Health checklist before travel to Philippines

[ssbib]

My maximum time in the Philippines has been a month or less, over several visits since 1978 ( when I worked for a year at the University Hospital in Kuala Lumpur, Malaysia ). At no time did I consider it necessary to have rabies or Japanese encephalitis vaccines, or antimalarial tablets, because of the places I visited, and my home in Malaysia was on the University campus next to the hospital.



I can’t give advice to individual members, most of whom I don’t know personally. All I can do safely is to give information based on best available evidence. It’s a matter for each person to reach a decision according to their general health, where they plan to visit ( or live ), and what they intend to do during their visit - after consultation with their doctor / nurse, and reading reliable source(s).



So-called " pre-exposure prophylaxis " ( immunisation ) is different to " post-exposure prophylaxis ". Each depends on the age and general health of the patient, and ( after a bite ) whether or not the suspect animal can be shown to have rabies.


Essentially pre-exposure involves several intramuscular injections and booster dose(s) of vaccine. Post-exposure involves not only further vaccines but also immunoglobulin for immediate " passive " immunity.


Each regime is indeed expensive, either in UK or the Philippines. Of course, once there are symptoms - after a variable incubation period of usually 1 - 3 months, rabies is almost always fatal. It is preventable ONLY by vaccination ( and immunoglobulin ).

Forgive my ignorance Alan but does that mean if I get bitten by a rabies infected animal while in the Philippines and I have NOT had the pre-exposure vaccination then I am essentially screwed? if I get to the hospital straight away and take the post-exposure vaccinations ONLY will I be ok?

[Doc Alan]

Forgive my ignorance Alan but does that mean if I get bitten by a rabies infected animal while in the Philippines and I have NOT had the pre-exposure vaccination then I am essentially screwed? if I get to the hospital straight away and take the post-exposure vaccinations ONLY will I be ok?

You would NOT be " screwed " if bitten by a rabid animal without having had pre-exposure vaccination. The wound should be cleaned carefully and thoroughly with soap and water, and left open. A course of post-exposure vaccines should be started and immunoglobulin should be given as soon as possible after the bite.

Of course there are far more animal bites than cases of rabies in the Philippines. The management of each situation needs judgement according to circumstances and what is known ( or becomes known ) of the animal's rabies status ( positive, previously immunised, or negative ).

[ssbib]

You would NOT be " screwed " if bitten by a rabid animal without having had pre-exposure vaccination. The wound should be cleaned carefully and thoroughly with soap and water, and left open. A course of post-exposure vaccines should be started and immunoglobulin should be given as soon as possible after the bite.

Of course there are far more animal bites than cases of rabies in the Philippines. The management of each situation needs judgement according to the circumstances and what is known ( or becomes known ) of the animal's rabies status ( positive, previously immunised, or negative ).

Am I right in thinking that even after having the pre-exposure vaccinations you still go and have the post-exposure vaccinations. So the hospital will still try and find out information about the animals rabies status etc and act accordingly? Basically what I'm asking is having the pre-exposure vaccinations doesn't mean you are immune to rabies, just that you have longer to seek medical attention?