Most people travelling to Bali think about the sun, surf, sand, food and cultural experiences they will get to enjoy on their travels. What many people don’t consider, however, is the very real risk of contracting rabies on the island paradise.
Rabies has been prevalent in Bali since 2008. Despite efforts to minimise and eradicate the disease, rabies is still listed on the Australian Government’s Smart Traveller website as a risk throughout Indonesia, especially in Bali and nearby islands.
What is rabies?
Rabies is a fatal, infectious disease of the brain which occurs in all warm-blooded animals, including humans. It is due to a specific virus which occurs in saliva and is usually transmitted to people from the bite of an infected animal.
According to the World Health Organisation, tens of thousands of people die from rabies each year, mainly in Asia and Africa, and 40% of those bitten by rabid animals are children under 15 years of age.
Dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans. However, rabies can also be transmitted through bites and scratches from cats, bats and monkeys.
Rabies is almost 100% fatal once symptoms appear.
How is it spread?
Rabies is almost always spread by an animal bite. It can also be contracted when an infected animal’s saliva comes into contact with a person’s eyes, nose, mouth or broken skin.
Rabies is transmitted mostly through bites and scratches from dogs, cats, bats and monkeys.
It is estimated there are around 150,000 free-ranging dogs in Bali and around 700,000 people visiting the island’s four main monkey temples each year, with at least 6% of those visitors bitten by the monkeys at these sites.
Initial symptoms may be vague, non-specific and flu like, including headache, fatigue, fever and an unusual or unexplained tingling, prickling or burning sensation at the wound site.
The illness can very quickly progress to paralysis, delirium, convulsions and death in the space of only a week or two.
Other symptoms can include hyperactivity, agitation, hydrophobia (fear of water), aerophobia (fear of draughts and fresh air) and muscle paralysis.
A pre-exposure rabies vaccination at least 1 month before you depart for your travels is the best way to avoid the disease. The vaccine is generally given in a 3-dose schedule at 0, 7 and 21-28 days.
The risk of rabies is usually highest in developing countries across Asia (including Bali), Africa and Central and South America. However, animals in developed countries still have the potential to be infected.
When you are travelling, the Australian Immunisation Handbook recommends you take the following precautions to reduce your risk of contracting rabies, particularly in regions where the disease is endemic:
What should I do if I come into contact with a potentially rabid animal?
If you are bitten or scratched by an animal that potentially has rabies, you should immediately undertake the following steps, even if you have previously been vaccinated for the disease:
Even if you do receive treatment overseas, it is still recommended that you see your doctor when you return to Australia, to reassess your risk and complete the course of your treatment, as required.
To find out more about our travel health services, visit https://www.illawarramedical.com.au/travel-health.html
- World Health Organization - http://www.who.int/news-room/fact-sheets/detail/rabies
- Australian Government Department of Foreign Affairs and Trade, Smart Traveller - https://smartraveller.gov.au/Countries/asia/south-east/Pages/indonesia.aspx
- Australian Government Department of Health - http://www.health.gov.au/internet/main/publishing.nsf/content/ohp-rabies-consumer-info.htm
- New South Wales Health - https://www.health.nsw.gov.au/infectious/factsheets/pages/rabies-travel.aspx