Chile Forum

Statistically speaking, it is the little things that will get you in Chile. Most of the time it is the same little things that would get you back home (e.g. car accidents, a paper cut).

Think about where that foreign doctor gets his information to make a decision about recommending a rabies shot or anything else for Chile. It is likely something along this following chain or similar.

Chile reports to the World Health Organization or similar international body. It reports figures that likely takes Chile a year or two to collect and report (perhaps longer), the World Health organization takes another year or two to collect and report (perhaps even longer), then the governments gets those stats that they only compile every so many years (because they are doing this for the whole world) and it is placed on a list likely determined by relative threat when compared to other countries, they then release a recommendations through whatever government bureaucratic channels, those then likely go through various rounds of debate in the medical journals / universities / research labs, and then back to the government committees (this likely goes through the political and scientific wash cycle several times). The final recommendations then gets trickled out through things like the U.S. state department, with a required political spin attached to insure no one in the government is held responsible for not being sufficiently aggressive in their recommendations and at the same time important allies in whatever the issue of the day are will not be offended by impacting their tourism industry / trade agreements / whatever. Don't forget all this will be properly colored by the highly objective assistance of the vaccine manufactures on the one hand, and various government tourism groups for each country on the other. Most likely one of those things the Chilean government fails to properly appreciate is the economic impact on the tourism industry and does not allocate resources to keep up the lobby around the World (they hardly do any tourism promotion at all of any sort).

Finally, about 5-8 years after a actual case of rabies is detected in Chile (and chances are up to 10 years or more), that info is published and trickles down to your local doctor in whatever foreign country, that not having encountering very often people on their way to Chile or even South America for that matter, goes and looks it up in his dusty two year old medical journal or very stale government pamphlet that has exactly one sentence or less recommending that you be vaccinated for rabies in Chile (likely just a check box on a table of countries). So, yes, your doctor is most likely not an expert on rabies or any other thing in Chile. I am sure he knows what Rabies is, how to treat it, how diagnose it; but, unless he is an epidemiologist specializing in rabies in Chile as a hobby, he likely has little more information about the statistical prevalence of rabies in Chile, effectiveness of vaccine in Chile, availability, health care system, and so on than we do as laymen trying to make a basic decision about if we should get the shot or not (assuming someone that knows nothing about Chile to start with).

Here is the flip side of this hysteria. I walk in to the Temuco tourism office of the Chilean government. Sitting on the front desk, the first thing you see, is a big expensive pamphlet warning tourist about SARS. How very nice they are concerned about my health. Just one problem. They are still there 10 years after the SARS outbreak in China. As a foreigner the first thing that would pop in to my mind is, "is there a SARS problem that is not being reported internationally in Chile"? I want to kick the director of the Chielan tourism office SENTUR in the head for stupidity (long list of other reasons also).

admin wrote:He is infected with chichia. There seems to be an outbreak around every sept 18th.

Ok. Then protect your ears, Chookcha shall speak now.

Any answer to the original question (that was asked by the OP) is wrong, no matter what the "answer" would be. For the process of our "trying to make a basic decision" is nothing but illusion. Whether your doctor is an expert, or they are not at all, the very word "expert" is the wrong word.

When the question arises in your mind, the "question", as it really is, must be clearly seen. When the "answer" is arrived at, the rightness of it must be directly known. If you feel that what you "do" when you "think" about the problem is "the real process of your own thinking" then without the right understanding of what such "thinking" is, that "feeling" is wrong.

Why is preventing kids from managing nuclear power stations, or plumbers from driving passenger aircraft considered good? For that same reason, preventing people from "making a basic decision" based on the wrong state of their mind would be just right.

Do vaccination. Don't do vaccination. Ask an expert. Ask an astrologist. Jump up and down. Stop doing anything. Bite your dog. Touch the Moon. Dance on your table. Pee your pants. Learn medicine. Pray. Cry. Sit. Stay. Run. Say, "haaaa!.."

Any answer to the original question (that was asked by the OP) is wrong. Anyway.

The chicha must be working its way out of your system.

Thanks for all the replies! Admin, for the comprehesive behind-the-scenes stuff and AussieMum and Maxine for your experiences. Maxine, your experience, coincidental or not, fits in with what I've heard about side-effects etc. Rune, you've totally lost me. Again.

I think we'll hold on getting the shots done, and if we go on a big trip anywhere very very remote possibly think about getting them done when we're in Chile, and only then.

I'm really excited rather than scared about moving to Chile - don't worry, I don't perceive it as some backward end of the world country. I just like to be as organised and prepared as possible because it is a pretty big move. So thanks for reassuring me and getting that item off my list! I guess the £120 each for the vaccinations will add nicely to our Chile "cushion" account.

I was bitten by a stray dog here in Chile and was advised to do the post-exposure shots. I got the first in the emergency room of the clinic I went to after being bitten. For the rest, they told me to go to the vaccine nurse at the consultorio in my municipality and it would be free of cost. I went here in La Reina. As I was told, they did not charge me and I never had to wait more than 5 minutes.

120 pounds?

That will buy a whole lot of chicha, and you will not care that you got bit. Although you might still foam at the mouth, it just will not be the rabies fault.

I have had the rabies vaccination, and it was no big deal. I had the worst reaction of anyone in my group, and all it was was a tickle in the throat, like maybe I would come down with the flu in a day or two (and never did).

There is a lot of talk about all the stray dogs in Chile. If they are strays, they probably aren't vaccinated against rabies, and if one bites you, there isn't much chance that you can identify and isolate it for observation.

I wouldn't consider having my dog in Chile without a rabies vaccination. I can't see anything wrong with a human having one as a precaution.

The after-bite series of anti-rabies serum is also no big deal. The "painful shot" scare is just an old wife's tale intended, I suppose, to frighten children. The series is quite expensive, but if you can get the shots for free in Chile, that certainly makes it easier.

I've been following this thread with some interest, I don't remember rabies ever being mentioned when I went to the county health department for my vaccinations prior to my trip to Brazil, and later when I was first planning for Chile. It might have been on the CDC information sheet I received, but if it was I glanced over it.

Out of curiosity, I decided to see what the current official recommendation was for the U.S. and the U.K.

Centers for Disease Control wrote:Rabies vaccination is only recommended for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. These travelers include wildlife professionals, researchers, veterinarians, or adventure travelers visiting areas where bats, carnivores, and other mammals are commonly found.

Sounds pretty reasonable, especially for a country that's at the mercy of BIG PHARMA.

National Travel Health Network and Centre wrote:Transmission may occur following contact with the saliva from an infected wild or domestic animal (including bats), most often via a bite or lick to an open wound. Risk of exposure is increased by type of activity (e.g. running, cycling), occupation (e.g. veterinarians) and longer duration of stay. Children are at increased risk as they are less likely to avoid contact with animals and to report a bite or lick.
....
Pre-exposure vaccination should be given to adults and children who are:
* at risk of rabies (see above)
* travelling to remote areas where medical care is not readily available.

So... if you leave the house, technically you could be at risk if there are animals around, so you should get vaccinated.

As someone who doesn't work with animals and doesn't plan to travel to areas where I'm days from medical help, I'm personally not too worried about it. Being from rural Illinois, I imagine I'm more likely to cross paths with an infected animal visiting my parents than I am here. There are certain things that I chose to vaccinate/immunize for - Hepatitis and Tetanus to name a couple - not because I plan to put myself at risk, but because it makes sense in a sort of cost-benefit way (Hepatitis, I'm looking at you especially).

I use to catch bats when I was a kid in a butterfly net at night in MN. I knew to handle them with thick pair of rubber gloves mostly because they are kind of freaky looking and have teeth. I knew they had a reputation for having rabies even when I was 7 years old (everyone was aware of rabies where I lived), but never worried much about it.

In the remote remote parts of the Patagonia, where you are say a couple days from a trauma center routine surgery should be of concern to you from something like a bad fall or whatever. Getting rabies treatments at the local government clinics or hospitals is likely one of the few things they are setup to handle, even at the smallest postage stamp size town. Personally I can not think of a place in Chile right off hand that you would not be able to get medical treatment for something like that within 24 hours. Perhaps if you where like a 2 or 3 day horseback ride in to the mountains or something to start with. If you are within a day of road, you are basically within a day of a doctor.

Oh, and LOL:

maxine wrote:When we got to Chile and I took my son for his 12mnth vacinations I asked the doctor when my son was supposed to have his rabies and typhoid vaccine. He got quite offended and said there was no typhoid in Chile and that as far as the rabies vaccination went you have to see if the animal that bit you gets the symptoms after a week and if the animal is ok then you are ok, if not you get a shot.

According to Johns Hopkins, Typhoid remains endemic in rural parts of Chile (not sure if they're talking just outside the cities, or the far far off places). Interestingly enough, before the mid '80s, Typhoid was much worse in Santiago than it was in rural areas. Even though they got that under control, as late as 1991 Chile was still seeing infection rates as high as 0.1% per year. It was roughly at this point that Chile took heavy public sanitation measures in Santiago to prevent Cholera, which had the side effect of reducing typhoid. The most recent numbers I've seen for typhoid incidence is 7 in 100000 per year (2007 or 2008?).

I don't worry too much about it because I'm careful about how I prepare my food and what I eat in the streets, but I don't see how someone can claim that there's no typhoid. I'd like to think that there was just a simple communication breakdown; however, I've seen doctors here say and do some pretty questionable things.

The reason people aren't vaccinated against rabies is that people are supposed to be smart enough to realize when they've been bitten by an animal and seek treatment.

With the majority of other diseases, you have no way of knowing when you are exposed. Therefore preventitive vaccination is more important. You wouldn't know when to seek treatment for exposure until symptoms start.

By the way, if you wait until the symptoms of rabies start, you are soon dead. The death part isn't optional.

The system to prevent rabies in the USA is intense and very well developed. It's just that most people don't know it is there unless they are exposed.

oregon woodsmoke wrote:
By the way, if you wait until the symptoms of rabies start, you are soon dead. The death part isn't optional.

It is important to get treatment ASAP but the incubation period for rabies is 1-3 months which gives you plenty of time even in Patagonia to find a facility with the treatment on hand. And thank god the old 20 shots in the stomach is a thing of the past, now it is about six shots (in the butt), a few days apart, the first being the Vaccine.
rabies in Chile appears very rare and this articl;e states it is controlled in Dogs. Hmmm
http://www.cdc.gov/ncidod/eid/vol8no1/01-0108.htm