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Despite the availability of safe and effective rabies vaccines and immune globulins, rabies encephalitis still kills as many as 60 000 people per year in resource-poor countries due to lack of awareness and access to these products.1 In contrast, there are less than three deaths per year in travellers.2 This stark comparison probably reflects both the relatively small time that travellers spend at risk compared to local people (weeks compared with years in most cases) and the ability of travellers to obtain timely post-exposure prophylaxis (PEP). In recognition of the fact that the vast majority of human rabies cases occur in local people, the World Health Organization set out to see if a change in recommendations could safely make rabies immunoprophylaxis less complex, less expensive and more available. They undertook an extensive review of the literature and gathered committees of experts who had numerous face-to-face meetings over an 18-month period. They released their recommendations in April 2018.3 Since then, travel medicine practitioners have been striving to understand the impact that these new recommendations might have on their current practice.4

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