My partner and I are going to start our world trip mid-September and we had booked to start our rabies jabs next week, however the nurse has just called to advise us there is a vaccine shortage and basically they are currently unable to obtain any for us. My question is this: we'll be traveling around southern china and SEA for about 4 months - spending approx 1month in Cambodia and Laos. I've heard that if we did not have the rabies jab we would only have 24hours to get to a hospital which would have the vaccine - I know the best places would be Beijing, Hong Kong, Hanoi, HCM and Bangkok - but are all these places easy to get to within 24hours?? I can't quite get my head round it - if we are travelling down the mekong in northern Laos and happened to get bit etc is there any way we could realistically get to a hospital and get the jabs in time?? Are we just being too cautious (first time travelling n all!!) We were going to get the jabs to put our mind at rest - I don't know if we should desperately try to track some down or just leave it to fate!!
Is it possible to go to another area in the UK for a weekend and get the shot?
Another alternative is to get it when you are overseas. I've been overseas for a few years now, and had plenty. Go to the better expat clinics if you're unsure.
Try calling around some of the health clinics in the UK though, or some tropical doctor clinics, I am sure it will show up.
All the best
The last time I travelled in Asia (a few months ago), I went to get a Rabies booster shot and was told that I really didn't need a Rabies vaccination unless I was going to be working/living in a particularly rural area for several months. I'm not sure what your exact travel plans are, but it might be worth calling areound several travel clinics to check if you really do need the injection or not. Chances are if you a sticking to a well travelled route and you are careful to stay away from animals (be careful of the monkeys!) then you will probably be ok... but then I'm not a Doctor of any sort - just drawing on my own exeriences.
I reviewed the CDC's Temporary unavailability of rabies pre-exposure vaccination alert and the timetable for the release of additional vaccine is still approximately mid-July (2008). Hopefully, Sanofi Pasteur (manufacturer) will come through soon. But, you still have approximately 6-8 weeks before you begin your travels which is adequate time to receive the vaccinations if the serum is released in early August. The typical dosing regimen for pre-exposure jabs consists of 3 inoculations at 0, 7 & 21 or 28 days. You'll have to speak with your physician, but some will "fast-track" that timetable to 0, 7 & 14 days. Regardless, even the 21 day period can still be handled.
Pre-exposure (PE) vaccinations do three things: 1) Initiates a partial immunity to the rabies virus (by "forcing" your body to produce antibodies), 2) reduces the number of post-exposure injections (from 5 to 2), and 3) extends the time between infection and treatment by approximately 24 hours.
Patients exposed and unvaccinated will be treated with 1 injection of rabies immune globulin (RIG) and 5 injections of rabies vaccine. (RIG and the vaccine are different products.) The RIG immediately begins to fight the infection while the vaccine prompts the body to start producing it's own antibodies. (PE vaccinated patients do not receive RIG at time of treatment.)
As to the question of "hunting some down or just leaving it to fate" - it all rests on your comfort level and being informed about the risks. As with most things, the first line of defense against rabies is common sense. If most of your travels will be in rural areas and doing outdoor activities, such as camping, working with wildlife or working on farms, then the PE vaccinations are a very good idea. KoalaGirl has commented to this also. If that type of travel is not your agenda, then PE vaccinations basically bring piece of mind. The monkeys and stray dogs may be cute, but just don't pet them. Be aware of your surroundings, which includes the animals, and you will keep your risk of exposure to a absolute minimum.
I suggest talking with your clinic and requesting they notify you as soon as they receive more vaccine. Again, you do have time to wait. If the vaccine is not available by the time you leave, I wouldn't lose a lot of sleep over it. Keep in mind that most rabies cases in any country are locals in rural areas and not the visiting traveler.
CDC - Exposure & Treatment of Wounds
CDC - What to Do if You Have a Potential Rabies Exposure
Mayo Clinic - Diseases - Rabies
Wow, thanks so much for all of your replies. We are planning to be in rural areas but never too far from the tourist track. I think we will contact our travel nurse and see if she can advise us if it does come in - we do have about 3weeks until we need to have the first jab and if CDC are thinking it will soon be available I think we will try to see if this does come back in stock. If not we will just have to be extra cautious
Thanks again, my mind is more at rest!!