Published Date: 2008-12-12 19:00:39
Subject: PRO/AH/EDR> Rabies, canine, human - Indonesia (06): Bali
Archive Number: 20081212.3912
RABIES, CANINE, HUMAN - INDONESIA (06): BALI
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 12 Dec 2008
Source: The Jakarta Post [edited]
Groups coordinate rabies controls
In response to what is feared to be a rabies outbreak in Bali, several
authorities and health organizations expressed their readiness Monday [8
Dec 2008] to carry out several measures designed to curb the spread of the
disease. Their willingness was declared at a coordination meeting held at
the Bali Health Agency chaired by Tjandra Yoga Aditama, the director
general of disease control and environmental health at the Health Ministry.
The meeting was attended by officials from regency animal husbandry
agencies, the Bali Health Agency, police, tourism offices, community health
centers, state-run Sanglah Hospital, and other related institutions.
The Bali provincial administration has declared a condition of
extraordinary occurrence following the confirmation that a brain sample
from a dog in Kedonganan, South Kuta, tested positive to rabies. "This is
an extraordinary occurrence or an emergency situation. We have to quickly
work to restore Bali as a rabies-free area," said Dewa Ketut Oka, head of
the Bali Health Agency.
However, one only one brain sample of one dog tested positive, Oka said.
The results of laboratory tests on the 4 people who died in Ungasan
village, Uluwatu, recently after being bitten by stray dogs were not
available yet. "But from the clinical symptoms of a victim, there is a
strong indication they were infected by rabies," Oka said, referring to one
of the 4 victims.
At the meeting a number of steps to curb the spread of rabies were taken,
including culling stray dogs and vaccinating domesticated dogs in areas 10
km [6.25 miles] from Ungasan and Kedonganan villages. At least 20 000 doses
of rabies vaccine for dogs have been sent from Jakarta. Dog owners are
encouraged to fence their dogs so they are not infected by any other sick
"Seventy-five stray dogs in Ungasan and Kedonganan have been put down by
lethal injection in cooperation with the Yudhistira Swarga foundation for
wild dog welfare," IB Ketut Alit, head of the Bali Livestock Husbandry
Agency, said. "A similar program could be conducted throughout other
regencies in Bali as the program to curb the population of stray dogs has
been [conducted] on a routine basis," Katut Alit said. In a related
development, a dog lover in Bali who asked for anonymity agreed with the
provincial administration's drive to get rid of the wild dogs in the
affected areas. "Just go ahead with the program, but do it in a proper
way," she said. She also encouraged officials not to use techniques such as
putting dogs in gas chambers, shooting them or hitting them on the heads.
"Basically, do it in a humane way." The dog lover said mass culling was not
the only way to prevent the spread of the disease. Other measures also have
to be implemented correctly, especially in handling the og bodies by
properly burying, she added.
Bali Tourism Agency chairman Gde Nurjaya said it was important to protect
Bali's image as an international tourist destination. "The health of both
humans and animals is very important here."
(byline: Luh De Suriyani and Hyginus Hardoyo)
Infectious Diseases Registrar
Royal Darwin Hospital
PO Box 41326
Casuarina NT 0811
[The location of the island of Bali can be found using the HealthMap/
ProMED-mail interactive map of Indonesia at <http://healthmap.org/
promed/en?v=-2.6,120.9,5>. A map of the island of Bali is available at
<http:// www.baliguide.com/bali_map2.html>, showing the districts of Kuta
and Uluwatu at the southern tip of the island not far from the island airport.
The geographical location of the rabies outbreak at the southern tip of the
island suggests that it may be containable by rigorous application of the
proposals outlined above, comprising vaccination of domestic dogs and
humane culling of wild and stray dogs within a 10 kilometre radius of the
villages where the outbreak has occured. So far one dog has been confirmed
positive for rabies virus infection by laboratory diagnosis. Rabies
infection has not yet been confirmed by laboratory diagnosis as the cause
of death of the 4 villagers in Uluwatu who died following dog bites, but at
least one patient exhibited symptoms compatible with the disease.
The proximity of the outbreak to the island airport suggests that this may
have been the point of access of the infection. - Mod.CP]