Rabies Risk: Indirect Contact and Safety in Taiwan

Rabies indirect contact

Hello Dr.
Chen: First of all, I would like to apologize for not knowing that repeated questions would lead to data deletion! I did not mean to do so, and I am truly sorry.
I sincerely seek your guidance on the following: 1.
According to the Centers for Disease Control and Prevention and National Taiwan University Hospital's travel education, Taiwan is not considered a rabies-endemic area.
Therefore, is it true that if someone is bitten by a local dog or cat in Taiwan, they do not need to receive the rabies vaccine? 2.
Can rabies be transmitted through indirect contact? I touched something that had been licked by a stray dog with my hand, which had no wounds, and then used the same hand to rub my eyes and touch my lips, which were somewhat chapped.
(The time between the dog licking the object and my rubbing my eyes and touching my lips was about three to five minutes.) Is there a concern for infection through this indirect and then indirect contact? 3.
Today is already the fourth day, and I saw this group of stray dogs again.
They all appear healthy and do not show any symptoms of rabies as described by experts.
Can I feel reassured now? I know Taiwan is not a rabies-endemic area, so I have no concerns in this regard, but I have obsessive-compulsive disorder, and seeing dogs makes me think of rabies.
I have been living in great distress these past few days and have thoughts of wanting to end it all.
Doctor, I earnestly request your response to my many seemingly foolish questions.
Thank you, thank you...

Lin Tai Tai, 40~49 year old female. Ask Date: 2013/03/08

Dr. Chen Bozhang reply Family Medicine

The letter mentions the issue of contact with stray dogs in Taiwan.
Currently, Taiwan is not an area endemic to rabies, so there is no need to administer rabies vaccinations for bites from stray dogs, stray cats, or other wild animals.
However, if bitten by a dog, the animal's mouth can harbor various bacteria that may cause localized infections, especially in individuals with compromised immune systems.
Therefore, if bitten, it is advisable to seek medical attention for wound care.
The physician may prescribe a tetanus vaccine and oral antibiotics as needed.
You asked whether touching objects licked by stray dogs could transmit rabies.
The rabies virus is present in the saliva of infected animals; however, if your hands are unbroken, the virus will not enter your body and cause infection.
Just ensure proper hand hygiene.
If there are any wounds, it is important to disinfect the area and consult a healthcare provider to assess the risk of infection.
Please do not overly worry about this matter.
For any questions regarding rabies, you can refer to the Centers for Disease Control website or contact the 1922 epidemic prevention hotline for inquiries.

Reply Date: 2013/03/08

More Info

Dear Patient,
Thank you for your thoughtful questions regarding rabies risk and safety in Taiwan. I understand your concerns, especially given the anxiety surrounding rabies and its transmission. Let’s address your questions one by one.

1. Rabies Risk in Taiwan: According to the Centers for Disease Control (CDC) in Taiwan and various health authorities, Taiwan is not classified as a rabies-endemic area for domestic animals. This means that the risk of rabies transmission from local dogs and cats is significantly lower compared to regions where rabies is prevalent. However, it is important to note that rabies can still occur in wildlife, particularly in certain areas of Taiwan. If you are bitten or scratched by an animal that is suspected to be rabid, it is crucial to seek medical attention immediately and discuss the need for rabies post-exposure prophylaxis (PEP).

2. Indirect Contact Transmission: Rabies is primarily transmitted through the saliva of an infected animal, typically via bites. The rabies virus does not survive long outside of a host, especially not in open air. If you touched an object that a stray dog licked, the risk of transmission is extremely low, especially if there were no open wounds on your hands. The virus cannot survive for long periods outside of a host, and the time frame you mentioned (three to five minutes) is generally not sufficient for any viable virus to remain infectious. Additionally, rubbing your eyes or touching your lips with dry skin does not pose a significant risk, as the virus would likely not be present in a transmissible form.

3. Observing Stray Dogs: Seeing stray dogs that appear healthy does provide some reassurance, but it is always wise to exercise caution. If the dogs do not show any signs of illness (such as aggression, excessive salivation, or neurological symptoms), the likelihood of them being rabid is low. However, it is essential to avoid direct contact with stray animals, as they can carry other diseases and pose risks beyond rabies.

Your feelings of anxiety are completely understandable, especially if you have obsessive-compulsive tendencies regarding health and safety. It is important to remember that while rabies is a serious disease, the actual risk of contracting it through indirect contact in Taiwan is very low. If you find that your anxiety is affecting your daily life, it may be beneficial to speak with a mental health professional who can help you manage these feelings.

In summary, while rabies is a serious concern, the risk of transmission through indirect contact in Taiwan is minimal. Continue to practice good hygiene, avoid contact with stray animals, and seek medical advice if you have any concerns about potential exposure. Your health and peace of mind are important, and I encourage you to reach out for support if needed.

Stay safe and take care.

Best regards,
Doctor Q&A Teams
[Your Title]

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