Rabies Post-exposure Prophylaxis (PEP)
Rabies PEP is a series of urgent vaccinations given after a potential rabies exposure, such as an animal bite abroad.
Rabies PEP is a series of urgent vaccinations given after a potential rabies exposure, such as an animal bite abroad.
Also known as
Rabies PEP, Post-bite treatment, Rabies immunoglobulin + vaccine, Anti-rabies treatment
Why travellers need to know
Rabies is present in most of Asia, Africa, and parts of Central and South America. Any bite, scratch, or lick on broken skin from a mammal (dogs, monkeys, bats, cats) in these regions should be treated as a potential exposure. PEP must begin within hours, not days. The critical challenge is that rabies immunoglobulin (RIG) is often unavailable in rural areas and smaller hospitals. Knowing where to find PEP in your destination before you need it can save your life.
Real-world example
You're walking near a temple in Bali when a monkey scratches your hand, drawing blood. Rabies is present in Bali's animal population. You go to BIMC Hospital in Kuta, where they clean the wound and start rabies PEP: an immunoglobulin injection plus the first of 4 vaccine doses. The initial treatment costs $250. Rabies is virtually 100% fatal once symptoms appear, so starting PEP within hours is non-negotiable.
Country-specific notes
🇮🇳 India
Highest rabies death toll globally; PEP widely available
India accounts for roughly 36% of global rabies deaths. The good news: PEP is available at most government and private hospitals in cities and towns, and is very affordable ($15-30 for the full course). Rural availability is less reliable.
Wash any animal bite or scratch immediately with soap and running water for 15 minutes. This single action significantly reduces rabies risk before you reach a hospital.
🇹🇭 Thailand
PEP available at most hospitals; pre-exposure vaccine recommended
Thailand has widespread rabies in its dog and monkey populations. PEP is available at most hospitals including on tourist islands, though immunoglobulin can be scarce outside Bangkok. Pre-exposure vaccination (3 doses before travel) simplifies post-bite treatment significantly.
If you've had pre-exposure vaccination, you need only 2 booster doses after a bite instead of the full PEP course with immunoglobulin. This is a significant advantage where RIG is scarce.
🇮🇩 Indonesia
Bali has active rabies; PEP stock varies by hospital
Rabies was confirmed in Bali's animal population in 2008 and remains present. Monkey bites at temples and dog bites are common exposures. BIMC and Kasih Ibu hospitals in southern Bali stock PEP reliably; smaller clinics may not carry immunoglobulin.
Ubud's Monkey Forest is a common exposure site. If scratched or bitten, go directly to BIMC Kuta or Kasih Ibu, not a local clinic, to ensure immunoglobulin availability.
Frequently asked questions
Should I get a pre-exposure rabies vaccine before travelling?
If you're visiting countries with high rabies risk (India, Southeast Asia, sub-Saharan Africa) and will be in rural areas, trekking, or around animals, pre-exposure vaccination is strongly recommended. It doesn't eliminate the need for post-bite treatment, but it simplifies it dramatically: 2 booster doses instead of a full PEP course with immunoglobulin.
How quickly do I need rabies PEP after a bite?
As soon as possible, ideally within hours. Rabies PEP is effective even days after exposure, but sooner is always better. There is no 'too late to start' cutoff as long as symptoms haven't appeared. Once rabies symptoms appear, the disease is almost always fatal.
Your Nomedic record stores your pre-exposure rabies vaccination dates, so a treating doctor knows immediately whether you need the full PEP course or just booster doses.