Verorab and Murphy’s Law

First, let me start off by saying I am just fine now.  However, a couple of weeks ago, while we were taking the sailing course, a stray dog bit me during a lunch break while walking along the beach near Ocean Marina in Sattahip, Thailand.  This incident made the remainder of the sailing course more challenging.

I share this story as a cautionary and instructional tale.

When we were not on the boat sailing, the theory of sailing was taught in a conference room at the Ocean View Marina Hotel.  The beach south of the hotel offered a short cut to a small village with restaurants and various small shops.  Chris and I had walked this beach a number of times earlier in the week and noted the large number of stray dogs (10-20).  The dogs never gave us any trouble or notice, for that matter, other than the evening we considered walking the path in the dark.  However, that evening, we chose the longer road back to our hotel after noting some aggressive behavior by some of the dogs.  It is important to note that stray dogs seem to be everywhere in Southeast Asia (e.g. while biking in Cambodia, Vietnam  and Thailand), and we also encountered stray dogs on biking trips in Europe (e.g. Puglia, Italy) without any prior incidents.

In my case, I was bit on the back of the leg.  The dog came up from behind while we walking and started growling.  Since the dog was behind us, I did not realize how close it was to me; otherwise, we may have taken a different course of action.  That said, when the dog was growling, our strategy was to remain calm and continue walking (not run). However, before I knew it, I could feel its mouth around my leg just above the ankle.  We yelled at the dog, and it took off.

Thankfully, we were close to the Gulf Charters office, and an individual in the office assisted with cleaning the wound and putting a bandage on it. Not to get too gruesome, but the dog put a few good scratch on the right side of my leg and on the inner side of leg, one of his canine teeth put, what we later learned, to be a 1 inch deep hole in my leg.  Initially, I was not sure if I needed to go to the hospital thinking it was not too bad.  However, our instructors in the course did not even question and suggested I go to the hospital right away.

Upon arriving at the Bangkok Pattaya Clinic, they immediately recommended a Rabies shot (Verorab) and cleaned the wound.  While 50728I do not think I was exposed to Rabies, had I not gone to the hospital, it is highly likely an infection would have ensued.  In addition to Rabies shots, the doctors and nurses required that we make a daily trip to the clinic for cleaning of the wounds.  In summary, lessons learned:

  1. Beware of feral dogs.  Locals will tell you they are benign and most are, but be vigilant and cautious.
  2. Before traveling in Asia, get a Rabies shot.  This was the one shot we decided not to get.  See our post regarding the travel shots and prescriptions https://gocircamundi.com/2015/08/21/shots-and-prescriptions-uw-travel-center/.  We have encountered dogs many times on previous trips, while hiking and biking, and never had a problem.  We thought most of the issues in Asia were caused by monkeys and bats – both of which we thought we could safely avoid.
  3. If you are exposed in any way to a stray dog, go to the hospital or clinic right away. It sounds like a “no brainer”, but sometimes with the shock, you do not always think clearly. Even in a non rabies prone area, the risk of infection is very high.
  4. The challenge with animal wounds are they can not be stitched because of the risk of infection. They need to be aggressively cleaned daily and left open to drain.

We visited the clinic roughly 5-6 times for 3 rabies shots and daily cleaning.  (A total of 5 rabies shots are required over a 30 day period.  I got the 4th rabies shot in Chiang Rai and will get the last when we are Madrid.)

The clinic was pristine, and the care by the doctors and nurses was fantastic.  The cost ranged from $6-$50 per visit.  The rabies vaccine was less than 10% the cost of the shots back in the States, and the nurse care was almost free. The majority of the expense was buying bandages and cleaning kits for the nurses or to take with us when we had to do some self-cleaning while overnight on the boat.  (Chris was a great nurse.)

A huge thank you to the wonderful nurses and doctors at the Bangkok Pattaya Clinic on Sukhumvit Road next to Chic Republic in Pattaya, Thailand .  If for some reason you find yourself in Pattaya (BTW, we definitely do not recommend going to Pattaya, for any reason, other than the sailing course.) and in need of some medical help,  the clinic is exceptional.

 

Travel Shots and Prescriptions

The nurse at the University of Washington travel center began her consultation by stating that her job is to scare the “living bejeebers out of us”.

While planning  for previous international travel, we learned that a trip to a travel clinic is always a great idea if your plans include remote locations. Two hours later, six shots and four pretty sore arms, she did an excellent job.  The shots included Yellow Fever, Hep B, Mumps, Measles and Rubella, Flu, Typhoid and Japanese Encephalitis.  In addition to the shots, prescriptions were given for malaria, travelers diarrhea, altitude sickness.  Some key items we learned while we were there:

  1. Yellow Fever is recommended for anyone under the age of 60 that is traveling in risk areas.  However, once inoculated with the vaccine, there is a 1 in ~225K risk of coming down with Yellow Fever within the 1st 7 days. Many countries in Asia and Africa deny entry without this vaccination.
  2. Japanese Encephalitis is recommended for those traveling throughout Asia and is the one shot we received that requires 2 shots in a 30 day period.
  3. In Asia, 80-90% of Malaria pills are counterfeit so best to buy your prescriptions in the States prior to leaving and have friends or family mail refills.
  4. As a preventative measure for Travelers’ Diarrhea, take 1 Pepto Bismol tablet prior to eating to help reduce risk.
  5. There are a four options for Malaria pills but not all prescriptions work in all locations.  There are certain prescriptions that are recommended for those traveling in Asia and those traveling in the Caribbean.
  6. Go to the travel clinic no less than 6 weeks prior to travel as some shots require 2 vaccinations.
  7. Check your insurance as shots and prescriptions can be costly.  For example, the malaria prescription for estimate 60 days was estimated around $400 if not covered by insurance. Not all insurance covers all vaccinations.
  8. GoodRx is an app that will check pricing of prescriptions at pharmacies near you.

Highly recommend UW Travel Center as they were extremely informative and concerned about getting it right and not the time spent with the customer.  The other benefit of UW Travel Center, for those close to it, is that you can e-mail them questions while traveling either directly to the nurse or the main mailbox.  If you do not live near Seattle, check out your closest university.