Should You Get a Rabies Vaccine After a Dog Bite in Taiwan?

Is it necessary to receive a rabies vaccine after being bitten by a dog?

Dear Dr.
Tsai,
I would like to consult you regarding a dog bite incident that occurred recently in Hualien, where I was bitten by a neighbor's dog (it has been two days).
I have already received a tetanus vaccine, but I am still uncertain whether I need to receive the rabies vaccine, as the incubation period for rabies is quite long and the disease is terrifying with no cure.
I am very concerned about what would happen if I were to contract the disease.

In this situation (or in general), do you recommend receiving the rabies vaccine? Does the administration of the rabies vaccine require an application or a visit to a designated medical center? Are the side effects of this vaccine severe? Although Taiwan has not been a rabies-endemic area since 1959, there was a recent case in Hualien involving a visitor from mainland China who died from rabies.
While this was an imported case, is there a possibility of transmission to individuals with geographical connections?
I hope you can take the time to respond, and I would greatly appreciate it.
Wishing everyone health and happiness.
Sincerely,
Linda
November 19, 2002

Linda, 20~29 year old female. Ask Date: 2002/11/19

Dr. Cai Xingzhi reply Surgery

Dear Miss Linda,
In Taiwan, rabies is not considered an endemic area, and there have been no cases of rabies for several decades.
Although there were two reported fatalities this year, both were due to bites from stray dogs from abroad.
The incubation period for rabies typically ranges from 6 days to 6 weeks.
During this time, please observe your dog for any changes (such as unusual behavior, biting, aggression, or signs of illness).
If your dog appears to be fine, it is unlikely to develop rabies.
The symptoms of rabies are caused by the rabies virus infecting the central nervous system.
Early symptoms include fever, headache, anxiety, insomnia, sore throat, and difficulty swallowing (which can be extremely painful).
As the disease progresses, more severe symptoms such as seizures and altered consciousness may occur, ultimately leading to death.
If there are no early symptoms, sudden death is unlikely.
Please take good care of the wound and seek treatment from a licensed surgeon.
If necessary, debridement may be required.
I hope for your swift recovery.
Sincerely,
Director of Surgery, Dr.
Tsai Hsing-Chih

Reply Date: 2002/11/19

More Info

In Taiwan, the risk of rabies transmission from dog bites is relatively low, especially since the country has been rabies-free since 1959. However, there are still important considerations when it comes to rabies vaccination after a dog bite, particularly if the dog is unknown or has not been vaccinated.

1. Assessment of the Dog's Vaccination Status: If the dog that bit you is a pet and has been vaccinated against rabies, the risk of rabies transmission is minimal. In such cases, if the dog is observed for 10 days without showing signs of rabies, you may not need to receive the rabies vaccine. However, if the dog is a stray or its vaccination status is unknown, it is advisable to get the rabies vaccine as a precaution.

2. Timing of Vaccination: Rabies vaccination should ideally be administered as soon as possible after a potential exposure. The rabies virus has a long incubation period, but once symptoms appear, the disease is almost always fatal. Therefore, if you have been bitten and are unsure about the dog's vaccination status, it is better to err on the side of caution and receive the vaccine.

3. Procedure for Vaccination: In Taiwan, rabies vaccines are available at hospitals and clinics. You do not necessarily need to apply for special permission to receive the vaccine, but it is advisable to go to a medical facility where they can assess your situation and provide the appropriate treatment. The rabies vaccination schedule typically involves a series of shots, usually administered on days 0, 3, 7, and sometimes 14, depending on the exposure risk.

4. Side Effects of the Vaccine: The rabies vaccine is generally well-tolerated, with most people experiencing only mild side effects such as soreness at the injection site, mild fever, or headache. Serious side effects are rare. The benefits of vaccination far outweigh the risks, especially considering the potential consequences of contracting rabies.

5. Recent Cases and Public Health: While Taiwan has not had endemic rabies since 1959, there have been isolated cases of rabies in imported animals or travelers. The recent case you mentioned involving a visitor from mainland China highlights the importance of vigilance. However, rabies is not transmitted from person to person, so there is no risk of transmission to you or others in your community from such cases.

In conclusion, if you have been bitten by a dog, especially one of unknown vaccination status, it is prudent to receive the rabies vaccine. Consult with a healthcare provider as soon as possible to discuss your specific situation and receive the appropriate care. Remember, rabies is a preventable disease, and timely vaccination is key to ensuring your safety.

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