Rabies virus and Australian bat lyssavirus (ABLV) are members of the Rhabdoviridae family, genus.1 These viruses cause the rabies disease. Lyssavirus infection is a notifiable disease and considered to be an urgent public health priority1
Australian bat lyssavirus ABLV – (first identified in 1996) has been found in several species of flying foxes and bats in Australia, and has been associated with 2 human deaths, one in 1996 and one in 1998.
It is assumed that ABLV infection has the same clinical features as rabies. Hence, rabies post-exposure prophylaxis recommended for patients with a possible exposure to ABLV or rabies.
Clinical features of Rabies
Incubation period : 1 week to several years (usually 3-8 weeks)
Risk highest in bites to head and neck (close to CNS) and fingers (richly innervated)
Bites, scratches, mucous membrane or broken skin exposure to saliva or neural tissues from a wild or terrestrial mammal (e.g. dogs, cats, bats and monkeys) in rabies-endemic regions (Asia, Africa, Central and South America). Includes Bali from August 2008. See WHO: Rabies enzootic areas
Bites, scratches, mucous membrane or broken skin exposure to saliva or neural tissues from a Australian flying fox or microbat.
Post exposure management is recommended for any potential exposure
Post exposure management should start as soon as possible following the potential exposure
All exposures require wound care
If the risk is determined the post exposure prophylaxis is dependent on previous vaccination
Unvaccinated: Human Rabies Immunoglobulin (HRIG) and Human Rabies Vaccine (HRV)
Vaccinated: Human Rabies Vaccine (HRV)
Discuss patients who are immunocompromised with an Infectious Diseases Consultant
Management of Exposure
Wash all wounds with soap and water thoroughly for approximately 5 minutes as soon as possible after the exposure
Apply a virucidal antiseptic solution (povidone-iodine)
Primary suture of wound is to be avoided where possible. If required it should only occur after HRIG administration.
Consideration should be given to the possibility of tetanus and other wound infections
Human Rabies Immunoglobulin (HRIG) and/or Human Rabies Vaccine (HRV)
Advice can be gained from the Public Health Unit/Communicable Disease Control Directorate on rabies/Australian bat lyssavirus post exposure prophylaxis
North Metropolitan Public Health Unit
After Hours/ Weekends
Communicable Diseases On Call Physician
Some Perth travel clinics have government funded rabies PEP on premises and often can see patients that day. Their numbers:
The Travel Doctor Perth. Shop 9 St Martin’s Arcade, 50 St Georges Tce, Perth Ph: 6467 0900
Perth Vaccination and Travel Centre. 168 Adelaide Tce, Perth Ph: 9221 4242
Travel Health Fremantle. 85 South St, Fremantle Ph: 9336 6630