Rabies is a viral disease which affects the central nervous system, essentially the brain and spinal cord and is transmitted from infected mammals to humans. Once symptoms appear in humans who have not been vaccinated, the disease is invariably fatal. The good news for my friend, and others, is there have been no human deaths from rabies in Phuket for over 20 years.

All mammals, including humans are susceptible to rabies. In Phuket, cats, dogs and monkeys are the most likely mammal to contract and pass on the disease to humans, and it’s important to understand that humans can only contract rabies through exposure to a rabid animal. Exposure is nearly always through a bite, but rabies can also be transmitted if a rabid animal scratches a person or if its saliva comes into contact with broken skin.

To decrease the likelihood of getting rabies, it's best to minimise any exposure to animals that may have the disease – and this certainly includes any wild animal, including stray dogs and cats which are acting abnormally. The Thai authorities are also reducing the risk by vaccinating dogs and cats, and if you have a pet, you should ensure that it has been vaccinated. Keeping exotic or wild animals as pets should be discouraged, as is having your photo taken with wild animals on Bangla Road and at other tourist areas.

If you are bitten, or believe you've been exposed, immediately clean the area with lots of soap and water and see a doctor as soon as possible. It's likely that the doctor will recommend a course of rabies injections, possibly including a vaccine and Rabies Immune Globulin, depending on whether you've been vaccinated before. These injections are not as painful as common myth has led some people to believe, but they are expensive. You'll also need to attend a hospital or clinic on five occasions, as the course requires five injections over a 28 day period.

It's very rare in Phuket for the observation or testing of an animal to rule out the possibility of rabies. In some other countries, authorities may catch the animal and keep it under observation to see if it develops rabies and only then do the bite victims get their rabies shots. Another option is to kill the animal and examine the brain tissue to eliminate or confirm rabies. Again this is rarely done here in Phuket and you're more likely to just get the rabies shots.

If you get rabies, the early symptoms include irritability, headache, fever and sometimes itching or pain at the site of exposure. The disease eventually progresses to spasms of the throat and the muscles used for breathing, convulsions, delirium, paralysis and eventually death. Remember, by the time any symptoms appear, rabies cannot be successfully treated. Usually the time between exposure and the onset of symptoms is two to ten weeks, although much longer time periods have been reported.

There's also a vaccine that's given to people who are at risk of getting rabies, for example veterinarians and those who work with wild animals. In some countries being vaccinated for rabies before coming to Thailand is recommended by health officials, although this is not really necessary, unless you intend to work with wild animals.

It’s good to know that rabies is not a serious disease in Phuket, but the possibilities of contracting the disease still exist. It’s also nice to know that exposure to a rabid animal does not always result in rabies. If preventive treatment is obtained promptly following a rabies exposure, nearly all cases of rabies will be prevented. However, if preventive treatment is not administered and signs of rabies develop, the disease is invariably fatal. Most doctors here in Phuket therefore recommend that all bites from animals where you're unsure if they've been vaccinated should be evaluated by a qualified expert or doctor.

Peter Davison is the Manager International Services
at Phuket International Hospital.
Tel: +66 (0)76 249400. Email: info@phuketinternationalhospital.com