Being bitten by a cat or dog is never a pleasant experience and in Turkey – as in many other countries – the bite carries with it a risk of tetanus and rabies. Therefore it is good to know that the Turkish health services have an extremely well organised and efficient system to make sure that with prompt and correct attention the fatal “worse case scenario” – in this case certain death – can be avoided.
All pets are supposed to be immunised against the fatal disease of rabies but sadly, enforcement is difficult and this is compounded by the prevalence of strays roaming the streets and countryside. Wild animals can also be carriers of this deadly and highly infectious virus and bites or contact with infected saliva from an infected animal can pass on the disease to farm animals including donkeys and cattle.
Humans are at risk from all these animals and for tourists and travellers it is essential to be aware of the risks of playing, stroking or otherwise making physical contact with an animal. But this risk should not mean that opportunities to explore are limited so long as certain precautions are taken and everyone is armed with the knowledge to know what to do in the event of being bitten by an animal.
A few weeks ago I ignored all the advice I used to give to my children and friends visiting from abroad when I tried to rescue an injured feral cat and I suffered the consequences. The lesson I have learnt has not only taught me to be more than a little wary of approaching an animal I don’t know but also I have learned what an excellent service the Turkish health services provide.
Dr. Uğur Çomak, Assistant Medical Director of Fethiye’s State Hospital has all the information and statistics for Fethiye and Muğla at his fingertips. Regular conferences are held so that the medical profession are up to date on the last technology and a globally integrated communication and treatment system is in place so that in the event of any suspicious animal death or a human being bitten an immediate and efficient response can be activated.
Last year’s (2009) statistics for Fethiye area showed that 484 patients who presented with bites were treated by the hospital. In total 1108 anti-rabies injections were administered. On arrival at outpatients the patient receives the first jab and a tetanus booster if necessary.
Each courses of anti-rabies comprises 5 intra muscular injections. The course is only completed if the animal cannot be shown to have any symptoms… so if the animal is available – either dead or alive and rabies can be definitely ruled out.
Otherwise the full course must be completed. Until the end of the 1980s injections were being given in the stomach. These were very uncomfortable to the extent that people would try to avoid having them but now the injections are given in the upper arm and are completely pain free. In addition to these, two shots of specific anti-rabies globulin are also administered in the buttocks one time at the start of treatment.
Treatment with an antiserum and vaccine works well if you receive them soon after being bitten. People who should be immunised against rabies include those who work with animals and travellers to remote areas where medical help may not be readily available.
So, what should an individual do should they get bitten, scratched (or in extreme cases licked) by an animal? The wound should be washed under clean running water, with soap. If the animal is owned and the owner should produce an up to date rabies vaccine certificate signed by a veterinary surgeon. If the animal is not owned or the owner cannot produce the certificate the injured person should go immediately to the nearest state or private hospital emergency department.
The wound will be treated if necessary and the first of 5 injections administered. Further jabs will be given on day 7, 3, 7, 14 and 28. This course must be completed and the hospital will require full contact details. In the event of your failure to show… they can send the police or Jandarma to pick you up. It is in your interest and that of society to get any wound treated and report any animal behaving suspiciously to the police or Jandarma. As in all these things, compliance is much easier than avoidance.
In Fethiye a very successful “Neuter and Return” programme has meant that many strays have been vaccinated against rabies but the most important piece of advice would probably be to avoid petting, stroking and playing with animals you don’t know.