Alert Status:
Active
Issued Date:
05 Apr 2024
Rabies cases have been detected in dogs in the Oecusse enclave of Timor Leste. Rabies is also present in the Indonesian province of West Timor. Given the porous land border between West Timor and Timor Leste, and with frequent travel between Australia and Timor Leste, the risk of rabies for Australian travellers to Timor Leste has increased.
Background
- Classical rabies is a disease of mammals that occurs in many parts of the world, but not in Australia. Rabies can sicken and kill the affected mammal. When people get rabies, usually through a bite or scratch from an infected animal, they almost always die.
- Rabies is a risk to travellers to Indonesia, including Bali; many other Asian countries; the United States of America; Canada; South and Central America; much of Europe; Africa; the Middle East; and many other countries.
- Timor Leste had previously been considered rabies-free, however an outbreak of rabies in the neighbouring Indonesian province of West Timor has now spread to the enclave of Oecusse in Timor Leste.
- Australian bat lyssavirus has been detected in Australian bats, including in South Australia, and also causes rabies.
Clinical features
- Rabies symptoms include: headache, fever, malaise, sensory changes around the site of the bite or scratch, excitability, an aversion to fresh air and water, weakness, delirium, seizures and coma.
- Death usually follows several days after the onset of symptoms.
- The incubation period for human rabies disease after an exposure can be up to several years.
Medical practitioners are advised to:
- Recommend pre-exposure prevention strategies including:
- Rabies vaccinations for people travelling to rabies-endemic and risk countries, including Timor Leste, in line with the advice in the Australian Immunisation Handbook (https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/rabies-and-other-lyssaviruses)
- Avoidance of contact with wild and domestic animals overseas. See the Australian Immunisation Handbook for tips on how to decrease risk.
- Supervision of children who may come into contact with wild or domestic animals overseas.
- Avoidance of direct contact with bats in Australia unless trained, wearing appropriate personal protective equipment, and vaccinated.
- Recommend and/or arrange post-exposure prophylaxis after any bite or scratch from a wild or domestic animal in a rabies endemic or risk country, including Timor Leste, or any bat in Australia.
- Thoroughly wash any wound immediately with soap and water for at least 15 minutes.
- Apply an antiseptic solution such as povidone-iodine or alcohol.
- Seek immediate medical attention.
- Arrange post-exposure prophylaxis (PEP) (in the form of rabies vaccine, plus or minus rabies immunoglobulin). In South Australia, PEP rabies vaccine and immunoglobulin is funded and distribution is coordinated by the Communicable Disease Control Branch. Complete the rabies or lyssavirus post exposure treatment form and email during business hours to: healthimmunisation@sa.gov.au
