Rabies jabs for Madagascar

Thanks Nutrax - I knew we could rely on you to provide a cool logical explanation. For me prevention is better than cure. Rgs O_Mike

Hi
I don't know which country you are from but I also need a course of the Rabies vaccine for my forthcoming trip. However, it is unavailable in Australia, at present. So if you decide to get the shots it may pay you to try and secure the vaccine ASAP.

Hi Grahami - sorry to correct you but I was able to get my rabies shots in south western Sydney (check out one of the travel doctor places) in June/July 2011. These were the "pre-exposure" vaccinations - not the immune globulin. The three shots cost around $450, but you can claim against some health fund insurances. As far as I know you can get the immune globulin if you need it - my nephew had to have in on arrival back from South America.

Nutrax, as usual, is closest to the mark here. There is no fixed time within which you need to get your booster shots, and unless you experience something like a truly “massive attack to the head” after which you’d probably need flying out anyway, there is almost certainly no need to let it ruin your holiday.

I always keep my pre-exposure shots up to date, and after a dog bite my medical adviser in Germany, who is experienced and well qualified in tropical and travel medicine simply advised me to complete the remaining two weeks of my programme and then see him on my return. I’m still alive.

Two points to keep in mind, though:

1 Do not rely on any vaccine available in the provinces of Madagascar, and probably not in the capital, either.

2 Don’t take the danger too lightly – for example in 2010 six people died of rabies in Maroantsetra.

That said, if you’re sensible, stay in hotels and don’t pet any dogs or cats, you should be OK. The disease is not widespread among lemurs.

Can't really add much to what's been said, but just wanted to mention that you can definitely get the vaccine in Fort Dauphin, easy and free. A friend was bitten by a cat a few weeks ago and hadn't had pre-exposure vaccines. I believe he had to go to the hospital on days 0, 3 and 7 for shots.

It's easy enough to avoid bites, since dogs are fady and don't really come near humans because they don't get treated well. The aforementioned cat was stuck in a basket and not too happy.

The problem with getting vaccinated within Madagascar (with the possible exception of the Institut Pasteur mentioned by Nutrax) is that in a country with frequent and often prolonged power cuts, you need to ask yourself if the appropriate storage conditions for any vaccines have been adequately maintained, quite apart from questions of pirated pharmaceutical products, which in Madagascar, as in many developing countries is a whole unsavoury can of worms.

With all due respect to #14, dogs are not fady everywhere in Madagascar, far from it. It is also certainly worth mentioning that rabid animals generally can lose their fear of humans, so “don't really come near humans” is no protection either – in this case very much the contrary. If an unknown dog approaches you, you should, for your own protection assume it to be potentially rabid.

The household where I live when I’m in country has among other animals a complement of three dogs all of them treated pretty much in the same way as pets in Europe – in fact they’re possibly valued even more due to their role as guard dogs.

And while I can and do insist that all the animals I live with are vaccinated, I can’t do the same with animals belonging to neighbours or strays which come into the yard to copulate, fight and otherwise interact with “our” animals. For this reason, I always keep my pre-exposure vaccinations up-to-date, and I advise anyone intending to travel to the more remote areas of the country and live in simple village hotelys to urgently consider doing the same. You can’t tell the difference between someone’s pet guard dog and a stray, and both are probably unvaccinated anyway.

However, as others have said, in the final analysis the amount of risk you’re prepared to take is always a personal decision, and I suppose a trip along the main tourist thrash from Toliara to Soanierana Ivongo and over to Sainte Marie, staying in tourist hotels, might be the kind of trip where I might be persuaded to “chance it”.