Updated A-Z About Rabies In Bali: The History of Rabies outbreak in Bali

The date was December 1st, 2008 when Indonesian Minister of Agriculture signed the statement of the rabies outbreak in Bali.

It was also revealed that the rabies outbreak on the Island of Bali was the first in history, because until then Bali was rabies free. An incursion occurred, and the disease spread rapidly across the Island.

Determination of the rabies outbreak was issued after study of a clinical symptoms which were seen in dogs as rabies transmitting animals or humans as victims.

In addition, the rabies outbreakmination refers to the epidemiology of the disease and results of laboratory tests on specimens of wild dogs as well as pet dogs who had bitten all human victims. The resulting epidemic led over 100 human rabies deaths and thousands of human exposures inquiring expensive post exposure treatments.

This tests was conducted at Denpasar, Bali Veterinary Center (BB-Vet) and confirmed by the Maros BB Vet in South Sulawesi on November 28th, 2008.

Rabies in Bali was revealed after four (4) people from three (3) villages in Bali were bitten by dogs in September- November 2008. Of those four people, two were infected with rabies while the other two had a history bitten by dogs.

The three villages are Ungasan village in south Kuta district, Kedonganan and Jimbaran villages in Kuta district, Badung regency in Bali. It was quite a big shock for everyone, and due to condition that Badung has not any nature boundaries for the isolation of the rabies dogs so the rabies will not spread to areas outside of Bali, the status of rabies outbreak was set throughout the whole Island of Bali.

Bali Governor Regulation No.88/2008 was issued by the Governor of Bali at that time concerning The Temporary Closure of Imports or Expenditures of dogs, cats, monkeys or other national animals to and from Bali province as of per December 1st, 2008.

Bali was also declared a quarantine area. Based on Standard Operation Procedures, if one case of infectious animal disease was found in an area that was previously rabies free, an outbreak should be declared immediately. It was stated that until December 4th, 2008, 110 dogs were vaccinated to anticipate rabies transmission and 196 dogs infected with rabies, stray dogs and those left to be eliminated.

 

It saw truly a very sad situation for all animals especially dogs and cats in Bali. And it turned out that there were still many obstacles in the midst of Indonesian Government efforts in realizing Healthy Indonesia 2010 in handling diseases especially animal diseases that can be transmitted to human.

The presence of Rabies in Bali which was previously rabies-free was one proof of how weak the health system in Indonesia was, focusing the National Animal Health system in Bali, which is a world-class tourism area, which since the Dutch colonial era was rabies-free is now becoming just memory (historical record based on The Hondsdolhed Ordie/ Staatblad 1926 No.451 yunto Staatblad 1926 No.452, stated that several residency areas and Islands in the Dutch East Indies/Indonesia at that time were rabies-free included Bali residency).

Rabies  and What You Should Know About

Rabies or mad-dog disease is an animal disease caused by virus which is zoonotic with a 100% mortality rate  (case fatality rate) if it has clinical symptoms arise, both in animals and human. Rabies is a serious problem in the developing world, with 98% cases occuring in Asia and Africa. Rabies kills 55,000 people a year, half of them were children under the age of 15.

  • Dogs Bites

If you’re in Bali and got bitten by a rabid dog and do not immediately clean the bite wound properly and follow up quickly with a complete series of post exposure rabies vaccination, you are at high risk for contracting rabies.

The rabies virus is carried in saliva, and when a person is bitten or licked over an open wound, spreads via the central nervous system to the brain. Symptoms may not appear for a year, but once they do appear, death is inevitable.

Cleaning the wound immediately, right then and there is very important. Do not wait until you’re home or in a clinic. Wash the wound for at least 10 full minutes under running water and soap or even better, detergent, because it breaks down the wall of the virus.

If you’re doing this for someone else and you have a cut on your hands, protect yourself from contamination with gloves or plastic bags over your hands. Then apply iodine or alcohol to the bite wound and quickly get yourself to clinic or hospital for further care.

  • Post Exposure Rabies Vaccination

Vaccination should ideally begin on the day of the bite. Rabies Immunoglobulin is essential part of the treatment if the bite was above the waist as it is closer to the brain. For your info, rabid dogs can carry the virus for six months (rarely up to a year) without being contagious.

When the virus reaches the brain, it becomes present in the animal’s saliva an first symptoms begin to appear. The animal will die of the disease in maximum of ten days after the first symptoms.

  • Vaccination of Dogs

Numerous of scientific studies has proven that culling does not eradicate rabies. World Health Organization studies shows that if 70% of dogs are vaccinated against rabies, the epidemic will quickly die out.

If you haven’t already done so, have your dogs and other pets like cats and monkey vaccinated against rabies and make sure they get a collar or tags so they will be recognized as vaccinated pets. Maintaining high vaccination coverage is key to successful rabies control but mass dog vaccination can be challenging and population turnover erodes coverage. Declines in rabies incidences following successive island wide vaccination campaigns in Bali suggest that prospects for controlling and ultimately eliminating rabies are good. In the eight years after rabies outbreak, vaccination campaigns have continued but sadly dogs and humans are also have continued to die.

Up until today, both the Dinas Peternakan (DP) and many animal welfare included  Bali Animal Welfare Association (BAWA) are vaccinating dogs banjar by banjar. BAWA also vaccinates street dogs. Dogs vaccinated by BAWA wear orange collar or ribbon, while the ones vaccinated by DP wear red collar or ribbon or may not be marked at all. Vaccinated dogs frequently lose their collar so it is not always possible to tell. There is no doubts that the relationship between the Balinese people and their dogs has changed. People now keep fewer dogs, dogs now wear collars, something that would not have been seen prior to 2008. A collar dog indicates owned and vaccinated dog.

The Government have decreed that dogs be chained and caged, which has resulted in suffering for both dogs and humans. Balinese people believe that confining a dog is ‘against the spirit of the Bali dog’.

Ministry of Agriculture increases priority on rabies-free in Bali this year.

Since Bali is Indonesia’s anchor as tourism destination for both domestic and foreign tourists, the Ministry of Agriculture via the Directorate General of Animal Husbandry and Health has increased the priority and targeted in Bali’s rabies free in 2019, to ensure tourist’s safety and comfort.

 

According to I Ketut Diarmita, Director of General of Animal Husbandry and Health, rabies cases in Bali tend to under control and there have been number of regions which in recent years have not encountered cases such as Denpasar City, Nusa Penida Island, Lembongan and Ceningan in Klungkung regency.

Actuallly more than 80% of 716 villages in Bali have no rabies cases in 2018. Ketut also asked the people of Bali to immediately report any cases of animal bites and human deaths due to rabies. He also hoped that the Bali Provincial Animal Husbandry Service, Denpasar Vetinary Center will work hand in hand with the Provincial Health Office to treat the disease until Bali is one more time declared rabies free.

There is a considerable work still to be done to bring the disease under control though. More education programs are needed to ensure that people know what to do in the event of a dog bite from a suspect animal.

A study by Widyastuti in 2015 has found that only 62% respondents to a survey believed that washing a wound from a suspect dog bite was necessary due to a widely held belief that (pre rabies) that dog licks could heal wounds. The same study makes a valid observation “improving animal management practices without stigmatizing community beliefs of the importance of dogs requires better understanding of community attitudes & beliefs”.

But Honestly Rabies is preventable in Bali http://hydromedbali.com/rabies-bali/

When visiting any banjar these days, you will still see free roaming of Bali dogs. The vast majority will wear yellow collar and red ribbon indicating vaccine status. Local dog owners will tell you that their dogs are rabies vaccinated  and will ensure that dogs wear collars in order to keep them safe from any culling activities.

The human-dog relationship in Bali is multifaceted, and whilst the fear of rabies is influencing its dynamics this relationship will continue. It is the next generations of Bali who will adopt community driven drivers of responsibility into their behaviours and their attitudes toward their dogs.

And last but not least, it is our duty and responsibility to keep ourselves well informed our about all diseases we might possible caught in every part of the globe we go.

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