Rabies Outbreak in Bali: Update from Australian Chief Health Officer

Rabies alert - Bali

Rabies has been diagnosed in dogs on the Indonesian island of Bali. Previously Bali was considered to be rabies free, hence this presents a new risk to Australians visiting Bali.





The Indonesian media have also reported that several people with rabies-like clinical signs and symptoms have died after being bitten by dogs. The diagnosis of rabies in these people has not yet been confirmed.
Although rabies has previously been known to be present on other Indonesian islands, this is the first report of an outbreak of rabies on Bali. There is at present no indication that the disease has spread to animals other than dogs. However, any animal should be considered to pose a potential risk.


Rabies is a disease primarily of animals and is transmitted to humans via a bite or scratch from an infected animal. Person-to-person transmission is extremely rare. Rabies is an almost invariably fatal disease of the brain with an average incubation period of three to eight weeks. Without medical intervention, patients die from respiratory paralysis. Although rabies in travellers is rare, such cases do occur. Travellers to rabies-endemic areas should be informed of the risk and advised to avoid contact with wild and domestic animals.


Authorities in Bali have taken steps to control the situation, including implementing a program of culling and vaccination in dogs and vaccination of people in the villages affected.


Visitors to Bali are strongly advised to avoid direct contact with all dogs and cats (including pets), monkeys and other animals. If bitten or scratched by any animal, they should immediately wash the wound thoroughly with soap and water, apply an antiseptic containing povidone-iodine, and seek immediate medical attention. 


The Department advises that any patient who has returned to Australia with bites and/or scratches from an animal in Bali since 1 August 2008 should receive rabies immunoglobulin (RIG) and commencement of the rabies vaccine post exposure prophylaxis (PEP) schedule as soon as possible after the exposure. For the details of management of patients potentially exposed to rabies, please refer to the Australian Immunisation Handbook 9th Edition 2008.
Rabies vaccination should also be considered in those planning travel to Bali.


DHS funds RIG and rabies vaccine for individuals warranting rabies PEP. If you require RIG and/or rabies vaccine for PEP, or to replenish stocks you have used for such a purpose, please call DHS on 1300 882 008 or fill out the attached order form and fax it to 1300 768 088 and DHS can organise for them to be sent to you.
Please call DHS on 1300 882 008 if you require further information about this situation.


Yours sincerely,


Dr John Carnie



Chief Health Officer
Victoria, Australia.


Source: http://www.health.vic.gov.au/chiefhealthofficer/alerts/rabies.htm#