From: balilocal@yahoogroups.com [mailto:balilocal@yahoogroups.com] On Behalf Of Rucina Ballinger
Sent: 12 September 2010 13:44
To: Rucina Ballinger
Subject: [balilocal] FW: Deadly Reality Bites in Bali
The Sydney Morning Herald
September 11, 2010
Deadly Reality Bites in Bali
Indonesia is struggling with an outbreak of rabies that has
caused many fatalities, writes Chris Vedelago.
Australians travelling to Bali are being warned to avoid any
contact with animals following a worsening rabies outbreak on
the island that has killed dozens of Balinese.
The Department of Foreign Affairs and Trade (DFAT) updated its
travel advice for Indonesia following reports that more than 70
people on the island have died from rabies in the past two years
after being bitten by dogs. The infection has also spread to
Nias Island.
The Indonesian government is struggling to contain the outbreak.
Post-exposure rabies vaccinations are in chronic short supply at
a time when more than 30,000 dog bites have been reported in
Bali during the first half of this year.
The warning comes as Bali gears up for an influx of tourists
following the October release of the movie Eat Pray Love,
starring Julia Roberts, which is set on and was filmed around
the island.
The national medical advisor at medical group Travel
Doctor-TMVC, Dr Tony Gherardin, says rabies-infected dogs were
brought to Bali on fishing boats in 2008.
''The clear message is that there is now a rabies risk on Bali
for tourists,'' Gherardin says. ''If you get bitten by a
rabies-infected animal and develop the disease, you will die.
''If you get post-exposure treatment immediately, then your risk
of dying reduces dramatically. But the vaccines have only been
imported there in very limited amounts, so the likelihood of
getting treated is very small.
''People who have been bitten have had to go to Singapore,
Darwin or go home to get treatment. It will definitely spoil the
holiday.''
It can take days or months for rabies symptoms to appear after
being bitten by an infected animal - typically, dogs, cats, bats
or monkeys - but once symptoms appear, the disease has a
fatality rate of almost 100 per cent within two to 10 days,
according to the US Centre for Disease Control (CDC).
The DFAT Smart Traveller advice says: ''If bitten or scratched,
you should seek immediate medical attention. Availability of
post-exposure rabies treatment in Indonesia may be limited,
which may require bite victims to return to Australia or travel
to a third country for treatment within seven days.''
Post-exposure treatment involves administering an injection of
human rabies immune globulin ˆ of which there is a world-wide
shortage -- and a vaccine injection on the day of the bite and
then further vaccinations three days, seven days and 14 days
later.
The Australian Department of Health reports that this year about
30 Australians a month have sought post-exposure rabies
treatment at home after being bitten or scratched in a foreign
country. Nearly one-third of those treated were bitten in Bali.
There has been no recorded case of overseas-acquired rabies in
Australia since 1990.
Gherardin warns that the rabies outbreak could get even worse if
the disease spreads to other animals, particularly the monkey
population that inhabits popular tourist attractions in Bali
such as temples and monkey forests. ''The best preventative
measure is stay away from animals and animal attractions,'' he
says. ''Don't pet a dog or pick up a kitten. Don't go to the
monkey forest.''
DFAT, the CDC and the World Health Organisation advise that
those who plan an extended stay in Bali, particularly in rural
areas, or who will work with animals should consider
pre-exposure vaccinations, which reduce the extent of treatment
required following a bite.
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