Travel Vaccinations for developing countries

  Real-world advice for Backpackers / Independent Travellers - 2016

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Rabies is a disease that most backpackers don't quite know how to deal with - i.e. to vaccinate or not(?)
The reality is that it's a judgement-call based on where you're headed, what you're up to and your understanding of the rabies vaccine, which doesn't work in the way you might think ... 

Rabies is an infectious disease caused by a virus usually entering the body from an animal bite, scratch, or when an animal licks you on cuts or broken skin. Most people get infected by stray dogs, but the disease can be spread by bats, cats or just about any warm blooded animal. Rabies is found in almost all developing countries, however the majority (95%) of infections occur in Africa & Asia, with India being the country with most fatalities.

If untreated, rabies is a very deadly disease, once it reaches the central nervous system (i.e. when symptoms appear) survival is rare, the death-rate for untreated rabies is >99%

With such a high mortality rate youíd think that almost all backpackers would be vaccinated for rabies, but Iíd say that the majority of independent travellers donít get the Jab. And youíll see from my Vaccination Card that Iím one of the people who chose not to get it.

Being vaccinated for Rabies isnít as straight forward as for other inoculations, the vaccine itself consists of 3 injections taken in the arm (not in the stomach as some urban myths would have you believe) the injections are taken over a period of a month; on Day 0, Day 7 and Day 28, so three visits to the nurse/surgery are required. This initial dosage will give protection for 2* years, after this 2 year period, a booster will provide a further ~5* years of protection. (* Depends on the brand of vaccine taken).

Unfortunately, simply getting vaccinated for rabies isn't quite the end of the storyÖ
Because individuals who have been vaccinated still need to take action if they get bitten by a rabid animal Ė the vaccine effectively buys you time and allows a simpler post-infection treatment regime to be administered.

Here are the 2 scenarios:
If you have been vaccinated for Rabies and you subsequently get bitten by an infected animal, your post-exposure treatment is to: wash the wound under a running tap, clean with antiseptic or alcohol, see a doctor and receive 2 further doses of vaccine, one immediately and a further dose within 7 days.

If you have not been vaccinated for rabies and you subsequently get bitten by an infected animal, the treatment is more complex; again you would clean and disinfect the wound, but you would then need an injection of rabies immunoglobulin antibodies (giving you instant protection, preventing the virus travelling to your nervous system). Then 5 doses of the vaccine over the following month; on Day 0, Day 3, Day 7, Day 14 and Day 30. One further issue with this scenario is that rabies immunoglobulin can be difficult to find in developing countries; which may require you to pack-up shop and take an emergency flight home.

With rabies, an awareness of the incubation period is crucial to understanding the disease:
The incubation period (i.e. the time it takes for symptoms to emerge after a person has been bitten or otherwise infected) is usually 2-12 weeks(*). During this time the disease is treatable, with an excellent success rate, using the standard vaccine and/or rabies immunoglobulin treatments described above. The treatment must be administered during the incubation period. Once the incubation period is over and symptoms start to appear, rabies is more or less incurable and thatís the point at which thereís a > 99% chance youíll die from the disease.
Taking action when the disease is in itís incubation phase is critical and the most important thing you need to be aware of with rabies.
(*) In extreme cases, the incubation period for rabies can be a short as 4 days or as long a 2-3 years.

The rabies vaccine is expensive (USD $180 for the 3 shots) and doesnít actually guarantee you anything, but it does buy you time, gives you and your family peace of mind and itís certainly worthwhile for those people travelling/working in high risk areas. If I was volunteering in an animal rescue centre in India, I would certainly get vaccinated for rabies, if I was just backpacking through Asia I probably wouldnít bother. You pays your money Ö


This page was last updated on 03-Feb-2016