Bali Suffers Numerous Setbacks in its Battle Against Rabies.
http://www.balidiscovery.com


(2/27/2010) New cases of rabies infections continue to mount in Bali. Radar Bali reports that deaths attributed to the disease are also mounting in the face of the depletion of emergency government funds allocated to fight rabies.

In the light of the worsening situation, Governor Made Mangku Pastika on February 23, 2010, convened those delegated with fighting rabies in Bali for a meeting. In attendance were representatives from the Bali Department of Health dealing with communicable disease, environmental health officials and representatives from Bali's main general hospital.

Following that meeting, the officials told the press that Bali was still in an "extraordinary situation" in its confrontation with rabies, made worse by the high rates of dog bites being reported to health authorities everyday.

Bali main general hospital at Sanglah is reporting a daily rate 60 dog bites, with other satellite general hospitals across the island treating an average of between 25-30 cases a day. Authorities estimate around 85 dog bites are taking place island-wide on a daily basis.

Since November 2008, a total of 31,000 dog bite injuries have occurred in Bali with 28,000 people being given anti-rabies serum. The current count estimates that there have been 59 confirmed cases of rabies of which 28 have been clinically confirmed as resulting from the disease.

Fearful of a further spread of the disease, disease control authorities have renewed their calls for the elimination of stray dogs in Bali.

Dr. Ken Wirasandi of the Sanglah General Hospital, who serves the the Secretary of the hospital's rabies control center confirms that rabies has now spread to almost every regency and metropolitan center in Bali. "Klungkung which was formerly said to be safe, has now seen on patient from that area die at Sanglah hospital. The only area still free of rabies is the regency of Jembrana," explained Dr. Wirasandi.

Concerning to Dr. Wirasandi is that fact that at least 5 of those who have died of rabies received two of three treatments with anti-rabies serum, with one having received the complete regime of 3 shots. Post-mortem studies revealed that two of the patients receiving two sets of serum did, in fact, died of rabies.

Rabies treatment must be commenced as quickly as possible after suffering a possibly contagious bite. Unfortunately, once clinical symptoms of rabies appear in a patient there is little that can be done medically to save the victim's life.

There are also also a growing problem securing a sufficient supply anti-rabies serum. A 5 year old boy died of rabies in Bali on Sunday, February 21, 2010. The child, who came to the hospital for treatment after being bitten in the face by a dog, did not receive the needed serum, apparently because officials had no supply of the serum to give the child.

There have also been reports in the Bali press of drugs stores in Bali selling anti-rabies vaccine that should, according to law, be available from hospital without charge to the public.

Bali Responds as New Cases of Rabies Discovered on Island' North Shore.
http://www.balidiscovery.com

Confirmed cases of rabies now stretch to all four corners of Bali with rabid dogs now detected in two communities at Sambirenteg, Tejakula in the Buleleng regency, North Bali. Officials in Buleleng are responding by educating the local community on preventive steps to stop the further spread of the disease. Local authorities are also in the process of eliminating stray dogs on a village by village basis in combination with a program of vaccination for the local pet dog populations.

Meanwhile, Bali's provincial government has pledged to make Bali "Rabies Free" by 2012, three years ahead of the earlier announced target of 2015.

Jakarta Globe quotes Tjandra Yoga Aditama of the Indonesian Health Ministry as saying because of Bali's role as a tourism icon the island was being prioritized in the national fight against rabies, saying: "This is an important battle given Bali's role as a world-class tourist destination and its strategic contribution to the national economy. If we are late acting on this issue, the disease could have a negative impact and spread to other areas."

From an initial case one year ago isolated in Bali's southernmost regency of Badung, rabies cases have now been confirmed to have spread island wide with cases reported in Gianyar, Tabanan, Bangli, Karangasem and Buleleng. At least 15 human fatalities have been linked to the current outbreak.

Rabies control units are now in operation in six regions of Bali offering anti-rabies vaccine for those who are bitten by potentially rabid animals.

Current estimates are that 26,705 dogs have been culled from a total dog population put at 500,000 animals.

Kompas.com reports that Rp. 2.4 billion (US$240,000) is being allocated in 2010 to prevent the spread of rabies. A total of Rp. 8 billion (US$800,000) has been spent in 2009 in Bali in the fight against rabies.

Officials in Bali insist that any shortage of vaccine is only momentary, tied to supply-chain issues and not a lack of funding to secure vaccine.

Yoga Aditama is recommending that Bali set up rabies centers in all of Bali's regencies and municipalities to help meet the 2012 target for elimination of the disease and quickly address any new cases discovered in the coming months.

Nation-wide Indonesia reports confirmed cases of rabies in 24 of its 33 provinces, with the worst affected areas in North Sulawesi and South Sulawesi.