Rabies

Most Americans only know about rabies because they have to get their dogs and cats rabies shots every year. In the U.S., rabies shots are required for dogs plus you have to register that your dog has received this shot (or at least in Illinois you have to).

After we moved to China last year, I was at a couple of different presentations where doctors were speaking. These doctors were strongly encouraging and recommending that people living in China also be vaccinated against rabies. I didn't even know that this was possible. The only thing I remember ever hearing about people getting rabies shots were after they were bitten by an animal, and it was unclear whether the animal had received it's annual rabies shots. I think the thing I always heard was that then the person would have to receive shots into their stomach after the bite.

In China, the government has implemented not only the one child per couple policy, but it has also implemented the one dog per household policy. The point of this is that if only one dog was owned then the owners would be able to afford the rabies shot for the dog.

Now, I lived in Beijing for 9 months. During this time, I don't ever recall seeing a stray dog. There would occasionally be a dog off of a leash. I am sure that in more rural areas of China there are plenty of stray dogs. The report I could easily find on the internet reported that there were over 2500 cases of human rabies in China in 2004. Anyway, I started having the thought that maybe S and I should get the human rabies vaccine. Some of our friends did the series of 3 shots in Beijing. I decided to see if we could get it back in the U.S. I checked when we were there in May and found out that the easiest place to get the set of shots is through the local public health department.

Well, now I am living in India. There are stray dogs everywhere here. Hundreds, thousands of them in Chennai alone. The few times that S and I have went out walking to the beach, we probably have encountered around 20 to 30 stray dogs each time. The dogs pretty much stay away from us. Nevertheless, I have already determined that we were going to get the rabies shots when we were in Illinois in December. The shots are very expensive. Even through the public health department, which only charges $10 to administer each shot, the shots are around $175 each. Multiply this times six (3 for me, 3 for S), and the cost is over $1000. I need to check with our insurance company to see if we can get this covered. Either way, we are going through with the shots. We will be in the U.S. just enough days to be able to receive all three shots.

Now after receiving these shots, we are not totally protected from rabies if a dog bites us. We would still have to go receive medical treatment of two additional shots. However, without these pre-exposure shots, if we were to be bit, we would have to receive 5 shots. I think after living here in India for almost 5 months now, I will feel a little better having had the pre-exposure shots.

Yesterday, our company had a panel of doctors from the big hospitals and clinics here in Chennai talk to us ISEs. I honestly thought the entire morning felt like I was sitting through health class again. Most of the topics covered were about things that we already know about (plus a lot of the details and facts about health they provided were not the same as what we have been taught in the U.S.). I wish they would have covered topics more relevant to us being foreigners in this country. Anyway, I had hoped the topic of rabies would be brought up. It was. They told us if we were bitten to wash the bite area with soap and water and to seek medical treatment to receive the 5 shots. I asked about pre-exposure shots for humans. The answer I received was that they only recommend these shots for veterinarians and zookeepers. The general public is not at a high risk of rabies exposure like these people are. Hello? Have you been outside? Have you seen the stray dogs everywhere?

So, this morning, I decide to do a little more research into whether or not we should receive the rabies vaccination. I visit the Center for Disease Control website. Sure enough, we fall into the category of "infrequent" risk category. Basically what this means is that we are at a greater risk than the general population for being exposed to rabies. The general population falls into the "rare" risk category. Because we are spending a lot of time in India, we are bumped up to the "infrequent" category (this is in my opinion on the way I read the information). For this category we fall into, it is recommended that we receive pre-exposure immunizations for rabies. Please note that small children in India are at an even higher risk of being exposed to rabies, because they often times will go up to dogs unknowingly, be bitten, and not report the bite to their parents.

Anyway, I decide to also do a little research on just how many human rabies cases are in India every year. From the few different websites I checked out, I gather that there are between 20,000 to 30,000 cases of human rabies every year in India. This actually may be a low number because I guess India does not require that cases be reported. Another website I read estimated that 1 person in India dies every 30 minutes due to rabies. No one really knows what the exact number are here. The one constant fact I did find though was that India by far has the most cases of human rabies than any other country. No other country even comes close to the numbers India reports.

So, what are we going to do? S and I are definitely going forward with getting the rabies shots when we are in the U.S. It'll give me a little piece of mind knowing we have had these shots when we are out and about with the stray dogs everywhere here.