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Ask The Travel Doctor-TMVC

Q: I have been told that there is a problem with rabid dogs in Bali.  Could you please tell me if this is a real concern and what precautions my daughter could possibly take when she visits there in May?

Fiona

 

A:  Unfortunately this now is a real concern. Traditionally Bali has been free from rabies which has been known to be present on many other Indonesian Islands. In late 2008 sick and dying dogs appeared and then human cases of rabies after local people had sustained dog-bites. The virus had spread from dogs brought onto Bali by fishermen from other islands. The local authorities have responded by culling dogs, but the real answer will lie in efforts to vaccinate dogs, something which is happening very slowly at present. So for all people in Bali, including tourists, the practical issue is to avoid dogs completely. While a sleepy dog in the street can be easily avoided, groups of dogs on the beaches are more of a problem, and travellers are urged to be alert and careful.

If a dog bite or scratches are sustained, immediate washing of the wound with soap and water for 10 minutes before applying antiseptic should be done. Then seek medical assistance, as post-exposure vaccination needs to be completed. Bali International Medical Centre in Kuta is the best place to go.

For people who not vaccinated against rabies, treatment consists of 5 vaccinations and rabies immunoglobulin (not available at the local hospitals), and is very expensive and spread over 1 month.

Travellers who are already vaccinated against rabies do not need immunoglobulin, and only need 2 booster vaccine doses.

Pre-exposure vaccination against rabies involves having 3 doses of vaccine before travel, given over 1 month, and although relatively expensive, provides a high-level of protection and a much easier post-exposure treatment. Certainly for travellers who will have long exposures (travels) to Bali and other developing countries, it should be considered.  For all travellers however, the best advice is "don't get bitten!"

Dr Tony

 

Disclaimer: Information provided in this health column is of a general nature & should not replace specific advice from your own personal Travel doctor-TMVC consultation.
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