A rabies epidemic continues in Bali, with little apparent control and inadequate access to vaccination. Another person died of rabies last week. He was bitten by a dog in July and taken to a local health centre, but rabies vaccine was not administered. It’s not clear whether healthcare providers recommended post-exposure vaccination and the person declined or whether they did not offer vaccination. 

Access to post-exposure treatment in such regions is a serous concern. Apparently, up to 50 people a day are denied potentially life-saving post-exposure treatment because of a lack of adequate vaccine supplies. Because of the limited availability, doctors are focusing on treatment of people bitten by dogs in areas that are heavily infected with rabies. That makes complete sense, but it’s still not a good situation.  It’s not only those heavily infected areas that are a concern. More rabies vaccine needs to be secured so that everyone who has been potentially exposed can be properly treated. Local officials are blaming the current shortage on a holiday weekend, but it’s unclear whether the situation is truly going to improve in the near future.

People traveling to any part of Bali need to be aware of the risks. You don’t need to cancel your vacation, just use common sense. Don’t approach any dogs or other mammalian pets or wildlife. If you are bitten, immediately go a physician. If rabies vaccination is not offered, ask for it. If it’s not given, get on the next plane out of the country and get treated. You don’t need to be vaccinated immediately after exposure, so don’t panic, but you don’t want to unnecessarily increase the risks if you have been bitten.