Rabies in Bali

In September 2008, the first cases of rabies were reported in Bali. The number of reported human deaths has now surpassed 40, but only 28 are ‘officially’ reported. No deaths in tourists so far. Post bite vaccination is not readily available in Bali. A Sunshine Coast family were reported to be in Bali for less than a day when their child received an animal bite, and they had to fly back to Australia to get adequate post bite treatment.
Most people that I see bitten are not patting dogs, they are just in the wrong place at the wrong time, walking along a beach, watching fireworks, taking photos, wandering in temples etc.

There is also a myth that pre bite rabies vaccine is only necessary if persons are visiting risk countries for more than a month. I dont believe this to be a good predictor of risk…I have plenty of cases on my books of persons bitten within a few days or weeks of arriving in a rabies infected country.

It is always difficult to decide if one should spend the money on rabies vaccine. Many travellers don’t budget for travel vaccines, so it is a bit of a shock to be told you need to spend once hard earned cash on vaccines, especially for rare diseases one has barely ever heard about.

However, I am often on the receiving end of phone calls from stressed travellers in remote parts of the world who have received an animal bite, so I am biased in favour of giving pre departure rabies vaccine. Travellers are much more relaxed if they are pre immunised when they get a bite, and somehow the cost of the pre-exposure vaccination does not seem so much in that circumstance. The trick is to have the pre departure rabies vaccine 8 weeks before travel, so the vaccine can be given more cheaply via the intradermal method, and there is time to have a blood test to confirm the vaccine has been effective. If you are pre-immunised for rabies for one trip, you dont need to be pre immunised for future trips. You only need a booster if you receive an animal bite.

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