We visited Cambodia in March of 2018. During our trip in the southern town of Kep, I received a small bite on my hand from a healthy looking dog which barely broke the skin. At first, this didn’t seem like much of a risk, but after researching rabies in Cambodia, we found that up to 50% of dogs carry the virus, making immediate treatment essential. This post explains the process we followed to obtain a series of rabies vaccinations in Cambodia.
Rabies is a virus which is spread through saliva or central nervous system tissue from animal to human. There are high rates in bats and raccoons, but spread to humans is more common from cats and dogs due to frequency of contact. Like the rest of Southeast Asia, Cambodia does not have a widespread rabies vaccination program or even routine veterinary care for dogs and cats, meaning you should think twice about contact with animals in this country.
If you’ve been bitten, the first and immediate thing to do is wash copiously with soap and water for 10-15 minutes. You should also use alcohol hand sanitizer afterwards or before until you are able to wash throughly. Rabies care is essential, it takes only days or weeks to become symptomatic after a bite. 100% of rabies infections are fatal in humans once symptoms develop! The only prevention is post-exposure prophylaxis, otherwise known as after bite vaccinations. You will need to be seen by a doctor as soon as possible to determine if rabies vaccines are needed.
There is one dedicated rabies center in Cambodia, The Institut Pasteur de Cambodge Rabies Vaccination Center which is located in Phnom Penh. They evaluate for the necessity of vaccines after bites and have a subsidized program where a series of three shots costs just $15. This service is available for locals and travelers in Cambodia.
After I was bitten, we got a bus to Phnom Penh to visit the Institut Pasteur as soon as possible. The center is open from 7:00am to 5:00pm weekdays and 7:00am to 11:30am on Saturday. On my first visit, I had to fill out the patient intake form including information relating to the bite incident. English versions are available from the window. It is quite busy in the mornings and I was the 70th person treated that day despite arriving at opening hour. Although, it was much less busy when I visited in the afternoons.
After my intake form was complete, I waited to be seen by a doctor who reviewed the form and asked follow up questions. It was determined that I required rabies vaccines even though it was a minor bite. They called my name after paperwork input and gave me a packet which included: an immunization record, name stickers and a receipt. I then got a number and waited my turn to receive the vaccine, which was given just under the skin of both upper arms. For subsequent visits I simply brought the paperwork to the check in desk on each required day. These visits were much quicker, typically lasting only a few minutes.
The first shot needed to be given within 24 hour of the bite, or as soon as possible afterwards, which for me was closer to 48 hours. Depending on the exposure and the health of the dog after 10 days, there are between three and five shots required in the series. My second shot was given on the third day following the original, and the third shot on the seventh day after the original (first shot is Day 0, second shot is Day 3, third shot is Day 7). The dog needed to be under observation during this time. Fortunately in my case, the dog lived at our hotel in Kep, so the clinic called on our behalf and was able to confirm ongoing health. Since it was still alive and exhibiting no strange behavior after the 10th day following my bite, only three shots were needed. If it had developed symptoms of rabies during that time, two additional booster shots would have been administered later in the month (Day 14 and Day 28).
We had originally planned on leaving Cambodia during this time, but had to stay longer to ensure completion of the full series. We traveled to neighboring towns in between appointments to fully utilize this time. Originally our research showed that rabies vaccines were available only in Phnom Penh, but later found that many local clinics around Cambodia keep shots on hand. You can go to any clinic or pharmacy and ask about the rabies vaccine and its cost, although communication can be challenging (Google translate is mostly worthless in this country). We did manage to communicate through charades and online pictures of dogs. We ultimately decided to get all shots at the main clinic in Phnom Penh to ensure quality of care, but it was nice to know that there are other options if necessary.
That was my experience being vaccinated for rabies in Cambodia. Feel free to Contact Us if you need any specific information about my experience with treatment in Phnom Penh. Also, be sure to check out this article on rabies from the Phnom Penh Post and the CDC Website for more information. If you are going to be traveling to high risk areas extensively, it may be wise to get pre-exposure vaccinations before your travel. Talk to you travel doctor to discuss your risks as this will reduce the number of rabies vaccines needed after a bite.
You can read more about our trip in Cambodia on our Travel Site. Also take a look at other posts from our adventures including our trek through Nepal, camper van-cation around Tasmania and misadventures in India. They are sure to inspire your lust for travel!
Do you need long term travel in your future? Check out our Planning Page where you can learn how to prepare for a lengthy trip, see how to never check your bags on planes, find out about travel security and make sense of travel insurance, amongst others.