Rabies. I have been bitten by a dog in Juarez.

[Mogy]

This happened last Thurs in the evening. I haven't been given any rabies vaccine.
I was advised by the hotel staff to go see a doctor that they have in all of the Similares Pharmacias here.
The bite wound was cleaned by a very young doctor that was in the office in the evening. He told me that rabies is not a problem in Mexico and the issue was risk of infection so he gave me a prescription for 3 injections of antibiotics, 24 hrs apart. He gave me the first injection and I was on my way.
I didn't think much about it because I was trying to track down my motorcycle which had been stolen and I was a bit preoccupied. After I get my motorcycle back I start to investigate rabies. There is lots of information out there that is conflicting.
I didn't follow the schedule for the antibiotics very closely and just got the third one this morning. The more mature doctor told me that I should have gone to the Center of Health that was not far away and gotten a rabies vaccine shot. It would have been better to do it earlier but I have up to 15 days. Tomorrow it will be open.
There is a paper on the internet put out by the Pan American Health Organization that says that Mexico did not have any cases of rabies in humans that was passed to them by dogs between 2013 and 2016. I mentioned this to the doctor and he told me that there were 3 cases in Chihuahua this year. There is lots of info but it doesn't all agree.
The dog did not appear to be sick and took direction from a shop keeper. I haven't been able to track them down. Holiday weekend.
Should I be worried?
Another graph from the University of Glasgow.
[IMG]https://photos.app.goo.gl/p4HMsi3tkfzUdRHK8
[/IMG]

[Mogy]

I was hoping to just put one graph from a larger report.
I did something wrong. The whole report is here:
https://www.google.com/url?q=https:/...Ziu6_FtIUb31-R

[shu...]

wow, that totally sucks.

I'm not a doctor, but this is what I remember from a dog bite incident involving a friend's dog 30 years ago. I would bet it's still the same.

I think that a Doctor here in the USA would advise you to begin Rabies treatment if either:

- the dog did not have a rabies vaccination;

- the dog could not be found.

By the time Rabies symptoms are observed in a human victim, the usual result is death.

I myself would be talking to a Doctor I trusted immediately. (and looking for a clinic that had the proper injections.)

Buena suerte..................shu

[backofbeyond]

The medics in my family say take it seriously as rabies is 100% fatal in humans. Symptoms can take months to appear and by the time they do it's too late. Even if you don't have it do you want to be wondering for the next year whether every ache or pain or thick head is the beginning of the end.

Mexico isn't one of the world's rabies hot spots but without the dog it's better to be safe than sorry. Don't put it off - hours and certainly days count. The doctor you saw may not be that worried but it isn't his life at risk.

[Tomkat]

UK Govt advice is that Mexico is HIGH RISK for rabies, get the shots now.

https://www.gov.uk/government/public...s-by-country#m

[Mogy]

Thanks for all of the replies.
I went for a shot this morning, first in line, but I found out they don't give rabies shots there. I could get one for Tetanus.
I decided to go talk to the Shoe Repair shop owner who was present when I was bitten. He was not the owner of the dog but he assured me that the dog had been vaccinated. I also saw the dog and it looked fine and healthy.
I returned and met the owners of the dog at 4 PM. They went to look for the Rabies Certificate but they're not very organized, something like me. Couldn't find it. I was assured by the mother that both her dogs have been immunized. She has several kids and will not risk having a dog without it's shots.
At this point I am convinced that the dog does not have rabies. Apparently, a rabid dog can only transmit rabies for the last few days of his life.
From this faq page on the Minnesota Health website:
References, Animal Bites and Rabies Risk - Minnesota Dept. of Health

"What are the signs of rabies in cats (or dogs)? My patient is confining a cat that bit her for a 10 day period following the bite. What signs should she be looking for?
An animal that had rabies virus in its saliva at the time of biting someone would develop severe illness or die within 3 to 4 days of the bite. (The 10-day observation period includes a safety factor.) Signs to watch for include loss of appetite, depression, lameness, fever, and neurologic signs such as behavior changes, vocalization, circling, or seizures. If the cat develops any of these signs the patient should contact her veterinarian immediately. If the cat is alive and well 10 days following the bite, then there was no risk of rabies at the time of the bite."

[g6snl]

Holy crap! that kinda makes the worries of "camping or hotel tonight?" seem quite tame.

You need to be 100% sure on this, nothing less.

[Tim Cullis]

I'll echo the comments made above by Shu... Once symptoms appear, death is irreversible.

The proper procedure is intensive washing and scrubbing with soap and water. Then find a source of vaccine as soon as possible.

There's a case a couple of weeks ago of a Moroccan living in the UK who was in Morocco on holiday and was bitten by a cat. He didn't get vaccine and died two weeks later.

A couple of years ago, Peter Buitelaar who runs Bikershome in Morocco underwent a series of injections after being bitten by a cat.

[eurasiaoverland]

It's an interesting question from my point of view.

Looking at it with a level head, it seems the chances of you having contracted rabies are almost negligible; the animal is a known, supervised domestic animal showing no symptoms. I was bitten by a dog in Kazakhstan years ago and since it lived its whole life in a yard, I decided not to worry about it.

On the other hand it's hard to see what you have to lose by getting the follow-up vaccinations; even if it takes a day to get to the capital and a couple of hundred dollars... If it somehow meant ending a long-planned RTW trip I would risk it, but it's hard to imagine that it's really going to impact you in any way more than a minor loss of time / money, so why risk it?

As with everything potentially fatal, it provokes strong reactions but it's a calculated risk; just like having unprotected sex, getting on a bike / in a car etc etc. If we had enough data I'm sure we could calculate that the probability of you getting rabies are probably way lower than you getting killed on your bike riding a few hundred kilometres to the nearest clinic. Hell, riding a bike through Mexico is pretty 'up there' in terms of dangerous leisure activities. But it's easy to protect yourself against the risk of rabies... and as Tim nicely says, death is irreversible.

And just to stir things up a little; here is an interesting account I happened to read a couple of weeks ago about an American girl who contracted rabies, full blown, with no vaccination, and is the only human known to have survived the disease: https://www.scientificamerican.com/a...bies-survivor/


EO

[lightcycle]

In Canada, a course of rabies shots will cost you $750 (about $570USD). And it's not covered under the government's universal healthcare program.

I know, I know. "It's your life!"

But $750 if you're pretty sure the dog doesn't have rabies...

[Mogy]

So I am back at home in Canada, waiting for my shots. I think that eurasiaoverland puts my perspective in words better than I can.
I think that there is a very very small chance that I contacted rabies with the bite and was ready to continue the trip. There was a niggling feeling, though, that I should get something done about it(Cholo?). It wouldn't let me get a proper sleep, only a couple of hours a night, so I decided to get the shots. I could not make any progress getting the shots in Juarez so I am taking a bit of a break from the trip.

[markharf]

There's always a problem assessing low-probability/high consequence risks, which is what's being discussed here. The chances of getting rabies are very slight, but the consequences if you do are severe, i.e., death. If risk = probability x consequence, this is at least a moderate level of risk--perhaps worth spending $750 on.

The other dimension of the problem, specific to low-probability situations, is that 99 times out of 100 (or 999,999 out of a million) nothing happens. You might conclude that, having gotten away with a situation or activity so many times, it must be "safe," or "low risk." That's a fallacy, and it leads to a lot of trouble. No matter how many times I successfully ride without a helmet (or armor, functional brakes or adequate headlight), drive without a seatbelt (or airbags, reinforced door pillars, or crush zone), or [insert your choice of risky activities here: unprotected sex w/ strangers, firecrackers in drought-stricken forests, blithely skiing avalanche slopes, etc.], it's incorrect to conclude that these activities are truly safe.

In fact, I'll never know how unsafe until something really bad happens and I suffer the consequences. The truth is that most of us get away with most of the stupid stuff we do most of the time, but it's a mistake to think this makes us less-than-stupid or renders the risks irrelevant.

Glad you're getting the shots. I'm not sure why your healthcare won't cover the costs, given you're at risk for a fatal disease. Is this true? Or do they not cover the cost preventively, but cover it in response to a possible exposure?

Mark

[shu...]

In my opinion, you made a good choice.

Markharf's got it right regarding situations with a very low probability of occurring but a very serious consequence if it does.

Nothing to regret, just money spent wisely.

..................shu

[Mogy]

Health care in Canada is a provincial responsibility. It's probably different in each province. Alberta Health is covering the cost for the RIG and 4 rabies vaccine shots as well as a Tetanus they say I need.
If I hadn't been bitten I would have had to pay for most travel vaccinations, although I have an extended health care plan through my employer that would help with that.

[markharf]

Ah, that’s what I thought: they won’t pay for you to get rabies vaccinations in advance (preventively), but once you’ve been bitten they’ll pay as a treatment.

Of course you really ought to have had a tetanus shot before going on your trip....plus a few others. I’m assuming your provincial healthcare will pay for routine vaccinations like that one, right?