Dit blog is gepubliceerd op 6 november 2019 en geschreven door Marchel Ratering
Rabies is an infectious disease that is relatively rare in the Netherlands. According to statistics, 3 people have died in the Netherlands from Rabies in the past 25 years.
The impact of a dog bite, or contact with a mammal in the sub(tropics) is usually significant. In recent years, advice to travellers on rabies has been given more frequently by vaccination centres. It is discussed whether or not to vaccinate after which people often choose not to vaccinate (partly influenced by protocols). People often choose not to vaccinate because of the extra cost and because they assume the chance of a mammal bite is small.
This is absolutely right as far as I am concerned. It is important that people who come to a vaccination centre are advised about this and that people know that it is better to stay away from animals. This means not petting dogs, cuddling cats or having their picture taken with a monkey and, of course, leaving bats alone.
Despite this, I have noticed that in recent years, people are having more and more contact with mammals in the tropics and that people are increasingly worried about infection. The number of people receiving treatment after a bite has increased. This means that people are more and more aware of the risk of Rabies and are worried about (even minimal) contact and would like treatment when this happens.
Rabies vaccination before a trip to the tropics is a very good investment
Let’s circle back for a moment to the 3 people in the Netherlands who died of Rabies in the past 25 years. All three had not been vaccinated against Rabies prior to their trip.
In my professional opinion, getting vaccinated before a trip to the tropics is a very good investment. You only need to do it once after which you are protected for the rest of your life. Protected in this case means that your body builds up immunological memory against this virus. This immunological memory lasts throughout your life and means that after a bite or contact with a mammal that might be infected with rabies, you don’t have to do anything but wash the wound with soap and water, disinfect it for a while and preferably get two Rabies vaccinations as soon as possible. How soon you should get these vaccinations depends on where on your body you have been scratched, bitten or licked and the severity of the wound. With scratching, there is a chance of infection but this chance is small. In case of biting, the chance is higher, so in that case, go and get a rabies vaccination as soon as possible. The vaccination stimulates your immune system’s memory cells to produce antibodies. As a result, your body makes its own protective immune cells.
If you are vaccinated before travelling, you don’t have to worry about getting immunoglobulins after coming into contact with a mammal (Marig: “human anti rabies immunoglobulin”). These immunoglobulins are difficult to obtain in many countries and the quality can also vary greatly in the tropics.
If you are going to the tropics, I recommend you read the information on Rabies carefully.
Travel safely and without worry
I myself was vaccinated against Rabies 10 years after my first trip.
It was only when I started travelling with my children that I noticed how vulnerable we are as human beings and that it is wise to protect yourself as much as possible. Even though the chances of getting sick while travelling are slim, you still have a lot less to worry about if you travel well prepared and with the right vaccinations.
As I was writing this blog, I received a call from a traveller who had been bitten by a dog in Thailand. He had not been vaccinated against rabies and told me that he had gone to the hospital in Thailand because he did not know what to do. There he received vaccinations against Rabies. After 2 weeks, he learned that he actually should have had Marig. Now he is worried because that means he actually didn’t get the right treatment.
Every day, travellers in the (sub)tropics are bitten or scratched by mammals. The impact of a bite during your trip is very significant. By getting vaccinated against rabies before your trip, you can travel safely and without worry.
Marchel Ratering, registered traveller nurse and owner of vaccinatiecentrum.nl