Rabies jabs for Madagascar

I'm not a medical expert but often visit countries with a 'high' rabies situation

I have never been vaccinated as I understand that even if I am, I will need an antidote anyway

Search for Nutraxfornerves on here, she's the specialist & will give you a more technical description!!

Kira

Rabies vaccination questions come up frequently on multiple TT branches. The bottom line is this is always a personal decision for which there is no "right" answer regardless of your location or itinerary. Rabies is a horrible, fatal disease and if inflicted one must seek immediate professional medical attention or they will die. On the other hand, contracting rabies is at least somewhat under your control (or at least you have ability to mitigate against contraction) so it's not likely to occur if you know the risk factors and use common sense.

You can read all the information, but it still comes down to a personal decision. I've been consistent with my decisions relative to being vaccinated, but I'm not you.

Have a safe trip.

Again I also have no specific medical training, but the question or issue with Rabies is: 1 where are you going to travel to or visit? ; and 2 how far from a major hospital will you be (if more than 24 hours) and in an area where Rabies in common then seek medical advice and consider having the vaccination. Yes even if you have had the shot you will still need treatment if bitten, but your window of treatment is extended to 72 hours and you do not need the more drastic treatments. (Hopefully Nutrax will come to our aid on this one).

Below are the UK and USA-CDC links for more information:

http://www.nhs.uk/Conditions/Rabies/Pages/Treatment.aspx

http://www.cdc.gov/rabies/medical_care/index.html

Personally I would get Rabies jabs for Madagascar.I would also check if the vaccine is available in-country. I wouldn't advise for somewhere like Kenya with good hospitals and reasonably good infrastructure but Madagascar is very different. Last year we drove through the Stans where rabies is common and you couldn't get the vaccine in-country. If you find that the vaccine is limited in Madagascar then consider taking some with you.

Getting in country not much use as it is a three shot process over about 4-6 weeks. As for Kenya having good hospitals - only Nairobi has the treatment for Rabies if you need the full treatment.

Mike - you may be right that only Nairobi can treat rabies but you can always get to Nairobi within the 24 hours needed to start treatment. There are very many flights from the various National Parks and towns that will get you back there quickly.

it is a bit like travel insurance - if you have it you wont need it
but if you don't have it and need it then disaster
when I first went to countries with rabies I thought no I wont get it
then when I was going to others I thought better get vaccinated as increasing the chances
perhaps check how many countries have rabies and will you be going to any of them

Wigstan - I thought we were talking about Madagascar - I would not want to be relying on getting an emergency flight to either Jo'burg or Nairobi to get treatment for rabies. As #7 says - yes it is a bit like travel insurance - you only really want or need it when you don't have it. Not worth the risk (for me).

Let me clarify one thing. There is no fixed time period during which you have to start treatment, but obviously sooner is better. The time frame depends on where you were bitten and how serious it is. A massive attack to the head is a crisis. A small nip on the foot, not as much of an emergency. The virus has to travel to the brain before you show symptoms. The closer the bite is to the brain and the more virus that is injected, the worse the situation is.

Preventive rabies vaccination is called "pre-exposure vaccination." It is a series of three shots given over a month.

Rabies vaccination does not make you truly immune--not like, say, measles shots. What it does do is buy you time to get treatment and reduce the treatment regime. If you get the pre-exposure vaccination, then the after-bite treatment is two shots of vaccine, three days apart.
IIf you were not previously vaccinated, then you need a shot of rabies immune globulin AND a series of five rabies vaccinations, given over the course of a month (not all at once). The immune globulin may be expensive and/or very hard to find. (I've seen report where people had to pay $US1,000). Sometimes vaccine has not been stored properly and is not fully effective.

The immune globulin should be given within 7 days of the exposure. You can start the vaccine immediately & then head for some place where you can get the immune globulin.

There is a branch of the Institute Pasteur in Antananarivo. They have a rabies treatment clinic. So the issue would be--can you easily get there?

Some people choose to put the money they would have spent for immunization into really good medical evacuation insurance--that would not only get you to some place where you can be treated, but would organize all the logistics for you.