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Rabies Vaccination: Protecting Yourself from Bali’s Canine Companions

Discover the importance of rabies vaccination and learn how to safeguard yourself against Bali’s canine population. Explore the prevalence of rabies in Bali and identify high-risk areas for exposure. Find out about the different types of rabies vaccines for humans and the recommended vaccination schedule. Gain valuable insights into preventing rabies through responsible pet ownership and strategies to avoid contact with stray dogs. Learn the crucial steps to take after a dog bite and the significance of post-exposure prophylaxis. Take control of your safety and stay informed.

Rabies is a viral illness that affects the nervous system and brain. It is almost always fatal once symptoms arise, but it is preventable. It kills approximately 59,000 people per year with over half of them being children younger than the age of 15.

It is caused by an infection with the rabies virus or other lyssavirus family viruses such as Australian bat lyssavirus. Rabies does not occur in animals in Australia; however, some bats carry Australian bat lyssavirus (ABLV), a closely related virus that can extremely rarely spread from bats to humans (only 3 recorded cases since 1996).

Although it is not natively found in Australia, there are several countries in which rabies is still common including India, Thailand, Nepal, China, Vietnam, Indonesia, Iran, Afghanistan, Egypt, Venezuela, South Africa, Somalia and many others. For travellers, the greatest risk of rabies comes from being bitten, licked, or scratched by an infected animal (such as a dog, monkey, fox, cat, or bat) while traveling to areas in which it is endemic. Exposure to rabid dogs accounts for 99% of rabies deaths worldwide.95% of cases occur in Africa and Asia. The best prevention is to avoid contact with any mammal while travelling. This includes patting dogs and cats which many travellers unfortunately tend to do.

Rabies is nearly 100% fatal without pre-exposure vaccination or prompt post-exposure treatment. After being potentially exposed to the virus through a bite or scratch, post-exposure treatment is almost 100% effective if it is started before symptoms begin. Symptoms may take days, weeks or months to arrive, but once they do, rabies is almost certainly fatal.

 

Therefore, prompt medical attention post exposure to the rabies virus is essential. Those who are traveling to areas in which medical care is limited and where the rabies virus is endemic should speak to a medical provider about potentially getting the rabies vaccination and other recommended vaccinations.

Rabies in Bali

The current situation of rabies in Bali is describe as The Bali Provincial Health Office has confirmed that four people have died due to rabies infection in Bali since the beginning of 2023. The Bali Provincial Health Office also stated that rabies vaccines are available at health facilities and regional health offices in Bali.

 

Head of the Bali Provincial Health Office, I Nyoman Gede Anom, stated that in terms of quantity, the number of fatal cases due to rabies infection in humans in Bali from January to early July 2023 is less compared to the same period last year. From January to early July 2023, there were four recorded cases of fatalities. Meanwhile, during the same period last year, there were 11 cases of death caused by rabies infection in Bali. “It has decreased by almost 64 percent,” said Anom.

Four cases of deaths due to rabies infection occurred this year in Jembrana Regency, with two cases, one case in Buleleng Regency, and one case in Badung Regency. The agency also noted that there were 19,095 cases of rabies-transmitting animal bites (HPR), especially from dogs, with 300 positive rabies cases. However, not all bite cases resulted in fatalities as victims received immediate treatment, including rabies vaccination. Anom stated that cases of rabies-infected animal bites result in fatalities because the victims were not immediately treated. “The deaths occurred because they were not given the rabies vaccine within one to three months of infection,” said Anom. The data from the Bali Provincial Agriculture and Food Security Office shows that the population of dogs in Bali is estimated to reach 599,719 by 2023. The availability of rabies vaccines in Bali until June 2023 is 510,000 doses. As of early June 2023, the rabies vaccination program in Bali has reportedly reached about 43.2 percent of the animal population, especially dogs.

However, transmission of rabies from dogs to other animals has been found in one of the neighbourhoods in Pujungan Village, Pupuan District, Tabanan Regency. Recently, a pet monkey owned by a resident was declared positive for rabies infection after fighting with a wild dog. The monkey then bit local residents and caused two people to be infected with rabies. The victims of the monkey bites have reportedly received treatment and obtained rabies vaccines.

Rabies Vaccination for Humans

Two rabies vaccines are usually available. Each one requires three intramuscular doses – an initial dose, a second dose after 7 days and a third at 21 or 28 days. Both vaccinations are very effective at preventing rabies. If you are planning on traveling to a country in which animals are known to carry rabies and you think you may come in contact with them, you may be recommended to receive a rabies vaccination before you travel as a preventative measure.

If your travel or work activities bring you in contact with potentially infected animals, you may also need a pre-exposure vaccination. Your doctor or travel health clinic will help you determine whether you should be vaccinated before your departure or not.

You should consult a travel health clinic or schedule an appointment with your doctor no later than 6 to 12 weeks before you depart overseas from Australia. This is essential to ensure you have enough time to receive the vaccination and for it to build your immunity, as it takes one month to administer the vaccine over 3 spread out doses.

 

 

Preventing Rabies in Bali

Avoiding Contact with Stray Dogs

Discover practical tips to avoid contact with stray dogs in Bali, such as keeping a safe distance, not feeding them, and avoiding eye contact. Learn how to navigate common situations and ensure your safety.

Importance of Responsible Pet Ownership

Understand the vital role of responsible pet ownership in preventing the spread of rabies. Learn about the importance of vaccinating and sterilizing your pets and keeping them securely confined to minimize the risk of exposure.

After a Dog Bite

Steps to Take

Discover the immediate steps you should take after a dog bite to minimize the risk of infection and assess the severity of the wound. Learn how to cleanse the wound properly and seek immediate medical attention.

Post-Exposure Prophylaxis for Rabies

Understand the importance of post-exposure prophylaxis (PEP) for rabies, including receiving prompt medical treatment, cleaning the wound, and getting vaccinated as a precautionary measure. Stay informed about the necessary precautions, even if you have been previously vaccinated.

In addition to receiving a pre-travel vaccination, there are several critical steps that must be taken after any potential exposure to the rabies virus.

  1. Cleanse the wound with soap and water as quickly as possible for 15-20 minutes. This may help to prevent infection, however post-exposure treatment is still needed.
  2. Apply iodine or alcohol to the wound if it is available. Do not bind the wound tightly, only cover it lightly with medical gauze or leave it exposed to air.
  3. Seek medical attention as quickly as possible as it is essential to begin post-exposure treatment promptly.

Do not wait to find out if the animal has rabies before seeking treatment, as this can take days. Also, do not wait until you return home. Seek medical attention while you are abroad from a medical provider or clinic with experience in treating rabies. If you are overseas your insurance provider may be able to help with accessing medical care.

 

Treatment includes delivery of a post-exposure vaccination and treatment with the blood product Human Rabies Immune Globulin (HRIG). This product can be very difficult to find, so patients may need to be flown to somewhere where it is available.

Those who have previously been vaccinated against rabies will still require post exposure treatment, however only 2 doses of the vaccine are required over 3 days. Previously vaccinated individuals will also will not require the blood product (HRIG) in the event of exposure. Those who have not been vaccinated will need 4-5 doses over 14 -28 days, as well the blood product (HRIG).

Prompt treatment ensures that HRIG can be injected at the wound site if needed, which provides a quick source of protective antibodies to control the spread of the virus, giving the vaccine more time to generate protective antibodies.

Conclusion

By understanding the prevalence of rabies in Bali and the importance of vaccination, you can protect yourself against the risks associated with Bali’s canine population. By following responsible pet ownership practices and taking immediate action after a dog bite, you can safeguard your well-being. Stay informed, stay safe, and help spread awareness about rabies prevention in Bali.

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