Travel Reference
In-Depth Information
I'vetalkedtoseveralpeopleaboutthisdilemma.Whatisthelikelihoodofaninfec-
tedanimalsurvivinglongenoughtobiteahuman?Lemurstameenoughtobiteatour-
istarefoundonlyinprivatereserveswheredogsareexcluded.Evenifarabiddogdid
get into the reserve would it be able to catch a lemur? And if it did catch one, would
it inflict a bite which infected the animal but didn't kill it? The likelihood seems very
small.
Alison Jolly, who has been studying lemurs for 50 years, says: 'I have never heard
of anyone catching rabies from a lemur. I think that the chances are so small that I
wouldn'tdreamofgettingrabiesshotsafteralemurbite-exceptinonecircumstance.
Ifthelemurwashand-raised,eitheracurrentpetorapetreleasedintothewild,itmay
attack a human without provocation. In that case you get a deep bite with no warning.
It probably is just misguided “normal” behaviour, treating you as one of its own spe-
cies, but you can't be sure, so I would get shots. A bite in self-defence, though, isn't
worth bothering about.'
DrJanecomments:'Ihavenowbeeninvolvedinquiteanumberofcasesoftourists
whohavebeenbittenoverseasandthenarebadlyscaredbytheprospectofthedisease
and finding clinical services abroad. Increasingly I encourage travellers to pay out for
the jabs before they travel.'
If you have not had pre-exposure rabies vaccine then you need to get rabies immuno-
globulin and five doses of a modern rabies vaccine. This may not be easy to get in Mada-
gascar, even in Tana, so the advice would be to evacuate to South Africa. If you have had
all three doses of pre-exposure vaccine then you should only need two more given on day
zero and three days later. Ensure that the vaccine being given is either Verocell, HDCV
or PCEC. The old brain-derived vaccines are not safe to have and should be avoided. You
should also take your own syringes and needles to ensure that sterile equipment is being
used. If you are unsure then again you may need to evacuate.
Reputabletravelhealthinsurersshouldbeabletoadvisewherethenearestsourceofsafe
vaccine and immune globulin might be. Sometimes embassies can help with such informa-
tion.
INFECTION AND TRIVIAL BREAKS IN THE SKIN
The skin is very prone to in-
fection in hot, moist climates: even the smallest nick or graze allows bacteria to enter and
cause problems. Mosquito bites - especially if you scratch them - are a common route of
infection, so apply a cream to reduce the itching. White toothpaste helps if you are stuck
for anything better. Cover any wounds, especially oozing ones, so that flies don't snack on
them. Antiseptic creams are not advised, since they keep the wounds moist and this en-
couragesfurtherinfection.Apowerfulantiseptic,whichalsodriesoutmoistwounds,ispo-
tassium permanganate crystals dissolved in water. Another alternative is diluted tincture of
