Monkey Scratch Injury: What You Need to Know About Rabies and Tetanus

Q: Monkey Scratch Injury: What You Need to Know About Rabies and Tetanus

Hello： 1. <br>Although Taiwan is currently considered a rabies-endemic area, the outbreak is limited to wild animals such as ferrets and civets, and the likelihood of monkeys in Taiwan contracting rabies is very low. <br>2. <br>Most injuries from monkey bites primarily require a

Injured by a monkey bite?

Hello Doctor, I was attacked by a wild monkey in Shoushan, Kaohsiung on December 29, resulting in scratches.
The wounds are small; I have two red marks on my shoulder without open wounds but with mild pain, and I suspect I may have a scrape on the back of my hand that did not bleed (I only discovered this later and am unsure if it was from the incident).
I received a tetanus shot on December 30, and due to my fear of getting sick, I paid for the first dose of the rabies vaccine on December 31.
I have a few questions regarding this experience:
1.
I went to a hospital that administers rabies vaccines, and the doctor mentioned that rabies is not prevalent in Taiwan, so vaccination is not necessary.
Does this mean that the monkey is unlikely to have rabies or other diseases?
2.
I have received the tetanus shot and started the rabies vaccination process.
Are there any other diseases or vaccines I should be aware of after being scratched by the monkey?
3.
Assuming there is a virus present, if I complete the entire rabies vaccination series, will the vaccine completely eliminate the virus, or does it merely suppress it? If the antibodies diminish, should I get another shot to prevent the virus from re-emerging and causing illness?
4.
Given the high fatality rate of rabies, I am anxious since I cannot confirm whether the monkey was sick.
Should I be concerned about being scratched by a monkey in Taiwan?
Thank you, Doctor.
I appreciate your help in addressing my concerns and alleviating my anxiety.

YEH, 30~39 year old female. Ask Date: 2024/01/02

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
Although Taiwan is currently considered a rabies-endemic area, the outbreak is limited to wild animals such as ferrets and civets, and the likelihood of monkeys in Taiwan contracting rabies is very low.
2.
Most injuries from monkey bites primarily require a tetanus vaccination, and it is important to monitor the wound for any signs of infection or cellulitis.
3.
The rabies vaccine stimulates the body to produce antibodies against the rabies virus; if there is a true rabies virus infection, the antibodies produced by the body will eliminate the rabies virus.
Even if the antibodies diminish, the rabies virus will not re-emerge.
4.
In Taiwan, there is no need to be overly concerned about contracting rabies from monkey bites, especially since you have already started receiving the rabies vaccine, making the risk of infection extremely low.

Reply Date: 2024/01/02

More Info

When dealing with a monkey scratch injury, particularly in regions where wild monkeys are present, it is crucial to understand the potential risks associated with rabies and other infections. Your experience of being scratched by a wild monkey in Kaohsiung raises several important questions regarding the management of such injuries, especially concerning rabies and tetanus vaccinations.

1. Rabies Risk in Taiwan: The doctor you consulted mentioned that rabies is not prevalent in Taiwan, which is accurate. The rabies virus is primarily transmitted through the bites of infected animals, and while wild monkeys can carry the virus, there have been no documented cases of rabies transmission from monkeys in Taiwan. This does not mean that there is zero risk, but the likelihood is significantly lower compared to regions where rabies is endemic. The absence of rabies cases in monkeys in Taiwan, as stated by the authorities, suggests that the immediate risk of rabies from your encounter is minimal.

2. Tetanus and Other Vaccinations: You have already taken the right step by receiving a tetanus booster. Tetanus is a serious bacterial infection that can occur from wounds, especially if they are contaminated. In addition to tetanus, it is also wise to monitor for signs of infection at the scratch site, such as increased redness, swelling, or discharge. Other diseases that could potentially be transmitted through scratches from animals include bacterial infections, but these are typically manageable with proper wound care and antibiotics if necessary.
3. Effectiveness of Rabies Vaccination: The rabies vaccine is highly effective in preventing the disease if administered promptly after exposure. If you complete the full vaccination series, your body will develop antibodies against the rabies virus, which will provide immunity. The vaccine does not simply suppress the virus; it actively stimulates your immune system to produce antibodies that can neutralize the virus. If you have completed the vaccination series, you should be well protected. However, if you experience any unusual symptoms or if there is a concern about a new exposure, it is advisable to consult a healthcare provider.

4. Anxiety and Monitoring: It is understandable to feel anxious about the possibility of rabies, given its high fatality rate once symptoms appear. However, it is important to remember that the risk of contracting rabies from a monkey scratch in Taiwan is very low. The best course of action is to monitor the scratch for any signs of infection and to maintain open communication with your healthcare provider. If you notice any concerning symptoms, such as fever, headache, or neurological changes, seek medical attention immediately.

In conclusion, while it is essential to take monkey scratches seriously, the risk of rabies in Taiwan is low, especially given your prompt action in receiving the tetanus and rabies vaccinations. Continue to observe the wound and maintain good hygiene practices. If you have any lingering concerns or symptoms, do not hesitate to reach out to a healthcare professional for further evaluation and reassurance. Your health and peace of mind are paramount, and staying informed is the best way to manage your anxiety regarding this incident.

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