Rabies post-exposure prophylaxis in travellers returning from Bali, Indonesia, November 2008 to March 2010.

Area of Science:

• Travel Medicine
• Infectious Diseases
• Public Health

Background:

• The 2008 Bali rabies outbreak highlighted the need for surveillance of rabies risk in popular tourist destinations.
• GeoSentinel and EuroTravNet monitor health issues in international travelers, providing crucial data on disease exposure.

Purpose of the Study:

• To assess the epidemiology of rabies post-exposure prophylaxis (PEP) among travelers returning from Bali.
• To identify the primary animal sources of exposure leading to PEP in this demographic.

Main Methods:

• Analysis of data from GeoSentinel and EuroTravNet network clinics from 2008 onwards.
• Focus on patients presenting for rabies PEP after travel to Bali.
• Categorization of animal exposures (e.g., monkey, dog) leading to PEP.

Main Results:

• 45 travelers received rabies PEP after visiting Bali, comprising 12.6% of all PEP cases in the network.
• Bali is identified as an emerging destination for travelers requiring rabies PEP.
• The majority of animal exposures were due to monkeys, rather than dogs.

Conclusions:

• Travelers to Bali face a significant risk of rabies exposure, primarily from monkeys.
• Public health messaging and animal bite prevention strategies in Bali should prioritize monkey encounters.
• Continued surveillance is essential to monitor rabies risk in popular tourist destinations.