for advice).

Post Exposure Vaccination procedure

During post exposure wound care is paramount

Always wash wound thoroughly with soap and water, Brush the wound if possible.

Avoid using Alcohol to wash the wound as alcohol tend to fix the rabies viruses to the wound.

You can use Betadine to wash the wound following initial through wash with soap and water.

Do not stitch the wound as closure of the wound with stitches can bury the viruses under the wound (it is better to live with scar).

It is important go to nearest Hospital or vaccinations clinic as soon as possible to receive.

HRIG (Human Rabies Immunoglobulin) vaccine

HRIG is passive rabies vaccination. Part of the vaccine has to be infiltrated around the wound (depends upon the size and depth of the wound and the remaining dosage has to be administered to the opposite arm or glutei area).

Dosage of the HRIG should be calculated depending upon the weight of the body, and size of the wound (20 units /kg).

In addition to this you also need Rabies vaccination HDCV Muriex, PCVC or Vera cell rabies vaccination as per recommended schedule on day 0,3,7,14 and 28 days regime to complete the post-exposure course of Rabies vaccinations.

Some countries give you initial 2 doses followed by 7 and 14 days.

Unfortunately there is worldwide shortage of HRIG vaccines, vaccine is not available in some countries and the vaccine is expensive.

Some countries use Equine rabies immunoglobulin derived from horse serum. This could cause some adverse side effects.

If HRIG is not available this could be next alternative as second line treatment.

However in some countries where HRIG is not available, offer series of large volume of injection from 14 to 21 days, this could be mouse brain derived nerve tissue vaccines is not recommended option by WHO (World Heath Organisation).

In the event you are unable to get appropriate post exposure Rabies vaccinations and HRIG it is strongly recommended to contact your travel insurance organization requesting them to evacuate you to nearest country where you could able to obtain HRIG and post exposure rabies vaccination. This is not only expensive but also spoil your holidays.

On the other hand if you receive pre exposure rabies vaccinations you are already carry rabies antibodies. If you happen to be bitten following the pre exposure vaccination you need to obtain one or two normal Rabies vaccination mentioned above to increase your rabies antibodies titre preferably on day 1 to 3 and second one 7th day. This vaccines are readily available in most of the countries.

REMEMBER IF UNTREATED OR IMPROPERLY TREATED POST EXPOSURE RABIES IS ALMOST 100% FATAL.

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Sydney New 2000

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