Rabies in Bali, November 2009

In December 2008, the Indonesian Ministry of Agriculture reported a rabies outbreak in dogs on Bali to the World Organization for Animal Health.  In May 2009, the South East Asia Regional Office of WHO reported that 8 human cases had occurred since the start of the outbreak. The Indonesian Ministry of Health reported at the end of October that there have been 15 human cases, with press reports suggesting additional cases.

Most human and animal rabies cases have been confirmed near popular tourist destinations on the southern tip of Bali (in Denpasar, Badung and Tabanan districts), but there is potential for further spread to the rest of the island. FAO and WHO have been supporting national authorities to carry out extensive campaigns of dog (and cat) vaccination, control of stray dog populations, and animal movement controls.

Reports suggest that human or equine rabies immunoglobulin is, for all practical purposes, not presently available in Bali and that the supply of WHO-approved tissue culture rabies vaccines also cannot be assured. If a traveller does incur a rabies exposure in Bali, the nearest facilities that are able to provide reliable post-exposure treatment are in Singapore, Bangkok and Australia.

NaTHNaC has posted information on its website reiterating advice that pre-exposure vaccination should be given to travellers at increased risk of rabies through exposure (e.g. occupation, long duration of stay or certain types of activity such as running or cycling,) or who are travelling to remote areas where medical care and post-exposure rabies vaccine and immunoglobulin are not readily available.

There is no change to current advice on post exposure prophylaxis (PEP) for travellers to Bali - this is a high risk country and those exposed should receive PEP following a risk assessment.

Last reviewed: 27 November 2009