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Archive Number 20091122.4014
Published Date 22-NOV-2009
Subject PRO/AH/EDR> Rabies, canine, human - Indonesia (18): Bali

RABIES, CANINE, HUMAN - INDONESIA (18): BALI
********************************************
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International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 18 Nov 2009
Source: The Jakarta Post [edited]
<http://www.thejakartapost.com/news/2009/11/18/rabies-originated-indonesia-not-bioterrorism-says-virologist.html>


The Molecular Biology Laboratory at the University of Udayana's 
School of Medicine [located in Bali] has confirmed the rabies 
outbreak in Bail originated in Indonesia. Ni Nyoman Sri Budayanti, 
head of the laboratory, denied reports the virus was related to 
international bioterrorism as previously speculated by a government 
official. "After conducting research and studies, we have concluded 
the rabies virus has similar characteristics to those identified in 
Sulawesi and East Nusa Tenggara," Budayanti said.

A number of virologists including Budayanti, Ngurah Mahardika, Raka 
Sudewi and Susilawati conducted a close examination of the rabies 
virus taken from victims in Bali. The 4 virologists used sequence 
data from all types of rabies found in Indonesia [obtained] from 
GenBank. "We assume the virus entered Bali through inter-island 
animal trafficking. Our study found the virus came from Flores in 
East Nusa Tenggara and Sulawesi," she said. Budayanti went on to say 
that many fishermen from East Nusa Tenggara and Sulawesi [had taken] 
their rabies-affected dogs while they were fishing in Bali waters. 
"The fishermen usually bring their dogs with them to ward off any 
problems that might arise during fishing," she added. The increasing 
demand for dog meat among Balinese people may have also exacerbated 
the spread of the virus on the island. "Many people are now consuming 
dog meat daily," she added.

Budayanti regretted the health authority had been slow to respond to 
the rabies outbreak saying they had not conducted any laboratory 
tests on any virus samples taken from the victims. Health officials 
at Sanglah General Hospital in Denpasar previously said the hospital 
could not afford to send the virus to the laboratory because it was 
too expensive. A laboratory rabies test of a virus sample costs 
around Rp 900 000 [USD 95] per sample. "As experts, we feel a 
responsibility to conduct laboratory checks on every sample of rabies 
virus to determine precisely the type of rabies virus that affects a 
victim," she said.

Despite limited funds, the university's laboratory had conducted 
laboratory tests on 23 samples of the virus. "We found that 11 out of 
the 23 samples were rabies-positive, including one [taken from] the 
13-year-old child who died last Friday," she added. "We don't have to 
send the samples to Jakarta. We can check them here," she added. The 
laboratory tests are conducted using polymerase chain reaction (PCR) 
with the suspects' saliva and skin from the neck, taken by biopsy.

The rabies outbreak hit Bali in November 2008 and has, so far, 
claimed 17 lives. Bali has a dog population of 500 000.

The Bali administration has carried out anti-rabies schemes including 
dog vaccination, the mass culling of stray dogs, public education and 
advocacy. The outbreak has hit 7 out of 9 regencies in Bali.

[Byline: Luh De Suriyani]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The number of rabies fatalities on the island of Bali continues to 
rise, having increased from 15 to 17 since the last report at the end 
of October 2009. There appears to have been no improvement in 
diagnosis (despite the availability of facilities at the University 
of Udayana) and treatment of human infections. The disease in canines 
remains uncontrolled. A comparison of rabies virus genome sequences 
available in GenBank by molecular virologists at the University of 
Udayana has confirmed that the rabies virus isolated in Bali is 
similar to the strains of rabies virus present in other parts of 
Indonesia. It has been introduced most likely by inter-island trade 
and not from elsewhere as suggested by one government official.

A map of the island of Bali can be accessed at 
<http://www.baliguide.com/bali_map.html>, and the 
HealthMap/ProMED-mail interactive map of Indonesia can be found at: 
<http://healthmap.org/r/00bi>. - Mod.CP]

[see also:
Rabies, canine, human - Indonesia (16): Bali alert 20091031.37651
Rabies, canine, human - Indonesia (15): Bali 20091016.3564
Rabies, canine, human - Indonesia (14): Bali, vaccine 20090930.3402
Rabies, canine, human - Indonesia (13): Bali, susp. 20090926.3370
Rabies, canine, human - Indonesia (12): Bali, poisoning 20090920.3299
Rabies, canine, human - Indonesia (11): Bali, poisoning 20090919.3289
Rabies, canine, human - Indonesia (10): Bali, susp. 20090915.3242
Rabies, canine, human - Indonesia (09): Bali, susp. 20090907.3152
Rabies, canine, human - Indonesia (04): Bali, RFI 20090311.1014
Rabies, canine, human - Indonesia (03): Bali, RFI 20090309.0984
Rabies, canine, human - Indonesia (02): Bali, alert 20090131.0440
Rabies, canine, human - Indonesia: (Bali), susp. 20090106.0050
2008
----
Rabies, canine, human - Indonesia (07): Bali 20081213.3925
Rabies, canine, human - Indonesia (06): Bali 20081212.3912
Rabies, canine, human - Indonesia (05): (Bali), alert 20081211.3899
Rabies, canine, human - Indonesia (04): (Bali), control 20081206.3837
Rabies, canine, human - Indonesia (03): (Bali) 20081204.3821
Rabies, canine, human - Indonesia (02): (Flores) 20081109.3523
Rabies, canine, human - Indonesia (Flores) 20080215.0606
2007
----
Rabies, canine, human - Indonesia (Flores) 20070227.0708
2006
----
Rabies - Indonesia (East Nusa Tenggara) 20060929.2793
2005
----
Rabies, human - Indonesia (Jambi) 20050625.1782
Rabies, human - Indonesia (East Nusa Tenggara) (02) 20050319.0802
Rabies, human, canine - Indonesia (East Nusa Tenggara) 20050209.0439
2003
----
Rabies, human - Indonesia (Ambon, Maluku): suspected 20030923.2398
2000
----
Rabies, human and canine - Indonesia (E. Flores) (02) 20001226.2280
Rabies, human and canine - Indonesia (East Flores) 20001224.2275
Rabies - Indonesia (Flores) (03) 20000622.1025
Rabies - Indonesia (Flores) (02) 20000619.0997
Rabies - Indonesia (Flores) 20000614.0960
1998
----
Rabies - Indonesia (East Nusa Tenggara) (04) 19980518.0956
Rabies - Indonesia (East Nusa Tenggara) 19980509.0914
Rabies, canine - Indonesia (Kalimantan) 19980415.0695
1997
----
Rabies, weekly report - France, Indonesia, USA (02) 19971031.2221
Rabies, weekly report - France, Indonesia, USA 19971020.2153]
................................................cp/msp/dk

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