On the evening of May 8, the patient became progressively agitated and combative and was noted to be gasping for air when attempting to drink water.
Hospital staff members questioned family about animal exposures, and the patient’s husband reported that she had been bitten on the right hand by a puppy approximately 6 weeks before symptom onset while touring in India. According to the husband, the patient cleaned the wound with the help of the tour operator but did not seek further medical treatment. The patient had no record of a pretravel health screening, did not receive rabies preexposure vaccination before the trip, nor had she ever been vaccinated against rabies.
The patient’s communicability period was presumed to have begun 2 weeks before symptom onset, on April 19. The patient was a resident of a communal living facility. The Piedmont Health District interviewed 13 residents of the commune who reported close contact with the patient, four of whom met the exposure criteria: three persons had direct contact with the patient’s saliva, and one person was bitten by the patient.
(Underlined by Corboy. Rabies virus tortures you)
All four were advised to initiate PEP.
The patient had participated in a lengthy organized yoga retreat tour of India during January 28–April 5, 2017. Seventeen tour members (including the patient) from five states (California, Illinois, Maryland, North Carolina, and Virginia) and two countries (United States and Spain) and six staff members from two countries (United States and India) participated in the tour.
Tour members confirmed that the patient was bitten by a puppy outside her hotel in Rishikesh, India, and that the wound was washed with water, but no further treatment was administered. Three tour members in addition to the patient reported direct contact with the same puppy; two were determined not to have been exposed to infectious materials. One, a North Carolina resident, reported having been bitten on the leg; TJHD recommended PEP for this person.
(PEP) is the rabies immunization series of shots administered to prevent rabies after exposure to an infected person or animal.
Boldface font by Corboy for emphasis
A tour manual was provided to all members before travel that recommended consulting with a physician regarding any pretravel health concerns, but did not list specific health risks or pretravel vaccination recommendations.
The World Health Organization International Health Regulations focal point with the Indian Ministry of Health was notified of the case, and local health authorities conducted an investigation (4). One rabid dog was reported from the area within the preceding 6 months, but no additional information regarding the puppy or its owner was available.
A Virginia woman who was bit by a dog during a yoga retreat in India died weeks later after contracting rabies, a new report released by the Center for Disease Control and Prevention revealed.
The 65-year-old woman, who was not identified in the report, traveled to Asia for the multi-month yoga trip in early 2017. While overseas, she came into contact with the dog that bit her in Rishikesh, but did not experience symptoms until early May — about six weeks after the bite — when she’d already returned to America.
She cleaned her injury after the dog bite with water but did not seek further treatment at the time, her husband said, according to the CDC report released Thursday.
Monkeys of Rishikesh and rabies
On both bridges in Rishikesh you will find lots of cheeky monkeys waiting for someone eating ice cream or holding a bag with food. Rule number one: the monkey always wins! Never carry any food across the bridge in a plastic bag as they will instantly know what it is and take the bag from you. If the monkey happens to scratch you or worse, bite you, you will need to go to Rishikesh town hospital straight away. You will need between 3 and 5 shots of rabies vaccine depending on the severity. It really pays to have your rabies and hepatitis A+B vaccines done before coming to India.
adhus and temple priests
Being blessed by a sadhu (wandering holy man) or a priest in a temple is great but be mindful and expect to pay for the blessing. There are numerous sadhus in Rishikesh begging for money in the streets and sadly these are not always sadhus but just beggars dressed as sadhus. Also, both will try to bless you without your permission by simply walking up to you, putting color on a finger and press it on your forehead, then the question for money comes.
Walking into a temple is fun but sometimes priests (also sometimes fake) will tell you that they will show you around for free and bless you. Do not fall for it, i have had it a lot and every time was expected to pay. When i didn’t they got very angry. So just politely refuse if you want to avoid this. It often helps to avoid eye contact and keep walking.
Unfortunately there are plenty of beggars who flock to Rishikesh during the tourism season. Now believe me, i would like to buy every beggar dinner but i always like to do some research before doing something. What i have discovered is that most beggars are part of street gangs, the woman en children are ‘owned’ by the gangs. The money they get, they have to give to them at the end of the day. The children they have with them are often not their own children and are sold by poor families to these gangs. When you try to buy them dinner, most will refuse and ask for money and if you say no, ask you to buy something from a supermarket. Sadly, what happens next is that they will go back into the supermarket and sell back the product to the shop owner who is in on the scam. He will sell the product to you at a more expensive price and then they split the difference when it’s sold back.
It’s not just financial hassle either.
Never have I been so aggressively leered and stared at while walking down the street. My experience as a female traveller in India was worse on the whole than other negative experiences in Egypt and Morocco as it was just so frequent. The clicking, hissing and staring were ongoing, pretty much everywhere we went. I was groped twice, just walking down the street – in broad daylight.
— And just to clarify (not that it should matter), I didn’t wear anything remotely revealing the entire time we were there. Trousers, jumpsuits, long skirts, arm covering t Shirts and scarves – the whole time. I even moved a ring onto my wedding ring finger based on advice I’d read before visiting. —
Sadly because we were left with so much distrust and suspicion we resorted to carrying our valuables on us at all times. India is the only place I’ve worn a money belt every day – containing our passports, other documents and some spare cash. It’s the only place Rob’s carried a backpack with the laptop and kindles on him every day.
I guess the only good thing on this topic is that we didn’t feel we were at much risk of street crime and theft. The chances were probably as high as in any other country but we felt pretty safe walking around with our stuff on us. Safer than leaving it in the hotel anyway!
6th December 2017 at 4:56 am
Hi Sarah, I recently discovered your posts through gapyear.com, and really appreciate your approach. This post in particular validates your “not another travel blog” mantra. I spent six months in India in 2009 as part of a long-term project, and I was essentially counting the days for the last five months. Everything you wrote is spot-on, and if anything a bit understated and too apologetic. That’s completely understandable, however, as one of the most incredible things for me about “incredible India” is the persistent perception by the rest of the world that it is some sort of transcendental and experiential mecca for soul-seekers and adventurers, full of vibrant colors, smells, and sounds. In fact it’s so squashed full of all that and more that it all sloshes into an endless barrage of mud and shit, often quite literally. But the extraordinary marketing of the country is so successful that this reality is almost impossible for people to believe unless they see it themselves (and sometimes not even then!), and the reaction to honest descriptions like yours can be dismissive or worse.
So like Kristine above I applaud your honesty, because people need to know and be as prepared as possible. Like you I don’t tell people they absolutely shouldn’t go to India, but it is the only place I’ve been (from nearly 40 countries around the world) where I categorically tell women not to travel alone (or even be on the streets alone for a moment), and where I STRONGLY recommend people book a tour through a reputable agency before arrival that arranges hotels, a private car, and a guide.
The country has so much to offer, but I found that the multiple dark clouds so obscured the silver lining as to render it almost irrelevant. I hope more people will be as honest as you, not to shut down tourism to the country but to give people the right expectations and preparation, and to put some pressure on the government to start earning their tourism rather than be content with a “if we built it centuries ago, they will come” mentality. Keep up the good work!