Scabies and Rabies

Scabies and Rabies: A personal journey in Morocco


She bared her teeth and raced furiously towards me, slobber dripping from her mouth while my wife and I stood statue-still, trying not to look like victims. What are you meant to do in this situation? Turn around? Make a noise? Run? Stand still? Despite my best efforts to not look like a threat, the dog continued to run towards me. Before I knew what was happening its jaws were clenched around my knee and its head was shaking from side to side. A lifetime later, though it was probably all of 5 (very long) seconds, the dog disengaged and bounded back around the corner.

More than slightly shaken, my wife and I did not chance following the dog to find out whether it had an owner or whether it had had its rabies shots. We were in Morocco, at the beginning of a wonderful 2 week holiday starting at the yearly Sacred Music Festival in the mediaeval city of Fes, when the aforementioned dog came to taste my leg.

Luckily I was wearing a pair of pants rather than shorts and on our return to the hotel to examine the damage, found that despite my trousers being saturated with dog saliva and the presence of some pressure marks there were no breaks in the skin. Nevertheless, copious amounts of skin washing followed.

Rabies is one of the many infectious hazards encountered by a surprising (and surprised) number of travellers and locals and many who do not seek or cannot afford treatment succumb to this preventable illness. If a possible rabies exposure occurs the rapid injection – which is optimally done within 48 hours – of the wound with rabies immunoglobulin (a blood product, so get this done where you are assured the blood products have been appropriately screened) followed by consecutive vaccinations over the next fortnight will protect you from developing this deadly disease. For those foresighted enough to have a course of prevention shots prior to travel, there is good evidence that the coverage will last for a lifetime. The pre-travel vaccines increase your chance of survival should you be far from medical help, preclude the need for the blood product, and allow you 7 days of time to get to medical care to receive a smaller number of rabies vaccines to guarantee you prevention. This is useful if you are travelling somewhere remote or somewhere that blood products are not available or safe.

Our next pest encounter was in the Atlas Mountains, where stunning trekking can be found in verdant countryside and far-flung villages provide hospitality in mud-brick inns attached to the local homes. Unfortunately apart from thick woollen blankets and romantic torchlight (many of the remote villages are not connected to the grid), one of our cosy rooms harboured friendly mites that decided to hitchhike with us for the next few weeks.

Scabies is a common mite infection around the world, causing extremely itchy papules all over your body. Application of scabecidal cream upon our return helped us clear this annoyance from our bodies.

Rabies and scabies aside, Morocco is a magical destination that is a feast for the senses: the delicious tastes of tagines suffused with preserved lemon enjoyed while sitting on a balcony overlooking the Atlantic ocean; the acrid smells from the leather tanners plying their trade in sulphurous vats the same way they have been treating the hides for hundreds of years; the sounds of Gnaoua musicians playing hypnotic pipe music while spinning their tasselled hats in a frenzy of excitement; the stunning scenery of desert dunes and ruined Kasbahs where ancient chieftains kept watch over their lands and stored their treasures and the soft touch of colourful (magic) carpets underfoot as you are plied with sweet mint tea while bartering on which handmade piece may get shipped home to take pride of place in the living room.

There were more superb experiences each day, with some of our highlights being admiring the mastercrafts men and women in their small booths in the mazes of the markets including such skills as metalsmithing, embroidering, or woodcarving (it is suggested that one makes sure there is plenty of space in your luggage for magnificent handmade objects); residing and dining in stunningly restored boutique riads – which are traditional courtyard homes with central fountains and rooftop terraces; wandering through agrarian villages in the High Atlas Mountains and being invited by a friendly local into their domain for homemade flat breads fresh out of the oven, accompanied by wild honey and olives; being taken to an abandoned 1000 year old mosque and finding out from the guardian that the peacock and peahen displaying themselves between the slanting shadows of the stone columns, had been left there the day before by the movie crew filming a period romance.

More highlights included touring mediaeval ramparts of a centuries-old town by caleche (a horse drawn buggy), then climbing up the town walls to find a stonecarver making 3D imaginings of Picasso masterpieces; exploring the coolness of a garden with the walls painted the deepest saturated blue imaginable by the original artist owner, the garden later becoming the home of Yves St Laurent; chancing on and walking along with a flash mob choir (from Australia!) singing 4 part harmony folk songs to delighted locals in the cobbled streets of Fes on the way to listen to a midnight Sufi music concert in a ruined garden; the list of wonderful adventures to be had in Morocco is myriad.

They didn’t say actually say this in the movie Casablanca, but we would like to “play it again…”

Dr Stan Khoo, Travel Medicine Centre Perth, TMA Perth

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