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Info on Rabies


Rabies consultation


The rabies vaccination is a series of three vaccinations. They are normally given on days 0, 7 and 21. An adaptation of the schedule is possible. The protection is two years but with a lifelong immune memory.  It is possible to boost the vaccination.  For people with a high risk of exposure, it is recommended to do a blood test. 



It is important to make an appointment for a rabies consultation. You can make an appointment by calling us or by sending an email (contact). If you name your phone number, we will call you back as soon as possible. 


Costs

The price of one rabies vaccination serie of 3 shots costs €107,50.  The rabies vaccine is administered intracutaneously. This method is not registered in the Netherlands, but it is widely used and approved by the WHO in Geneve. We already have 40 years of experience with this method and an important advantage is that the vaccine is cheaper.  


Protection

After a series of three vaccinations, you will have a lifelong immunological memory. That means that after being exposed to rabiës the need to give HRIG (Human anti-Rabies Immuno Globulin) is dropped. Because of this immunological memory it is possible to give a booster vaccination to keep an active protection.

Info on Rabiësvaccination

The spot on your arm where we vaccinate rabies is the right upper arm at the tip of the musculus deltoïdius. This spot may not have direct contact with UV rays for 24 hours. So if you're sitting in the sun or take a solar tanning just cover the spot otherwise it can become quite red and itchy. We choose for the right arm because if you get a BCG (tuberculosis vaccination) around the same time, this is always done on the left side. In this way interference is minimal. During the intradermal rabies vaccination series it is advised not to take certain malaria pills. These pills are Chloroquine (= Nivaquine) and Mefloquine (Lariam =). These anti-malarial drugs have a detrimental effect on the development of antibodies to rabies. So a test dose of Lariam should be delayed until one week after the third vaccination. We help to provide you an optimal schedule for the vaccines and the possible testing of malaria drugs.


General Rabies Info


Rabiës is a viral disease of the nerval system.  Rabiës is transmitted by a bite, scratch or lick of an infected animal. The saliva of an infected animal is contaminated with the virus and through contact with this saliva the virus can be transmitted to other mammals (including humans). Some animals can already be contagious several days before they get symptoms of rabiës themselves. That means that you always need to get a treatment for rabiës after every suspected contact with a possibly infected animal.
In any case of contact with an animal suspected of rabies (dogs, foxes, wolves, jackals, monkeys, bats, raccoons, skunks and cats), also when in doubt, wash the wound thoroughly with soap and water. Wash for at least 5 minutes and  desinfect the wound with iodine tincture. Then,  in all cases, consult a health post, doctor or hospital. 


For people who are not vaccinated against rabies 

After contact with a suspect animal, start vaccinating as soon as possible. Preferably within 12 to 24 hours starting with "human anti-rabies immunoglobulin (HRIG)". Further treatment will consist of at least five vaccinations with the rabies vaccine. Normally on days 0, 3, 7, 14 and 28. An embassy or consulate is always aware where the vaccine is in stock. 

For people who are vaccinated against rabies 

You have no need for treatment with "human anti-rabies immunoglobulin (HRIG)" anymore. Within three days to one week, but preferably as soon as possible you have to get 2 booster vaccinations (with active Rabies Vaccine 1ml). The first booster as soon as possible and a second booster 3 days later. Important is also the location on your body where you are bitten and the severity of the bite. With a bite in the foot or hand, you basically have more time than with a bite in the face. Take in all cases, your vaccination certificate with you so the doctor can see what diseases you are vaccinated against. Let the vaccinations you receive be registered in your vaccination booklet. 


For people who have occupational exposure to rabies 

It is recommended to do a titre check four weeks after the primary series of 3 shots. This is a blood test to determine the degree of protection. Officially it is recommended to do a titre check every six months and based on the height of the titre a booster vaccination might be needed. It is also wise to get a booster vaccination  12 months after the primary series and get another titre check after 4 weeks again. This booster dose often gives long term protection of at least 5 years. Even after any booster vaccination a titer check should be done every six months. Based on the semi-annual titre check you get a booster vaccination again if needed. There are different types of antibody tests in the Netherlands, each with a different interpretation. Please ask good advice of knowledgeable people.

 

Re-vaccination

Normally, booster vaccinations are not required for "common travellers" because after being exposed to rabiës a treatment of 2 boostervaccinations is always necessary. The need for treatment with HRIG is dropped for the rest of your life once you are vaccinated with a series of vaccination against rabiës. (With a booster vaccination you only buy more time in fact) 

Re-vaccination (or booster vaccination) is only needed for certain groups or certain circumstances.
(groups: i.e. veteranarians, biologists, people working with bats or when you have intensive contact with pets or mammals)
(circumstances: if there is a high risk of exposure or if medical treatment is more than 24 hours away. (i.e. cyclists in the tropics)

Regardless of the protection period or duration since the last vaccination, after exposure, as quickly as possible post-exposure vaccinations are needed.

Basic immunisation
day 0.7.21-28
active protection 2 years

day 0.7.21-28 and a booster after 1 year (day 365)
active protection 5 years

active protection means you buy more time to get a post exposure treatment.

Areas with a high risc on rabiës:
Afrika (exept Mauritius and the Seychelles)
Asia (exept Bahrein, Kuweit, Maldives, Taiwan, Hongkong, Singapore, Japan and Papua New Guinea)
South- and Central America (exept Uruguay)
Carribean (only in Haïti, Dominican Republic and Cuba)

 

 

 

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Vaccinatiecentrum Nijmegen

Nina Simonestraat 24
6541 EA Nijmegen
Tel.: 085 - 902 03 03

Alleen voor spoedgevallen en medisch overleg: 06 - 50 24 74 66

Vaccinatiecentrum Wageningen

Nexus (gebouw 117), Akkermaalsbos 14
6708 WB Wageningen
Tel.: 085 - 9020303

Alleen voor spoedgevallen en medisch overleg: 06 - 50 24 74 66

Vaccinatiecentrum Den Bosch

Vughterstraat 166
5211 GN DEN BOSCH
Tel.: 085 - 902 03 03

Alléén voor spoedgevallen en medisch overleg: 06 - 51 40 65 79

Vaccinatiecentrum Utrecht

Oudegracht 251
3511 NM Utrecht
Tel.: 085 - 902 03 03

Alleen voor spoedgevallen en medisch overleg: 06 - 51 40 65 79