Travel Immunisations

Hi,

I am going to be in India for 3 months starting from the 26th March. I start in Mumbai, then Goa for a month. After that, I fly to Delhi, then Rishikesh then Mcloed Ganj and around Himachal Pradesh. My concern is travel immunisations. I was told I need Hepatitus A, Typhoid/Deptheria and Tetanus which is fair enigh. I was also recommended Rabies jabs which is super expensive. I thought is it really worth it? I want to be safe health wise but I don't want to pay an arm and a leg if it is not needed. What are your thoughts on this please?

Mixed opinion, for rural living or remote areas ranging from maybe to for sure (knew someone who got bit in a sugar cane migrant workers camp)..

For general, probably not to maybe. If you are the kind to pet thieving vicious monkeys or a female dog with pups for sure. A stick & a snarl serve real well in my home base where strays are abundant..

On the question of rabies:

Can you avoid all animal contact? It's not just 'stray dogs' - all dogs, cats, monkeys, bats, you name it. Any puncture wound you have is a risk. All an infected animal need do is lick that wound. Talk to the families of 30,000 Indians a year who die of rabies. If you don't take the vaccine before you travel, your plans will be worthless the moment you have that animal contact. It's an easy choice. If you can't afford the vaccine, you can't afford to travel.

Goa has an abundance of semi-stray beach dogs many of which are befriended by tourists. There are stray dogs almost everywhere in India so a tourist could contract rabies from a rabid dog, cat, bat or other mammal, even a camel. I believe visitors often rely upon post contact treatment which has the risk that the vaccine or similar may be unavailable because of shortage or remoteness from a clinic holding the required material.

I read the WHO International travel and health, Rabies and Rabies vaccine web pages just now. The advice in summary is that preventative treatment is a matter of risk management.
The pages are worth reading by an intending India visitor.

Out of how many Indians? Are all of these rich (like foreign tourists) who could afford treatment? Where, urban rural breakdown, do these occur. Nah, use data as a social scientist not like slapping a cow dung patty on the wall of a hut..

There are quite a few threads on the subject of rabies vaccination; I suggest you look at the last few pages (or even just the last few posts) of this: Rabies vaccination - is it worth it?. I would say, you only really need rabies vaccine if you are going to a rural area and / or staying in India long term. As we discussed on the other thread, you can easily and cheaply get the vaccine when you get to India; in Mumbai and Goa, it will be available in every pharmacy for less than 400 (four hundred) rupees per shot, and any doctor can administer it (the doctor might charge another 100 rupees maximum). I notice you did not mention Hep B; that is also expensive, but might not be a bad idea to get if you have not had it for a while (I am not a doctor so this is really just a suggestion).

A strong argument could be made for Hep B over Rabies given the number of accidents that occur..

pre-exposure rabies vaccine (which I got but not before I was in India several times)doesn't mean you don't need to get it if you are bitten, it means you need 2 more shots as soon as you can.

If you don't get the pre-exposure vaccine & you get bitten you need 5 shots of the post-exposure vaccine THE FIRST ONE IMMEDIATELY GIVEN DIRECTLY INTO THE BITE. It's a much more painful and lengthy process. India has this vaccine but it might ruin your trip.

I love animals but never pet or try to engage with them when traveling. The real problem isn't the dog or cat or monkey you annoy, most rabid animals are unpredicable & hard to avoid if they come at you (especially monkeys or bats).

I think it's worth the expense but as I said, I made several trips without any problems, as most people do, before I got the pre-exposure vaccine.

also consider Japanese Encephalitis shots - expensive, but it's deadly, and only needs a mosquito bite.

(Note to self: think about rabies shot)

AndyD 8-)#

Another bother is mosquito carried chikungunya which is nasty enough and has been around in South India. Vaccines are still experimental. Best to stay at home.

On one of the threads was a very interesting post about inexpexpensive Rabies shots at a reputable clinic in Bangkok. Also, in India there was some mention of new style Rabies shots becoming available. Might want to check out the threads suggested above. JE is an interesting case for cost benefit analysis. Its only slightly more effective than 50:50 & of course expensive (time period effective?). Of course, getting it is pretty nasty indeed. With my luck I would catch Chikungunya & croak..

We were told that a full course of JE shots (3 or 4 depending on gap) gives around 90% protection (and there is no effective treatment if you get the disease, I thought that was when the 50:50 came in).

AndyD 8-)#

Could be so! As my boy says, don't ask him questions, he is not a real doctor..