Rabies Pre-Exposure Vaccine: Will Not Getting One Come Back To Bite You In The Butt?

dogRecently, a well-traveled friend of mine, whom I’ll call Jules, went to Belize on vacation. While on an idyllic, live-aboard sailing trip, Jules, her husband, and mother decided to explore some cays by sea kayak. What happened next is one of my worst developing nation nightmares.

While poking around what appeared to be an abandoned cay (this is why poking sans guide isn’t recommended, but few true travelers can resist), two semi-feral dogs “jumped out from beneath an overturned rowboat, barking ferociously.” Jules explains, “They were tied up, and we immediately headed back to our kayaks, when we saw a man. He told us the cay was ‘privado (private),’ and I started apologizing in Spanish as we pointed at our kayaks and picked up our pace. The next thing I knew, one of the dogs was let loose, and barreling after us. I started to run, and it bit the back of my right calf.”

The dog released her leg after Jules’ husband waved his arms at it while yelling, “NO, NO, NO, NO!” Then it re-launched itself at her, so she employed the same tactic, and eventually they made their way to their boats and escaped.

As if this story isn’t harrowing enough, the really terrifying part is that they were 10 miles out to sea and had four days left aboard ship. Fortunately, Jules’ mom is a medical professional. Immediately following the attack, she soaked her leg in sea water to flush the wound, then her mom accessed their first-aid kit and cleaned it with hydrogen peroxide, and applied antibiotic ointment. For the remainder of the trip, her mother repeated this procedure, changing the bandages up to three times a day.

dog biteI asked Jules why she didn’t insist upon returning to land immediately and seeking medical treatment.

“That’s an emotionally hard question to answer,” she explained. “The dogs weren’t foaming at the mouth, they didn’t look rabid, but rather in aggressive/protective mode. My mother was on the boat with us and she nursed my wound and kept checking my vital signs for any dangerous symptoms. Luckily, nothing bad came of it. There were no clinics in Placenia where we were, so I made the decision to go to the hospital as soon as I returned home six days later.”

There, she was advised to get rabies shots, which had to be administered through the ER (general practitioners apparently won’t provide them). Jules said the series of four treatments – eight shots the first visit, and one per follow-up – was awful. “I got one in each shoulder, one in each upper thigh, one in my butt, and three directly into the wound. The serum they inject feels thick and made my blood feel sluggish. I couldn’t think clearly and needed to nap every day.” She also wasn’t up-to-date on her tetanus, so that was the first shot she received.

Since Jules is one of the most energetic people I know, the shots really affected her ability to work, and she had to take a number of sick days on top of her two weeks vacation. That, of course, is the least concern in this scenario, and I asked my infectious disease doctor, John Szumowski, a fellow at the University of Washington, what the best course of action would be in such a situation.

“Once a person has symptoms of rabies, there’s little that can be done,” he says. “Only a handful of persons have survived even with intensive care. But the rabies pre-exposure prophylaxis vaccine series is felt to be very effective if administered to a person who doesn’t have symptoms.”

I’ve been telling myself for years that I should get rabies prophylaxis (a series of three recommended vaccinations) because I’m in what’s considered a high-risk group when I travel. I have a lot of exposure to animals, and I spend extended periods in rural areas where a delay in medical evaluation is likely. Thus, it’s a safe generalization to say that most adventure travelers would do well to get the series, even if they’re not animal lovers (for the record, despite my crazy dog/cat lady tendencies, I usually give creatures in developing nations a wide berth for this reason). I know I’m going to do it before my next big trip.

Getting the series, says Dr. Szumowski, “Also allows for a simpler course of post-exposure prophylaxis following a bite: fewer vaccinations and immunoglobin (which may not be readily available or of good quality internationally) isn’t needed. The pre-exposure series is available in travel clinics, but can be easily given in a primary care setting, too. Clinics may not have it immediately available, so calling the office ahead of time is a good idea.”
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Dr. Szumowski is quick to point out that getting the pre-exposure series does NOT mean medical evaluation should be skipped after an animal bite. Aside from rabies, bites can transmit other, primarily bacterial, infections. “Thorough cleansing of the bite site is an important step, regardless of vaccination status,” he adds. “Animal bites, even those that took place some time in the past, should be discussed with your medical provider because the incubation period for rabies can be up to years afterward.”

Need more compelling reasons for why adventure travelers should get pre-exposure shots? I’ve witnessed a puppy play-biting (drawing blood) a fellow traveler while we were visiting a Myanmar refugee camp in Thailand. I’ve seen a late-stage rabid dog staggering down the main street of a small village in Ecuador. I’ve been chased down an alleyway by a pack of mangy Vietnamese dogs, and had to scale a fence to escape. Gadling contributor Kyle Ellison has been chased by a dog while going for a run in a developing nation. I’ve been attacked and bitten two separate times by seemingly friendly cats here in the States, and still had to go to the ER, while animal control was required to quarantine and test the animals.

Rabies definitely isn’t limited to developing nations, nor is it restricted to dogs and cats. You should never get to close to wildlife, wherever you may be, for any number of safety reasons. But animals like raccoons, opossums, and bats are also frequent carriers of this deadly disease domestically.

For more information on rabies and other infectious diseases related to travel, the CDC’s Yellow Book is an excellent resource. And don’t let fear of rabies make you paranoid about indulging your fondness for animals when you travel.

Says Jules, “I’m an animal lover, and even after this horribly scary incident, I’ll continue to look for the wagging tails of approaching dogs. This was a minor blip on our trip, and will in no way stop me from continuing to see the world. It’s a part of traveling that makes us stop and re-evaluate taking precautions. We’re very protected in the U.S., and take that for granted. We need to respect the places that we visit and be our own advocates to protect ourselves and fellow travelers. From now on, I’ll also always consider travel insurance when visiting developing nations.”

[Photo credits: German shepherd, Flickr user State Farm; dog bite, Jules; dog, Laurel Miller]

Adventure vacation Guide 2012: Ecuador

Most Norteamericanos are hard-pressed to locate Ecuador on the map. Those familiar with this South American country the size of Colorado usually associate it with the (admittedly) spectacular Galapagos Islands. Yet Ecuador has so much more offer besides the Galapagos, and 2012 is the year to get your hardcore on. Why? Because the country’s adventure travel industry is blowing up–but it’s still affordable, especially if you opt for independent travel or book certain activities through domestic outfitters or U.S. travel companies that work directly with Ecuadorean guides.

Whatever your recreational interests, budget, or experience, odds are Ecuador has it: mountaineering, glacier climbing, and volcano bagging; trekking on foot or horseback; Class III to VI whitewater kayaking and rafting; sea kayaking, scuba diving, and snorkeling; surfing; remote jungle lodges and endemic wildlife, and agritourism. Need more convincing? Ecuador’s adventure tourism increasingly has an emphasis on sustainability. When it comes to protecting its fragile ecosystem and indigenous communities, Ecuador has become quite progressive for a developing nation, which hasn’t always been the case.

If you like a cultural or culinary component to your travels, there’s that, too. You can opt for an active, educational trip to indigenous-owned and -operated Amazonian eco-lodges, or play in the Pacific regions, which retain a strong Afro-Ecuadorean influence.

Agritourism is also hot in Ecuador, most notably at centuries-old haciendas, although there are also coffee and cacao plantation tours. Ecuadorean food is a diverse melding of indigenous and outside ethnic influences that’s regionally influenced: be sure to patronize markets, roadside restaurants, and street food stalls for some of the most memorable eats.

[flickr image via Rinaldo W]

Orcas, sea kayaking, and sea planes: a day trip to Washington’s San Juan Island

san juan islandsI woke up early one morning last week and realized that August 15th would mark two years since I arrived in Seattle. Normally I wouldn’t take note of such a thing, given that I tend to move with the frequency of a fugitive. Staying in one place just isn’t in my nature.

But here I was, 24 months into life in Seattle, and of the many things I’d yet to do, I hadn’t: been to the San Juan Islands (blame a longterm illness, an anemic bank account, and overwhelmingly crappy weather, in that order), seen an orca, nor flown on a sea plane despite living two blocks from the Lake Union terminal. As a travel writer, there’s really no excuse.

So I decided to celebrate my anniversary by knocking out all of those goals in one day, with a sea kayaking trip to San Juan Island. There are few things I love more than paddling, but I don’t have my own boat, so it’s tough to make trips happen. That’s where EverGreen Escapes comes in.

Last summer, I did an overnight paddle off of Whidbey Island with Evergreen, and was very impressed by the professionalism and knowledge possessed by my guide. The four-year-old “nature, adventure, and epicurean tour” company has a green ethos not uncommon in Seattle. What sets Evergreen apart from most of the other outfitters I’ve used is a staff who know their stuff and possess great people skills, diverse tours, and an emphasis on quality and comfort. Owners Jake Haupert and Dan Moore are actively involved in every aspect of their business, and it shows.

EverGreen just launched a partnership with Kenmore Air–the “seaplane airline”–this summer. The “Soar & Explore” upgrade allows you to fly one-way or round-trip on various EverGreen trips (see end of story for details). Kenmore has been around since 1946; I’ve enviously watched their little yellow-and-white planes buzz over my apartment hundreds of times, and I was jonesing to fly in one.

%Gallery-130546%san juan islandsI signed up for EverGreen’s full-day “Quest for Orcas, Pigs, and Wine” trip. In no way does that accurately describe the outing (it sounds more like a cross between Dungeons & Dragons and Tolkien), but I admit it begs further investigation.

The name actually refers to San Juan Island’s post-Civil War land dispute between America and England. The so-called “Pig War” began as a result of a farmer shooting a neighbor’s pig that was on his property. Said property became the subject of controversy as to where the U.S./current Canadian border was actually located, and for the next 13 years, American and English troops lived in “Pig War” camps where they primarily got together, drank too much beer, and waited for their respective governments to figure things out. I had hoped this part of the trip referred to sausage, but a little history never hurt anyone.

The “Wine” portion of the trip is a nod to Washington State’s burgeoning boutique wine industry, and the small selection of varietals to be served with lunch. San Juan Island also has its own vineyard and a Tasting Room in the main town of Friday Harbor.

Our day began at the crack of 6:45, when Evergreen’s luxury Mercedes van picked up my eight fellow whale, wine, and pig-lovers at their hotels. Our young guide, Tyler, is a naturalist and native Seattleite; before we’d even left the city limits, I’d learned more about Seattle’s history than I’ve gleaned on my own. An hour and a half later, we arrived at the ferry terminal in Anacortes. The weather was unfortunately behaving as it has for most of the summer: gray and dreary, but we could still catch glimpses of the Olympic Mountains across the Strait of Juan de Fuca.

An hour later, we docked at Friday Harbor. While crowded with visitors, it’s a cute town that manages to remain delightfully free of tackiness. Despite its popularity as a tourist destination, San Juan–at 55 square miles, the second-largest in the 172-island archipelago–is all about enjoying the moment. With a year-round population of just 8,000, the island is mostly rural; uncrowded roads wind past forest, prairie, deserted beaches, and pasture. Agriculture is still a big part of the island’s economy, and you’ll see everything from cattle ranches and alpaca farms to a hops plantation. There’s even a camel named Mona on one property; she’s become emblematic of San Juan’s quirky nature.
san juan islands
Our launch spot was Roche Harbor, a pretty, historic village/resort/ marina on San Juan’s northwest tip built in 1886. San Juan Outfitters provided us with tandem boats and gear, and Tyler gave us a brief tutorial on paddling basics (most of our group were newbies). We embarked on a two-hour paddle around Nelson Bay, encountering curious harbor seals whose heads popped up like corks around our boats. Bald eagles soared overhead, and beneath us, giant Purple Sea Stars and crimson rock crabs hid amongst the eel grass. Tyler stopped us in the midst of a bull kelp bed (encouraging us to snack on it), and talked about the ecosystem it supported.

Our first post-paddling stop was Lime Kiln State Park on San Juan’s west side, ten miles east of Vancouver Island–you can actually see the back side of the city of Victoria. Lime Kiln is the only dedicated, land-based orca viewing spot in the world. Most days, besa juan islandstween 3 and 4pm, the local Southern Resident Orca community (also known as the Salish Sea Orcas) pass by, following their main food source, Chinook salmon.

Tyler explained that there are three types of orcas (whether or not they are different species is a subject of scientific debate): offshore, transient, and resident. Orcas, actually a species of toothed whale in the dolphin family, are found worldwide. They’re opportunistic feeders (hence their erroneous name, “killer” whales), meaning they’ll eat a variety of prey species. In addition to salmon, harbor seals and rockfish make up the Southern Resident’s diet; they forage between the San Juan islands and southern Vancouver Island from April to September.

The Southern Resident community is federally listed as an endangered species due to a variety of factors that include a decline in their food supply, toxic exposure to industrial waste and human-related pollution, surface impacts (think boat exhaust, etc.), and low population. Orcas generally travel in pods and are very family-oriented. The Southern Resident community is comprised of three different groups: the J, K, and L pods (the oldest is a 100-year-old female named “Granny”). These pods are subjected to some of the highest boat traffic in the world, which is a good reason to try and view them via kayak. Unlike a whale-watching boat (which must still abide by strict regulations to protect the animals) however, kayaking doesn’t guarantee a show.san juan islands

Despite arriving at Lime Kiln around 3pm, we’d apparently missed the orcas. No matter–we saw dolphins, and enjoyed the views. Meanwhile, Tyler and intern Maggie set up a beautiful lunch on a picnic bench. Despite the cold (the hot tea Maggie offered was much appreciated), we enjoyed a meal of couscous salad, grilled chicken breasts, and the aforementioned Washington wines. Tyler noted the whale boats heading south, so we decamped to South Beach, where binoculars enabled us to see some orca action far offshore. We took some time to walk the driftwood-strewn beach before departing for Pelindaba Lavender Farm. Despite not getting any up-close views of the orcas, it had been a fun, interesting, relaxing day, and no one seemed put-out that the animals had been a no-show.

Back at Friday Harbor that evening, everyone else went to do some exploring on their own, but I had a sea plane to catch. The terminal is two minute’s walk from the ferry, and I climbed aboard the seven-seater to find my fellow passengers included a boxer wearing a pink, rhinestone-studded harness. The dog lolled across her owner’s laps, evidently a veteran of float plane travel. Unlike me. I was childishly thrilled to be onboard, and within minutes of taking off, I was fantasizing about a second career as a seaplane pilot. The sun had finally emerged, and the water was dazzling. Waterfront cabins sat amidst the lush undergrowth and evergreens, sailboats bobbed in emerald coves.

And then, just as we banked and headed south toward Seattle, I saw them. Two pods of orcas–about 20 in all–leaping and splashing no more than 200 feet below us. I pressed my face against the window in awe, watching them until they were lost in the expanse of blue. Happy anniversary, to me.

Travel tips
Wear layers (including one waterproof), and lots of ’em. The weather is unpredictable and changes rapidly this far north. Although the islands are in the “banana belt,” sea breezes can be chilly.

Bring sunglasses, a hat, and broad spectrum, high SPF sunblock, and use it–frequently.

If you’re paddling, it’s easy to get dehydrated. Drink small sips throughout to keep your bladder from getting full. And don’t forget to eat a small, high protein/complex carb snack to keep your blood sugar up (Evergreen provides snacks and water, FYI).

Kayaking attire should include a swimsuit, board shorts or waterproof pants, watersport shoes or sandals, and a long-sleeved nylon shirt (preferably one made with UPF fabric) or lightweight spray jacket. Your arms, and possibly your butt will get wet (if your boat’s spray skirt isn’t tight enough).
san juan islands
Soar & Explore

Evergreen Escapes offers a wide variety of summer and winter multi-day/activity packages, as well as customized tours for individuals or groups. San Juan excursions are offered year-round, with sea-kayaking April through October.

If you want the ultimate San Juan scenery experience, you can fly up in the morning, or go round-trip: there are terminals at Friday Harbor and Roche Harbor. Another option is to overnight/take two nights at Friday Harbor House, Earthbox Motel, or Island Inn, or add-on another island (including Vancouver Island, BC) or Olympic National Park. Kenmore Air has terminals throughout Puget Sound, the Olympic Peninsula, Vancouver Island, and British Columbia’s Gulf Islands (Canada’s name for their part of the San Juan archipelago). They also offer flightseeing excursions and have four wheeled aircraft in their fleet.

Want to support the Southern Resident Orcas? Click here for details on the Friday Harbor Whale Museum’s Adopt-an-Orca program.

Visit San Juan Islands in Washington

Croatia set to offer “world’s biggest welcome”

Croatia will soon issue the world's biggest welcomeCroatia is about to extend the “world’s biggest welcome,” thanks to an industrious outdoor enthusiast and a bit of ingenious use of technology.

Earlier this week, adventurer Daniel Lacko set out on a pre-designed course that will see him traveling by foot, kayak, and bike along the Croatian coastline. The 1550+ mile long route will take him through remote backcountry, across open water, and up towering mountains. All the while he’ll be using a GPS device to track his progress, and record his path, which will spell out the word “Welcome” across the map of Croatia when he finished.

Daniel’s planned route will pass through some of the most stunning landscapes in his home country, including eight national parks, three nature preserves, and several other protected areas. He’ll also climb ten mountains and kayak or swim through 370 miles of water along the sea and six different rivers. In order for this project to succeed, he’ll need to strictly adhere to the prescribed path, no matter where it might take him

If all goes as planned, Lacko hopes to complete the journey and arrive in Dubrovnik by June 5th, which is World Environment Day. If he is successful, he’ll also be issuing one giant “welcome” to the rest of the world. Follow his progress on the World’s Biggest Welcome website and on the project’s Facebook page.

Croatia is quite the destination for adventure travelers. The fantastic landscapes offer plenty of great hiking and climbing opportunities and its numerous rivers, not to mention great coastline, make it popular for paddlers as well. it was because of all those things that we put it on our recent list of five great European adventure destinations.


Aleksander Doba successfully sea kayaks across the Atlantic

aleksander doba sea kayakAn obscure Pole named Aleksander Doba has pulled off a somewhat obscure first: Sea kayaking across the breadth of the Atlantic Ocean in 98 days, 23 hours, 42 minutes, the longest open ocean kayaking adventure ever.

Leaving quietly from Dakar on October 26 and spending much of the first two months fighting into relentless winds and currents which kept pushing him north, it seemed – if you followed the GPS tracker online – that the 64-year-old Doba was going in circles, or repeating some kind of weird figure-8 patterns.

A straight line from Dakar to his finishing point in Fortaleza, Brazil, would have been just less than 2,000 miles. Of course thanks to winds, storms, currents and the two hours he slept each night, there are no straight lines in ocean paddling. In the end he paddled a total of 3,352 miles (average speed: 1.4 miles per hour; average daily distance, 33.5 miles; longest day, 78.6 miles).

Doba is hardly a novice to the kind of physical strength and mental endurance necessary for long solo paddles. Though this time he embarked in a sophisticated, 23-foot kayak with monster roll bars and a pair of flotation cabins at either end – he had previously kayaked more than 40,000 miles, including a 2,600-mile trip around the Baltic Sea in 1999, a 3,300 mile journey from Poland to Norway in 2000 and a 1,200 mile circumnavigation of Lake Baikal last year.
A previous effort to cross the Atlantic, in 2004, lasted just two days thanks to an “unstable” boat. This time around it wasn’t until the middle of the expedition that he worried he might not be able to push the heavily-loaded kayak (1,200 pounds) all the way across, especially when in December he became mired in a series of storms that had him traveling in circles at the same time his automatic desalinator went down, meaning to create fresh water he had to hand pump four hours a day.

On January 8, he confessed to feeling like Sisyphus, who rolled the boulder uphill only to have it tumble backwards on top of him. “This is how I feel fighting the current.”

His expedition manager was his son, Chez, who stayed positive throughout that his old man would make it across. “He promised his wife he’s coming back. He’s not a man to break a promise, otherwise she will kill him.”

While Doba’s effort is the longest paddle yet, he now tops a short-list of other obscure long-distance paddle record holders (thanks to Canoe & Kayak):

In 1928 Franz Romer crossed the Atlantic from Portugal to Puerto Rico in a folding kayak dependent on just a compass, sextant and a barometer. After landing in St. Thomas and a brief sail over to San Juan Harbor in Puerto Rico, Romer again took to sea, bound for New York. Unfortunately, he missed a hurricane warning by one hour and steered straight into the storm. No trace of him was ever found.

In 1956 Hannes Lindemann spent 72 days paddling from the Canary Islands to the British Virgin Islands in a store-bought folding kayak, subsisting primarily on beer, evaporated milk, rainwater and speared fish. His mantra? “West … Never give up … Never give up.”

In 1987 Ed Gillet’s left from California heading for Hawaii; the crossing took him 63 days. Out of radio contact for eight weeks, he ran out of food, endured a 40-hour stretch of sleep deprivation and winds that nearly drove him north of Hawaii. He was described as being in a “hallucinatory state” when he arrived at Kahului Harbor on Maui.

Englishman Peter Bray was the first to paddle west to east across the Atlantic in 2001, without the tropical trade winds to ease his passage. His first attempt nearly cost him his life: Asleep after his first day at sea, he awoke to find his cockpit three-quarters filled with water and his pumping systems inoperable. Bray survived 32 hours submerged in 36-degree seas and spent the next four months learning to walk again. A year later, he launched again from St. John’s, Newfoundland, reaching Beldereg, Ireland, 75 days later.

In 2007 Australian “Adventurer of the Year” Andrew McAuley attempted the relatively short (1,000) crossing of the very wild Tasman Sea, from Tasmania to New Zealand. In 29 days he got to within one day – 30 miles – of Milford Sound, New Zealand where his wife and young son waited on the beach for him. He disappeared on that last day; his boat would be found, but never any sign of Andrew.

In late 2007 a pair of young Australians – James Castrission and Justin James – successfully crossed the Tasman Sea in a custom-built, double-kayak, in 62 days.

[flickr photo via jurvetson]