Rabies Vaccination Shortage In New Zealand

 
Unfortunatley we currently have a rabies vaccine shortage in New Zealand. This is causing some restrictions on preexposure prophylaxis.  Remember that mammal bites in most countries of the world carry a risk of rabies and should be avoided. Travellers are more likely to be bitten in Asia than Africa or the Americas as there are many opportunities to mix with dogs and monkeys. The risk of a mammal having rabies is highest in Africa as dog vaccination there is low. Dog bites are the most common followed by monkeys. Children are more likely to be bitten than adults and as their bites are often on the face which has many nerves the bites are a higher risk.
Always keep away from pets especially those eating, sleeping or with babies. Avoid contact with free roaming mammals and stay away from bats. Don’t try to run away from dogs but stand still and avoid eye contact. If you fall over curl up and stay still. It is better not to visit monkey beaches or temples and if you do certainly don’t take any food with you. Again, staring them in the eye is a sign of aggression. Many bats have tiny teeth and wounds may not be readily apparent. Any suspected or documented bite or wound from a bat is a reason for seeking post bite treatment.
If bitten or scratched by a mammal wash the injury with copious amounts of water and finish with something like betadine. Then seek medical care as soon as possible. Vaccination with cell cultured vaccines following a WHO approved schedule should be started and in addition WHO category 3 injuries (single or multiple transdermal bites or scratches, contamination of mucous membrane or broken skin with saliva from animal licks, exposures due to direct contact with bats) should be injected with rabies immunoglobulin. This may not be available at the first medical centre you go to but you should go somewhere bigger until you find some.  Thailand is a country with excellent post bite management so although many people are bitten there deaths from rabies are low.
Pretravel rabies vaccines make it easier if someone is bitten. They already have antibodies so just need 2 doses of vaccine to boost their protection after an injury and don’t need immunoglobulin. Remoteness from healthcare, planned activities and duration of travel are all factors to consider when deciding whether to be vaccinated before travel.
​