Rabies in Bali, common misperceptions and the way ahead
Rabies is a problem in Bali, of that there is no doubt. However if treated quickly and properly it can be healed in almost 100 % of cases. The disease can be eradicated on the island, but only if the proper measures are applied.
It is a sad misperception that rabies can be controlled through culling even though at first glance it appears a logical option. Culling in fact aggravates the problem and has never been successful in controlling the disease. According to the World Health Organization [WHO] rabies can only be controlled through vaccination in combination with sterilization. It has worked in India [Chennai!] Costa Rica and many other parts of the world.
The Way Ahead
In Bali we need to vaccinate al least 70 % of the dog population in order to overcome the disease. Organizations like BAWA [Bali Animal Welfare Association] are at the forefront of fighting rabies on the island. So far BAWA have vaccinated over 70.000 dogs in Gianyar with encouraging results. Treated dogs are marked with red or blue collars for survey reasons. The Bali government recently announced its intention to launch a massive 3 month vaccination campaign in September aiming to inoculate all Bali dogs.
Sterilization in combination with vaccination makes sure that the population can be reduced in a controlled and sustainable way. Culling is counter-productive.
Everyone on Bali – residents and visitors alike – need to be made aware of what to do if they get bitten by a dog or any other animal capable of carrying rabies.
If bitten, flush and scrub the wound immediately for at least 15 minutes with soap/detergent and water, or just water alone if no soap/detergent is available. It is very important to prevent the virus from entering the body and central nervous system. Detergent breaks down the walls of the virus. The wound should also be disinfected with ethanol [alcohol] (700ml/l) or Betadine (tincture or aqueous solution).
Post exposure treatment must be continued at a clinic or hospital as soon as possible. Usually the treatment consists of emergency vaccination as well as a tetanus shot. In serious cases immunoglobulin needs to be administered. However this is a great problem because immunoglobulin is very scarce in Bali and expensive. If in doubt patients need to seek treatment in Singapore or Australia.
Sanglah hospital in Bali is the official rabies treatment centre, private health providers like International SOS or BIMC are amongst the best prepared.
Once rabies symptoms are detected in a person the disease will be fatal.
For further information check the extensive information on rabies, its treatment and eradication on the WHO rabies information websites and contact BAWA for a local update.