Rabies Vaccination in Patong, Phuket: 24/7 PEP, PrEP and Immunoglobulin
Same-day post-exposure shots after dog, cat, monkey or bat bites, pre-travel two-dose pre-exposure courses, and rabies immunoglobulin coordination. Walk-in clinic or hotel-room visit, day or night. Clinically reviewed by the Doctor Patong Takecare Clinic medical team.
WhatsApp now, start PEP today | Call +66 81 718 9080 | Find the clinic on Google Maps
Phuket has a large free-roaming dog and cat population, busy monkey viewpoints at Monkey Hill and Phromthep Cape, and bat caves on several islands, so animal exposures are one of the most common reasons travellers come to see us. The encouraging part is that rabies is fully preventable when treatment starts in the first 24 to 72 hours, and we stock WHO-prequalified vaccines and coordinate immunoglobulin supply locally so no one waits.
How rabies is transmitted and why time matters
Rabies is a viral encephalitis carried in the saliva of infected mammals, most often dogs in Thailand, but also cats, monkeys and bats. The virus enters through a bite, a scratch that breaks the skin, or saliva contact with mucous membranes or open wounds. From the wound site it travels slowly along peripheral nerves toward the brain, which is why the incubation period is typically one to three months but can be as short as a week for bites on the face or hands. Once the virus reaches the brain and symptoms of agitation, hydrophobia, paralysis and confusion appear, rabies is essentially 100 percent fatal. The whole logic of post-exposure prophylaxis (PEP) is to vaccinate during that quiet incubation window so the immune system clears the virus before it ever reaches the brain. This is why coming in the same day, even for a small monkey scratch on Monkey Hill, is the safe choice.
What we provide: PEP, PrEP, immunoglobulin and wound care
For people who have never had rabies vaccine before, the standard WHO intramuscular Essen schedule is four doses on days 0, 3, 7 and 14, with a fifth dose on day 28 for anyone immunocompromised. We also offer the updated WHO 2018 intradermal Thai Red Cross 2-2-2-0-2 regimen, which compresses dosing into three visits over one week and is the protocol most often used across Thailand. Both regimens are equally protective when followed correctly. For patients who already had a pre-exposure course at home, treatment is much simpler: two booster doses on days 0 and 3, and no immunoglobulin needed. Pre-exposure prophylaxis (PrEP) for travellers planning longer stays, scooter trips, jungle treks, cave visits or work with animals is now two doses given seven days apart (the 2018 WHO schedule replaced the older three-dose course). Rabies immunoglobulin (RIG) gives passive protection at the wound itself while the vaccine takes effect, and is required for category III bites in anyone not previously vaccinated. We use human RIG at 20 IU per kg or equine RIG at 40 IU per kg, infiltrated into and around the wound with any leftover volume given intramuscularly at a distant site. RIG is sometimes scarce in Phuket, and the clinic coordinates with hospital pharmacies and provincial supply to source it on the same day. We stock Verorab (purified Vero cell, Sanofi), Speeda and Rabipur, all WHO-prequalified. Pregnancy and breastfeeding are not contraindications. Alongside the shots we clean and irrigate the wound, give a tetanus booster if due, prescribe antibiotic prophylaxis for bite wounds (typically co-amoxiclav), and book all follow-up doses by WhatsApp reminder.
WHO bite categories and what each one needs
| WHO category | Exposure type | Treatment |
|---|---|---|
| Category I | Touching or feeding an animal, licks on intact skin. | No PEP needed if skin is genuinely intact. Wash anyway. |
| Category II | Nibbling on uncovered skin, minor scratches or abrasions without bleeding. | Wound wash plus full vaccine course. No immunoglobulin. |
| Category III | Single or multiple transdermal bites, scratches that draw blood, saliva on mucous membranes or broken skin, all bat exposures. | Wound wash plus full vaccine course plus rabies immunoglobulin (if not previously vaccinated). |
| Previously vaccinated, any category | Any new exposure in someone who completed a PrEP or PEP course before. | Two booster doses on days 0 and 3 only. No immunoglobulin needed. |
When to see a doctor
Any bite, scratch that breaks the skin, or saliva contact from a mammal in Thailand is a reason to come in the same day, even if the wound looks trivial and the animal looked healthy. The healthy-looking animal rule matters: a dog or cat that bites can be observed for 10 days, and if it remains well, PEP can sometimes be stopped, but starting treatment first is always safer because rabies is fatal once symptoms appear. Bat exposures are a special case: any direct contact, even without an obvious bite, is treated as category III because bat teeth can break skin without leaving a visible mark. Monkey bites and scratches from the macaques at Monkey Hill or temple sites also need full PEP.
Any bite from a dog, cat, monkey or bat. Any scratch that bled. Saliva on broken skin, eyes, nose or mouth. Wound on the face, head, hand or genitals (shorter incubation, treat urgently). Deep, multiple or large bites. The animal was acting strangely (excessive drooling, aggression, paralysis, unprovoked attack). The animal cannot be observed because it ran away or was wild. You woke up with a bat in the room, even without a remembered bite. You are immunocompromised, pregnant or have a small child who was bitten. These exposures need wound irrigation, vaccination and often immunoglobulin within hours, not days.
You are not sure whether the exposure counts, whether you finished a previous rabies course, or whether you need immunoglobulin. A five-minute assessment will categorise the bite, check your records and start the right schedule. We can also coordinate immunoglobulin supply if your wound is category III. WhatsApp +66 95 073 5550 for a same-day appointment or hotel-room visit.
Prevention and early self-care
The most important first-aid step after any animal exposure is wound washing, and it is the one most travellers underdo. Wash the bite, scratch or saliva contact site under running water with plenty of soap for a full 15 minutes by the clock. Soap inactivates the rabies virus on contact, and thorough irrigation alone has been shown to substantially reduce risk before vaccine is given. Rinse with povidone iodine or 70 percent alcohol if available, cover loosely with a clean dressing, and come straight in. Do not stitch the wound closed, do not apply herbal pastes, and do not delay to look for the animal. For prevention before exposure, the two-dose pre-exposure course is sensible for anyone planning long stays, scooter touring, jungle trekking, cave or bat exposure, work with animals, or travel with small children who pet strays. PrEP does not replace PEP after a bite, but it converts a complicated four-shot course with immunoglobulin into a simple two-shot booster, which is a meaningful difference if you are far from a clinic that stocks RIG.
Summary
Rabies in Phuket is preventable for every patient who reaches us in time. The pathway is the same every time: 15 minutes of soap and water at the wound, a same-day clinic visit, categorise the bite, start the right vaccine schedule, add immunoglobulin for category III in unvaccinated patients, and finish the course with WhatsApp-tracked follow-up. Travellers who completed pre-exposure shots before flying need only two booster doses and no immunoglobulin, which is the strongest practical argument for getting PrEP before any long trip in Southeast Asia.
“Most of our rabies patients are travellers who were on the way somewhere when a dog ran out. The animal almost always looks fine. We still start vaccination the same day, because rabies is the one infection where waiting to be sure is the wrong call.”
Doctor Patong Takecare Clinic medical team
Frequently asked questions
A stray dog scratched me on the beach but did not draw blood, do I still need shots?
If the scratch broke the skin at all, even without visible bleeding, it counts as a category II exposure and needs a full vaccine course. If it was only a paw on intact skin with no break, that is category I and washing is enough. When in doubt, come in: the assessment is quick and starting late is much worse than starting unnecessarily.
I had a rabies course before flying out, do I need the full series again?
No. If you completed a documented pre-exposure or post-exposure course in the past, any new exposure needs only two booster doses on days 0 and 3, and no rabies immunoglobulin. Bring your vaccination card or a clinic record if you can, but we can still treat you without it.
How quickly do I need to start treatment after a bite?
As soon as possible, ideally within 24 hours, and certainly the same day. Rabies vaccine still works if you start a few days late, so it is never too late to come in, but each day of delay is a day the virus has to advance toward the brain. Treat any exposure as urgent.
Is the vaccine safe in pregnancy or for young children?
Yes. Modern cell-culture rabies vaccines are safe in pregnancy, breastfeeding and infants. There is no contraindication, and rabies is universally fatal once symptoms appear, so the risk-benefit is firmly in favour of treatment for any meaningful exposure.
Do I need rabies immunoglobulin, and do you stock it?
You need immunoglobulin if your exposure is category III (transdermal bite, bleeding scratch, saliva on mucosa, any bat contact) and you have not had a previous rabies course. We coordinate human or equine immunoglobulin supply locally and can almost always source it the same day. If supply is delayed, the vaccine series starts immediately and immunoglobulin can still be given up to seven days from the first vaccine dose.
Will my travel insurance cover the course?
Most travel insurance policies cover post-exposure rabies treatment as an acute medical emergency, including vaccine, immunoglobulin and wound care. We provide itemised English-language receipts and a clinical letter suitable for claims. Pre-exposure shots for travel are usually self-pay. Check directly with your insurer for pre-authorisation rules.
Sources
World Health Organization. Rabies vaccines: WHO position paper, April 2018. who.int/publications/i/item/who-wer9316.
Centers for Disease Control and Prevention. Rabies (Yellow Book, Travelers’ Health). wwwnc.cdc.gov/travel/yellowbook/rabies.
World Health Organization. Rabies fact sheet. who.int/news-room/fact-sheets/detail/rabies.
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