The World Health Organization (WHO) has issued a medical product alert relating to three different falsified rabies vaccines (Verorab, Speeda, and Rabipur) and one falsified anti-rabies serum (Equirab) circulating in the Philippines, where a rabies vaccine shortage is ongoing.
The Philippines are classified as a high-risk country for rabies. Travel health professionals are reminded of the importance of discussing the risk of rabies with travellers and the benefits of receiving pre-exposure vaccination prior to travelling overseas. This is particularly important given this recent alert, and the potential for vaccine failure resulting in death, following exposure to the rabies virus.
No adverse reactions to the products have been reported and investigation and analysis are ongoing to determine their contents and better assess the risk to public health. The extent of potential distribution of falsified vaccines across the Philippines is not yet clear and most patients may have received a genuine rabies vaccine, however, as a precaution, patients who may have initiated rabies post-exposure treatment with any rabies vaccine in the Philippines should have their treatment reviewed. Public Health England (PHE) has produced a guide for management of these patients.
Anyone assessed for post-exposure treatment should consult with an infectious disease consultant in Scotland and the Rabies and Immunoglobulin Service (RIgS) team in England.
Travellers are advised that any animal contact in a rabies endemic area poses a potential risk of infection and that rabies is the most dangerous of all infectious diseases. There is no recognised treatment once symptoms begin and, with the exception of a tiny number of cases, those who develop symptoms of rabies will die.
Further advice on rabies can be found on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.
Sources: TRAVAX and fitfortravel (both 18 July 2019)