quote:

Originally posted by Oryxhunter1983:
Just so you know, if indeed you get the rabies vaccination, and you get exposed, you still have to get the follow up treatment within the 10 day time frame.

The vaccine isn't that useful for that reason. It doesn't prevent you from getting rabies~

quote:

Originally posted by MARK H. YOUNG:
Folks,

Just get whatever the CDC recommends. To do anything else is playing Russian roulete with your health. Be smart!

Mark

quote:

Originally posted by Oryxhunter1983:
Lane,

Taken from the CDC website...

http://www.cdc.gov/vaccines/pu...loads/vis-rabies.pdf

"A person who is exposed and has never been vaccinated against rabies should get 4 doses of rabies vaccine - one dose right away, and additional doses on the 3rd, 7th, and 14th days. They should also get another shot called Rabies Immune Globulin at the same time as the first dose.

A person who has been previously vaccinated should get 2 doses of rabies vaccine - one right away and another on the 3rd day. Rabies Immune Globulin is not needed."

So we are both kinda correct...it's not the end all!

quote:

Originally posted by crbutler:
I would get the vaccine.

First, CDC recommendations are usually based on some level of fact, not internet medicine.

Second, the comment on the vaccine vs the immune globulin- I have administered the rabies IgG and it is one of the most painful injections one can give. You first determine a dose based on weight, then you are supposed to (if possible) give half of it in the wound site- not too bad for a kid (volume and their tissue is pretty elastic), but not pleasant for an adult (for the doc giving it, let alone the patient) Immunoglobulin can cause serum sickness and if its not genetically engineered, it is usually horse sera. In the US, horse is a nonissue, but I don't know what it may be like in Zim. The remainder goes in IM elsewhere (usually your rump.) This is supposed to be given within 24 hours of exposure, but they will do it whenever you arrive as that is what is recommended. You also get the series of 4 shots, which are no longer the nasty stomach ones (if they ever did such a thing, that was before my time, but I heard about it.) The new vaccine is a genetically engineered vaccine that has no risk of giving you rabies (but then its not risk free for other things)

The third reason to get it is that you may not know if you have been bitten. The last statistics I saw were that most rabies fatalities in the US ended up being from unknown untreated bat bites.

Talk with your regular doc or someone who knows what your health history is AND what you are doing. My experience with travel clinics is they do just what some of you do- pull up the CDC recommendations and give whatever they say unless you object to it. The needs of someone going in to the bush of Zimbabwe are a lot different than the guy who is doing a photosafari in Kruger in SA. The travel clinic may be the only place you can get the shots, but your regular doc can guide you with personal advice based on your history.

quote:

Originally posted by Mike Smith:
I am a big proponent of vaccinations. I usually accept the cdc recomendations without question. Rabies is the only one I took a pass on. I figure unless I am in an area known to have heavy outbreaks the risk is no greater than normal. It would still be prudent to prevent if you could. The series of three shots just buys time if somehow you didnt know you were exposed. You still have to complete ther series and get the damn globulin shot. That is the one that is like shooting maple syrup and hurts like hell. As long as you are going to somplace civilized like RSA I figure it probably isnt an issue. Still, an ounce of prevention...

quote:

Originally posted by jetdrvr:
In July, 2009 in Luke Samaras's camp up in Maasailand, I was wishing I had. A rabid honey badger spent a very long five minutes trying to break into my tent. I was up on the bed with my rifle and flashlight, not knowing what the hell was out there so mad at me. He finally gave up and ran over to the staff area and attacked my assistant tracker and another guy in their sleep before somebody killed him with a panga. That was after their tent collapsed and they had this evil bastard in there with them. Very nasty business and in no way funny. Rama got chewed up pretty good.

The guys had to drive three hours into Arusha to get shots. So there is a threat, no matter how statistically minor it might be.

quote:

Originally posted by ledvm:

quote:

Originally posted by jetdrvr:
In July, 2009 in Luke Samaras's camp up in Maasailand, I was wishing I had. A rabid honey badger spent a very long five minutes trying to break into my tent. I was up on the bed with my rifle and flashlight, not knowing what the hell was out there so mad at me. He finally gave up and ran over to the staff area and attacked my assistant tracker and another guy in their sleep before somebody killed him with a panga. That was after their tent collapsed and they had this evil bastard in there with them. Very nasty business and in no way funny. Rama got chewed up pretty good.

The guys had to drive three hours into Arusha to get shots. So there is a threat, no matter how statistically minor it might be.

Animals like Kudu commonly get rabies as well and don't show "classic" rabies-like signs. Some just dull-depressed.

Could easily shoot one and get exposed.

quote:

Originally posted by Larry Sellers:
ledvm - Are you authorized to give rabies shots to us hunters going abroad?? Can hardly wait for your answer!!

Larry Sellers
SCI Life Member

quote:

Originally posted by ledvm:

quote:

Originally posted by jetdrvr:
In July, 2009 in Luke Samaras's camp up in Maasailand, I was wishing I had. A rabid honey badger spent a very long five minutes trying to break into my tent. I was up on the bed with my rifle and flashlight, not knowing what the hell was out there so mad at me. He finally gave up and ran over to the staff area and attacked my assistant tracker and another guy in their sleep before somebody killed him with a panga. That was after their tent collapsed and they had this evil bastard in there with them. Very nasty business and in no way funny. Rama got chewed up pretty good.

The guys had to drive three hours into Arusha to get shots. So there is a threat, no matter how statistically minor it might be.

Animals like Kudu commonly get rabies as well and don't show "classic" rabies-like signs. Some just dull-depressed.

Could easily shoot one and get exposed.

quote:

Originally posted by Edod:
Thank you to all who have made suggestions. Since the opinions vary so much, will plan to speak with an Infectious Disease Specialist and see what their official recommendation is.

quote:

Originally posted by lavaca:
Ledvm:

We could have a debate here, but with respect to whether you are qualified to give me the vaccination -- I'm a lawyer and tend to debate the point -- most people I know tend to think I'm a son a bitch -- so shouldn't you be totally authorized to give me the shot? Just askin'

quote:

Originally posted by lavaca:
Ledvm:

We could have a debate here, but with respect to whether you are qualified to give me the vaccination -- I'm a lawyer and tend to debate the point -- most people I know tend to think I'm a son a bitch -- so shouldn't you be totally authorized to give me the shot? Just askin'

quote:

Rabies is a viral disease of the central nervous system (CNS); it is one of the oldest and most feared diseases reported in medical literature. Incidence of rabies is widespread throughout the world.


Human rabies cases have been documented on all continents except Australia and the Antarctic. Many cases are unreported (or greatly underreported) in developing countries.


Since 1980, most patients with human rabies in the United States have not had definite exposure through a bite wound, making total understanding of the mechanism of transmission somewhat elusive.


Worldwide, canine rabies variants are still epidemic and a major source of human rabies. The World Health Organization (WHO) in 2004 estimates that as many as 55,000 deaths occur from rabies annually, with 56% in Asia and 44% in Africa.


Although rabies is considered to be a uniformly fatal disease, 3 cases of survival were reported in the 1970s.

Suspicion of rabies is clear when a history of an animal bite is given; however, because a history of an animal bite is obtained in less than one half of US cases, diagnosis is problematic. Presentation of a patient in the rabies prodromal stage without a clear exposure history is so nonspecific and rare that making the diagnosis in the ED is essentially impossible. Rabies progresses over 7-14 days, and the mean time between initial presentation and death is 16.2 days.


The 2 rabies vaccines currently available in the United States are the human diploid cell vaccine (HDCV, Imovax) and purified chick embryo cell vaccine (PCECV, Rabavert). Both are made for intramuscular administration and are equal in efficacy and safety. The vaccine takes 7-10 days to induce an active immune response, with immunity lasting approximately 2 years.


No postexposure vaccine failures in the United States have been reported since HDCV was licensed in 1980.

quote:

Since 1980, most patients with human rabies in the United States have not had definite exposure through a bite wound, making total understanding of the mechanism of transmission somewhat elusive.

quote:

however, because a history of an animal bite is obtained in less than one half of US cases, diagnosis is problematic. Presentation of a patient in the rabies prodromal stage without a clear exposure history is so nonspecific and rare that making the diagnosis in the ED is essentially impossible.