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Useful information for rare emergencies
PubL Hlth, Lond. (1982) 96, 54-56
Useful Information for Rare Emergencies compiled by Dr J. M. Dunlop 1. Rabies
(a) Rabies contacts from abroad Initial contact for advice should be made to the Communicable Disease Surveillance Centre (Tel. 01-200-6868) or to Dr Sylvia Gardiner of the Virus Reference Laboratory (Tel. 01-205-7041). Before telephoning, the following information should be obtained. 1. Name, age, weight and address o f person bitten, scratched or licked. 2. Part of body contacted by animal, with description of injury. 3. Exact location where incident took place abroad. 4. Date incident took place. 5. Details of animal - description, including behaviour at the time. 6. N a m e and address of its owner (if known). 7. Whether incident was reported to doctor or police abroad. (b) Wild/domestic animals contacted abroad The International Division of the D.H.S.S. (Tel. 01-407-5522, ext. 7334) knows exactly where Rabies is present in wild animals on the Continent. It can therefore tell anyone whether an incident has occurred within or without a Rabies free area, provided the exact location where the incident took plac~ is known. Precise details of any domestic animal involved (species, colour, size, behaviour, etc.) together with a description of any accompanying person or witness are required. The International Division will then try and establish whether the domestic animal might or might not have been rabid. 2. Relatives on Holiday
(a) Abroad If a person is in an N.H.S. hospital and their condition deteriorates to the extent that it is considered essential to contact relatives who are abroad on holiday, it may be possible to have a message broadcast in the country they are visiting. The Alliance lnternationale de Tourisme (AIT), in conjunction with the Swiss short-wave radio, provide a central service for emergency messages to tourists travelling in Europe, Africa and the Near East. Messages arriving at the Emergency Centre in Geneva (Tel. Geneva 35-80--00 - open 24 hours) will be systematically broadcast by the Swiss short-wave radio in seven languages, including English. Alternatively, for France, Denmark and Sweden the BBC (Tel. 01-584-4468) may be prepared to send a message on one o f its World Service Broadcasts. For Finland and Norway, Interpol may be contacted via New Scotland Yard (Tel. 01-230-1212). Anyone wishing to use this kind of service must give the name and address o f the person to be traced, together with the route, timetable, make and registration number of the vehicle, together with any distinguishing features concerning the holiday party, e.g. touring with caravan and/or boat on roof rack, trailer, etc., as well as the reason for the message. In exceptional circumstances, the Consular Department of the Foreign Office (Tel. 01-213--3666) might be prepared to help, provided the relative's address was known and lay within a few miles of a British Consul's residence.
Useful Information for Rare Emergencies
55
(b) In Britain Normally the police are the best organization to assist in locating them.
3. Repatriation of Medical Emergencies St John Aeromedical Service-Tel. (during office hours) or (out of hours)
01-235-9758 01-235--9759 01-235-5238
This organization should be contacted where it is desired to bring a medical emergency which has occurred abroad back to Britain. The Aeromedical Service is a specialized group within St John Ambulance. Over 200 St John doctors and nurses are trained and experienced in air escort duty; they travel worldwide to repatriate the sick and the injured flying over 500,000 miles a year. Charges vary with distance and type of transport used. Air escorts give their time and skill freely and willingly.
St John Ambulance Air Wing- (Tel. Epping 75624 or Epping 75042) - 24 hr cover A specialized unit within St John Ambulance to which 150 pilots volunteer their time and aircraft to fly urgently needed medical supplies and limited life organs, such as kidneys, needed for transplant operations.
4. Pre-exposure Vaccination Against Rabies Pre-exposure vaccination is a recognized precaution for persons at special risk of contracting rabies and, in particular, should be offered to those who are employed; (a) at kennels and catteries approved by the Ministry of Agriculture, Fisheries and Food for the quarantine of imported dogs, cats, etc.; (b) at quarantine premises in zoological establishments; (c) by carrying agents authorized to carry imported dogs, cats, etc.; (d) at approved research and acclimatization centres where primates and other imported mammals are housed; (e) in laboratories handling rabies virus; (f) at seaports and airports where they are likely to come into contact with imported animals or animals on ships or aircraft, e.g. Customs and Excise, and Police Officers; (g) as veterinary and technica} staff'of MAFF; (h) as inspectors appointed by local authorities under the Diseases of Animals Act or employed otherwise who, by reason of their employment, encounter enhanced risk.
Vaccinesfor above groups Rabies vaccine is a freeze-dried suspension of rabies virus prepared in human diploid cell cultures. The recommended schedule for vaccination is two doses (1-0 ml given intramuscularly) 4 weeks apart, followed by a reinforcing dose 6-12 months later and additional reinforcing doses every 2-3 years, depending upon the risk of exposure. Vaccine can be obtained from either the Virology Department, Public Health Laboratory, Bridle Path, York Road, Leeds (Tel. 0532--654011), or Colindale Public Health Laboratory, London (Tel. 01-205-704I).
56
J. M. Dunlop
Vaccine for travellers gohlg abroad or persons wortcing abroad Pre-exposure vac~cination is NOT recommended as a routine prophylactic measure, except in special circumstances such as persons visiting or going to work in remote areas where rabies is enzootic and there is a special risk. Human diploid cell rabies vaccine for purchase privately in these circumstances is available from Servier Laboratories Ltd, Fulmer Hall, Windmill Road, Futmer, Slough, Bucks SL3 6HH (Tel. Fulmer (028-16) 2744). They are the British agents for the vaccine which is manufactured in France by the Institut Merieux and costs £16.00+VAT (£18.40) per single dose ampoule. The three doses therefore required for a full course o f immunization will cost in total £55.20 as it is not available on the N.H.S. 5. Rabies-free Countries
As at October 1981, the following countries worldwide are still rabies-free-Australia, Finland, Iceland, Ireland, New Zealand, United Kingdom. Therefore, if a holidaymaker consults you and~states that he/she has been bitten, scratched or licked by a potentially rabid animal in any other part of the world, then I would suggest that you contact the Communicable Disease Surveillance Centre (Tel. 01-200-6868) or Dr Sylvia Gardiner o f the Virus Reference Laboratory (Tel. 01-205-7041), or the International Division of the D.H.S.S. (Tel. 01--407-5522).
Useful Information for Rare Emergencies compiled by Dr J. M. Dunlop 1. Rabies
(a) Rabies contacts from abroad Initial contact for advice should be made to the Communicable Disease Surveillance Centre (Tel. 01-200-6868) or to Dr Sylvia Gardiner of the Virus Reference Laboratory (Tel. 01-205-7041). Before telephoning, the following information should be obtained. 1. Name, age, weight and address o f person bitten, scratched or licked. 2. Part of body contacted by animal, with description of injury. 3. Exact location where incident took place abroad. 4. Date incident took place. 5. Details of animal - description, including behaviour at the time. 6. N a m e and address of its owner (if known). 7. Whether incident was reported to doctor or police abroad. (b) Wild/domestic animals contacted abroad The International Division of the D.H.S.S. (Tel. 01-407-5522, ext. 7334) knows exactly where Rabies is present in wild animals on the Continent. It can therefore tell anyone whether an incident has occurred within or without a Rabies free area, provided the exact location where the incident took plac~ is known. Precise details of any domestic animal involved (species, colour, size, behaviour, etc.) together with a description of any accompanying person or witness are required. The International Division will then try and establish whether the domestic animal might or might not have been rabid. 2. Relatives on Holiday
(a) Abroad If a person is in an N.H.S. hospital and their condition deteriorates to the extent that it is considered essential to contact relatives who are abroad on holiday, it may be possible to have a message broadcast in the country they are visiting. The Alliance lnternationale de Tourisme (AIT), in conjunction with the Swiss short-wave radio, provide a central service for emergency messages to tourists travelling in Europe, Africa and the Near East. Messages arriving at the Emergency Centre in Geneva (Tel. Geneva 35-80--00 - open 24 hours) will be systematically broadcast by the Swiss short-wave radio in seven languages, including English. Alternatively, for France, Denmark and Sweden the BBC (Tel. 01-584-4468) may be prepared to send a message on one o f its World Service Broadcasts. For Finland and Norway, Interpol may be contacted via New Scotland Yard (Tel. 01-230-1212). Anyone wishing to use this kind of service must give the name and address o f the person to be traced, together with the route, timetable, make and registration number of the vehicle, together with any distinguishing features concerning the holiday party, e.g. touring with caravan and/or boat on roof rack, trailer, etc., as well as the reason for the message. In exceptional circumstances, the Consular Department of the Foreign Office (Tel. 01-213--3666) might be prepared to help, provided the relative's address was known and lay within a few miles of a British Consul's residence.
Useful Information for Rare Emergencies
55
(b) In Britain Normally the police are the best organization to assist in locating them.
3. Repatriation of Medical Emergencies St John Aeromedical Service-Tel. (during office hours) or (out of hours)
01-235-9758 01-235--9759 01-235-5238
This organization should be contacted where it is desired to bring a medical emergency which has occurred abroad back to Britain. The Aeromedical Service is a specialized group within St John Ambulance. Over 200 St John doctors and nurses are trained and experienced in air escort duty; they travel worldwide to repatriate the sick and the injured flying over 500,000 miles a year. Charges vary with distance and type of transport used. Air escorts give their time and skill freely and willingly.
St John Ambulance Air Wing- (Tel. Epping 75624 or Epping 75042) - 24 hr cover A specialized unit within St John Ambulance to which 150 pilots volunteer their time and aircraft to fly urgently needed medical supplies and limited life organs, such as kidneys, needed for transplant operations.
4. Pre-exposure Vaccination Against Rabies Pre-exposure vaccination is a recognized precaution for persons at special risk of contracting rabies and, in particular, should be offered to those who are employed; (a) at kennels and catteries approved by the Ministry of Agriculture, Fisheries and Food for the quarantine of imported dogs, cats, etc.; (b) at quarantine premises in zoological establishments; (c) by carrying agents authorized to carry imported dogs, cats, etc.; (d) at approved research and acclimatization centres where primates and other imported mammals are housed; (e) in laboratories handling rabies virus; (f) at seaports and airports where they are likely to come into contact with imported animals or animals on ships or aircraft, e.g. Customs and Excise, and Police Officers; (g) as veterinary and technica} staff'of MAFF; (h) as inspectors appointed by local authorities under the Diseases of Animals Act or employed otherwise who, by reason of their employment, encounter enhanced risk.
Vaccinesfor above groups Rabies vaccine is a freeze-dried suspension of rabies virus prepared in human diploid cell cultures. The recommended schedule for vaccination is two doses (1-0 ml given intramuscularly) 4 weeks apart, followed by a reinforcing dose 6-12 months later and additional reinforcing doses every 2-3 years, depending upon the risk of exposure. Vaccine can be obtained from either the Virology Department, Public Health Laboratory, Bridle Path, York Road, Leeds (Tel. 0532--654011), or Colindale Public Health Laboratory, London (Tel. 01-205-704I).
56
J. M. Dunlop
Vaccine for travellers gohlg abroad or persons wortcing abroad Pre-exposure vac~cination is NOT recommended as a routine prophylactic measure, except in special circumstances such as persons visiting or going to work in remote areas where rabies is enzootic and there is a special risk. Human diploid cell rabies vaccine for purchase privately in these circumstances is available from Servier Laboratories Ltd, Fulmer Hall, Windmill Road, Futmer, Slough, Bucks SL3 6HH (Tel. Fulmer (028-16) 2744). They are the British agents for the vaccine which is manufactured in France by the Institut Merieux and costs £16.00+VAT (£18.40) per single dose ampoule. The three doses therefore required for a full course o f immunization will cost in total £55.20 as it is not available on the N.H.S. 5. Rabies-free Countries
As at October 1981, the following countries worldwide are still rabies-free-Australia, Finland, Iceland, Ireland, New Zealand, United Kingdom. Therefore, if a holidaymaker consults you and~states that he/she has been bitten, scratched or licked by a potentially rabid animal in any other part of the world, then I would suggest that you contact the Communicable Disease Surveillance Centre (Tel. 01-200-6868) or Dr Sylvia Gardiner o f the Virus Reference Laboratory (Tel. 01-205-7041), or the International Division of the D.H.S.S. (Tel. 01--407-5522).