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The World Health Organization 
has issued a Medical Product Alert (No 8/2019) relating to 3 different falsified rabies vaccines (Verorab, Speeda, and Rabipur) and 1 falsified anti-rabies serum (Equirab) circulating in the Philippines.
No adverse reactions to the products have been reported and investigations and analyses 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 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.
A rabies vaccine shortage is ongoing in the Philippines.
Public Health Englandhas produced the following guide for management of these patients:
|
Immunisation status |
Rabies vaccine received in Philippines |
Rabies vaccine received in the UK |
Additional management required |
|
Non-immune or partially immune |
None |
4 doses |
No further vaccine required |
|
1 dose |
3 doses |
No further vaccine required |
|
|
2 doses |
2 doses |
1 additional dose of vaccine offered |
|
|
3 doses |
1 dose |
Check antibody level |
|
|
4 doses |
None |
Check antibody level |
|
|
Fully immunised |
None |
2 doses |
No further vaccine required |
|
1 dose |
1 dose |
1 additional dose of vaccine offered |
|
|
2 doses |
None |
Check antibody level |
Note: Anyone assessing for post-exposure treatment should consult with an infectious disease consultant in Scotland and the RIgS team in England.
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 report; and the potential for vaccine failure resulting in death, following exposure to the rabies virus.
Further information can be found on the following pages:
