Rabies Death Toll Continues to Rise in Bali

Travellers visiting Bali, Indonesia should consider getting a course of Rabies vaccinations. Since 2008 there has been an on going rabies epidemic on the island and more recent reports suggest it is now present in the surrounding islands of Nusa Penida, which include the islands of Nusa gede, Nusa Cenningan and Nusa Lembongan. These islands were considered rabies free until the recent deaths of 2 residents.
Reports from the International Society for Infectious Diseases ( ISID)  suggest that the death toll from the outbreak of rabies in Bali is continuing to rise, despite mass immunisation of  dogs on the island, with at least 5 people known to have died in 2011. This takes the official death toll from rabies to 119 since the outbreak began in 2008.The Indonesian Authorities now confirm there are no longer any areas that are free from the disease.
Rabies is nearly always fatal and is spread through the bite, scratch or lick to an open wound from an infected animal.
Unvaccinated travellers need to have immediate treatment with rabies immunoglobulin which is currently unavailable on the island. Having a course of pre exposure rabies vaccines eliminates the need for rabies immunoglobulin.

Advice to travellers

• Avoid contact with animals on the island.
• Consider having a pre exposure course of rabies vaccine before your trip. This is given on day 0, 7 and 21 or 28. Discuss this with your doctor or nurse at least 6 weeks before your planned journey.
• Certain activities such as cycling put you at higher risk.
• If you do get bitten seek immediate medical attention, even if you have had pre exposure rabies vaccination.
• Check your insurance covers you for medical evacuation in the event you do get bitten and need to fly home for treatment.