Now you guys are ready to travel to Bali. You’re imagining the sun, sand, waves, surf, food, and many cultural experiences that you will get to enjoy. The basic preparation like tickets, itinerary, accommodation, medicines, vitamins, money, and complete apparel and other peripherals are ready! So, what else should I prepared?
However, what most people don’t really consider is a very real risk of contracting rabies on the island of paradise. If you happen to see many strain dogs and cats (or even monkeys and bats) in the streets around Bali, you might be careful and not just straight to touch them. Rabies is a fatal, deadly virus which attacks the brain system to all warm-blooded animals, including human. This virus is normally transferred by animal bites and scratches, mostly through bites and scratches from dogs, cats, bats, and monkeys, causing progressive inflammation of the brain and spinal cord.
Rabies has spread in many places around the world, but mostly in Asia, particularly India, Indonesia, China, Nepal, or Vietnam (among the most popular destinations with travellers the world over). Although the deaths remain rare among travellers. Yet an estimated 55,000 people die from rabies each year, according to the World Health Organisation, with most of its victims failing to access timely post-treatment or unable to afford it.
The rabies-infected animals may appear sick, crazy, or become more violent. However, they can also look too friendly, or sometimes confused. They may look like normal, or not normal. This condition is usually excreted with fever. As the virus develops, dogs that grow can become sensitive to touch, light, and sound. Dogs may eat things that are not usually eaten and like to hide in dark places. The throat and jaw muscles is paralysed, and there is a foam in the mouth of the dog. In addition, there is a loss of appetite, weakness, seizures, and sudden death. In human bodies, the incubation period (time of developing infection) by this virus until the appearance of the first symptoms averages from 35 to 65 days.
The signs that appear may look like the same as flu. Loss of appetite, nausea, pain or numbness in the bitten area could last for the first 3-4 days. Gradually, the virus will spread causing feelings of anxiety, confusion, paralysis, difficulty in swallowing, extreme hyperactivity and eventually the body will experience convulsions, followed by a coma stage. If rabies is not treated immediately after exposure, it almost always leads to coma, seizures, and death usually occurs from day 4 to day 7 after symptoms occur.
Whenever we travel, the health risks travel with us. So, first thing to consider is getting a really good medical travel insurance that could help you.
The second, the preventive rabies vaccinations are a necessary precaution, particularly when visiting tropical countries like Indonesia. This guide looks at common diseases and the vaccinations needed to protect ourselves from them as well as general advice on staying healthy overseas. Getting your vaccinations before you go is not only vital for your health, it can also be good for your wallet because, you could find yourself with a medical bill for tens of thousands of dollars if you need to be medically evacuated for treatment.
Preventive rabies vaccination is called “pre-exposure vaccination.” It is to protect those who are at risk of exposure to rabies. A series of three shots will be given over a month. Pre-exposure rabies vaccination is given in three shots injection into the upper arm. The second day after the first, and the third and final dose is given either 21 or 28 days after the first depending on the specific vaccine. All must be done along with tetanus vaccination if you haven’t had it before (valid for 5 years). However, rabies vaccination does not make you truly immune–not like, say, measles shots. What it does do is buy you time to get treatment and reduce the treatment regime.
The third, is the post-exposure treatment, to prevent the development of clinical rabies after exposure has occurred, usually following the bite of an animal suspected of having rabies. First thing you must do if you are bitten or scratched by any mammals (even if you have previously been vaccinated) is wash the wound thoroughly with soap and water. This will help to reduce the risk of infection. In the circumstances of an animal bite or other contact with an animal suspected to be rabid and potentially has rabies, it may require post-exposure prophylaxis, and medical advice should be obtained immediately referred to WHO-guidelines. A mauling to the head is a big emergency; a nip on the ankle is urgent but not an emergency. Obviously, though, sooner is better; you should never delay getting treatment as soon as you can.
To be completely effective, post-exposure treatment for rabies (called Post-Exposure Prophylaxis or ‘PEP’) should involve a blood product called Human Rabies Immune Globulin (HRIG), which is usually a wound before or with first vaccination. Designed to be an immediate immune response, it is the HRIG more so that it is usually hard to get overseas (and, therefore, always expensive). If you were not previously vaccinated, then you need a shot of HRIG and a series of five shots of vaccine given over the course of a month. Before, it is very hard to find in Bali, and people needing it have to go to Singapore, Hong Kong, Vietnam or even Australia. But we’ve seen the reports that some good clinics and hospitals do have it.
What makes rabies such an important issue for travellers visiting a rabies-infected country (which includes much of the developing and developed world) is that it is invariably fatal. There are no second chances. Typically, the period between contracting rabies and symptoms appearing is 1-3 months, however symptoms can begin in less than a week or not emerge for more than a year. It all depends on how long it takes to reach the victim’s central nervous system following a bite or scratch.
Because it is always fatal, even those people who have been vaccinated prior to travel should receive post-exposure treatment after a possible exposure. Once you get bitten, the protection of pre-travel vaccination is critical. The WHO estimates that more than 15 million people receive post-exposure vaccination each year, preventing hundreds of thousands of rabies deaths.
One of the factors causing difficulties in the eradication of rabies on the island is the Balinese culture towards dogs. The Balinese people have close companionships with dogs, even with the strays. They tend to let dogs wander around and often feed them. This has caused the dog population to rise in Bali to reach approximately 500,000. Other solution to stop of the transmission of rabies amongst dogs is by giving free vaccinations to all dogs in Bali. The government poured 23 billion rupiah to realize the Bali Rabies-Free program in 2020.
Nevertheless, this situation so far has not had a dramatic impact on tourism. The uncontrolled conditions have raised lots of questions and concerns regarding the safety of travellers coming to Bali. There are no official travel warnings or recommendation for rabies vaccination for travellers to Bali so far, but we recommend you, especially if you’re planning a prolonged stay.
Considering the fact that dogs, cats, bats, and monkeys which could interact with you can experience rabies, vaccination is not a bad thing before come here. Don’t get too close to them. And this is going to be the fourth tip for you, always avoid bites if possible (don’t approach dogs or monkeys, for instance) and seek immediate treatment if you are bitten. Don’t forget that a rabid dog may not be foaming at the mouth. It may appear normal or just a bit lethargic. Dogs can have rabies in their saliva a couple of days before showing symptoms.
When you’re get scared of seeing the suspicious stray dog, raise your hands as if you are going to throw a stone, they usually run. And also keep your children from getting too close to them. Remember, once symptoms have already developed however, there is no treatment and death is the usual outcome.
Seek medical attention immediately if you are bitten by any animal, including pets. Depending on the injury and the situation, the doctor could examine and then decide if you need to receive treatment and when to do the procedure to prevent rabies disease. But we would want to suggest to get in within the first 24 hours. As soon as you can. We would not put it off, especially because one of the vaccine-injections that we’re giving, at the site of the wound, is essentially neutralizing that virus if it’s there, so the sooner, the better.
In spite of that, don’t rely on vaccines. They are effective against the disease, but still, prevention is the best as it is. Make sure to not feeding or get too close to stray dogs, monkeys, bats or any warm-blooded animals if you really want to reduce your health risk.