Undiagnosed deaths in Bali; Rabies confirmed

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Source: http://www.thejakartapost.com/news/2009/01/10/bali-closes-doors-dogs.html

Saturday, January 10, 2009 7:28 PM
Bali closes doors to dogs

The Jakarta Post , Jakarta | Sat, 01/10/2009 4:30 PM | National
Bali Governor Made Mangku Pastika has called a halt to all canine import and export on the island, as provincial authorities try to control a rabies outbreak.

"We are closing the seaports and airport to any dog trade. This is to prevent rabies transmission off the island," he said while attending a rabies vaccination event in Denpasar.

The outbreak became official when a resident in Jimbaran, Badung Regency was confirmed to have died from rabies after he was bitten by a dog. Several people on the island had been confirmed dead from rabies since December.

Hundreds of people had been inoculated with the vaccine for humans while hundreds of dogs had been put down or vaccinated since the campaign began in December. The Bali administration estimates the island is hot to around 20,000 dogs. (dre)

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Source: http://www.thejakartapost.com/news/2009/01/19/rabies039-death-toll-rises-six.html

Tuesday, January 20, 2009 6:23 AM
`Rabies' death toll rises to six
Luh De Suryani,Contributor, Denpasar
| Mon, 01/19/2009 6:03 PM | Bali

Another person died of suspected rabies at Sanglah Hospital in Denpasar on Friday, after having been bitten by a dog six months ago.

His death brings the number of deaths attributed to rabies to six.

Thomas Aquino, 32, a resident of Ungasan village in South Kuta, began convulsing and salivating excessively on Thursday. Family members took him to Sanglah Hospital where doctors treated him for nine hours before he died. They gave rabies as the possible cause of death.

"We've diagnosed him with rabies for now considering the clinical symptoms and his history of dog bite," said Ken Wirasandhi, a physician and director of services at Sanglah Hospital.

"We're still waiting for the results of the blood test before making a final diagnosis. What is sure is that he had acute inflammation of the brain, which may have been caused by the rabies virus."

Thomas, a taxi driver, who was bitten on the thigh by a friend's dog in July last year. At the time, nobody suspected he might have contracted rabies because the outbreak was not officially declared until late last year.

Also bitten was his friend, Freddy, who refused to be interviewed. However, Freddy was vaccinated a few weeks ago during the Badung administration's rabies vaccination campaign, according to Dr. Sastrawan, a field operative with the Badung Health Agency.

"His family said they had managed to convince Thomas to get vaccinated too, but it was too late," Sastrawan said.

He said Thomas' health deteriorated extremely quickly - within one day - from when he began showing signs of sickness.

"There was no sign of anything, and then suddenly on Dec. 14, he began complaining of muscle cramps and was foaming in the mouth," said Sastrawan, who conducted an inspection of Thomas' family residence on Saturday.

Thomas is the sixth person to die of suspected rabies, according to The Jakarta Post's observations.

The first four casualties, all of whom were bitten by dogs before they died, occurred in Ungasan a few months ago. Earlier this month, 4-year-old Ketut Tangkas Adi Wirawan was reported to have died from rabies.

Sastrawan advised those who had been bitten by dogs to immediately get a rabies vaccination at their nearest Community Health Center.

"We have more than enough vaccine," he said. "Do not delay ifbeen bitten by dogs within the past year."

Ken added that Sanglah Hospital was giving free rabies vaccinations, also urging the public to take extra care to prevent dog bites.

"All these 6-month-old cases of dog bites are making us do a lot of time-consuming background checks, to find out the type of rabies virus we're dealing with and how we can handle it," he said.

The Badung and Denpasar administrations have carried out massive vaccination drives targeting stray and pet dogs in a bid to contain the outbreak.

On Sunday, scores of high-ranking Badung officials participated in a religious ritual at the Puncak Mangu temple to seek divine intervention to stop the outbreak. They have also reportedly planned a series of purification and sacrificial rituals with a similar aim in the coming weeks.

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Source: http://www.time.com/time/world/article/0,8599,1872680,00.html

Rabies Outbreak in Paradise
By Jason Tedjusukmana / Jakarta Wednesday, Jan. 21, 2009

Bali, whose mythic resorts have been struggling to fill their beachside villas during the global financial meltdown, has been hit by another unexpected crisis this month: rabies. The death toll from an outbreak on the island of 3.1 million rose to six on Monday, adding to the woes already faced by the Indonesian province after the downturn in the world's economy.

Doctors at Bali's largest hospital told the press that they suspected rabies was the cause of death in a resident admitted to the hospital last week convulsing and foaming at the mouth. The number of patients bitten by infected animals jumped from 15 in December to 10 each day since the beginning of January, according to officials. "It could be that in the past few months there were a number of cases that weren't reported," Ken Wirasandhi, the hospital's director of services, told the Kompas daily.

As the severity of the problem comes to light, the island is gearing up for a mass dog vaccination this weekend to help prevent the virus from spreading beyond the districts of Denpasar and Badung, where the first cases were reported in November. Since then, more than 6200 dogs have been vaccinated and more than 280 stray dogs put to sleep. Bali governor I Made Mangku Pastika has closed the island's borders to all dog traffic from outside, where the virus is believed to have originated.

 

[Gert van der Hoek]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Patients' Suspect 'Rabies Died

Denpasar (Bali Post) --

Patients suspect rabies, on Wednesday (28 / 1) yesterday at 13:55 WITA, died in Sanglah Hospital. RK initials, female patient (45) with a road Srikandi, Nusa Dua this had previously been treated in isolation sal bird flu since Tuesday (27 / 1) afternoon. The patient was already in critical condition with acute symptoms of clinical rabies.

The hospital can not ensure a positive rabies case RK infected until further investigation. Actually Thursday (29 / 1) This ceremony will be held their first daughter's wedding. The ceremony had diundur result incident.

RK history that have previously bitten by a dog is treated in a closed meeting room with a blue curtain to reduce Fobia of radiotherapy patients. Patient's condition continued to decline with the complaint Fobia rays, can not swallow, shortness of breath and other symptoms characteristics rabies infected. From the family said that the patient is experiencing shortness of breath since three days ago.

Family menuturkan patient, RK bitten by a dog about three weeks ago at the top of the left arm while making banten. At that time, RK bitten by the dog suddenly nyelonong go home.

RK itself directly taken to a health clinic for treatment. Three months since the incident, RK began to show strange symptoms such as cramps, wind and Fobia tongue speechless. Family was able to call people to check conditions before finally deciding RK RK taken to hospital for Surya Husadha then referred to the Sanglah Hospital.

As with RK, Sanglah Hospital previously treated patients also had a rabies suspect. They both died but up to now still waiting for laboratory results certainty. Strongly suspected, because the late death patients get treatment.

Secretary Of Rabies team from Sanglah Hospital. Ken Wirasandhi justify Sanglah Hospital treat patients with suspected lead to rabies. Patients come Tuesday (27 / 1) at around 13:00 WITA.

However, according to Ken, when patients were referred to come from the private hospital in Nusa Dua was initially diagnosed this broken heart. Because of the disruption came in the heart, the patient was getting treatment in the heart space.

During the period of observation, the symptoms start to the rabies found in the patients. Patients began showing symptoms of fear of water, fear of light and does not feel comfortable with the environment. (ded)

http://www.balipost.co.id/mediadetail.php?module=detailberita&kid=10&id=10468

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Source: http://www.telegraph.co.uk/travel/travelnews/4396609/Bali-tourists-warned-over-rabies.html


Bali tourists warned over rabies
The Indonesian island has first ever rabies outbreak, reports Charles Starmer-Smith.
By Charles Starmer-Smith
Last Updated: 11:02AM GMT 30 Jan 2009

Authorities in Bali are battling a rabies outbreak that has spread across the island and is threatening its tourism industry. The first cases were reported in Denpasar and Badung districts last November, but this month it spread to Kuta, one of the main tourist resorts.

Since the beginning of January, the number of infected people has increased from a ?handful? a week to at least 10 a day, hospital staff have said. Six deaths have been reported. More than 24,000 pet dogs have been vaccinated, while more than 1,000 strays have been culled.

?It could be that in the past few months there were a number of cases that weren?t reported,? said Ken Wirasandhi, the director of services at Sanglah, Bali?s largest hospital.

?We?ve received calls from tourists asking about the rabies situation, but we haven?t received reports of any tourists being bitten by dogs,?? said Gede Nurjaya, the head of the Bali Tourism Authority.

Tour operators report that the outbreak has not yet led to cancellations, but admit it is vital that the spread of the disease is contained quickly.

A spokesman for the tour operator Kuoni, which reported this week that Indonesia had moved up from 20th in 2007 to 16th in its annual list of popular long-haul destinations, said it was making passengers aware of the risks, but that no one had cancelled.

Since the onset of the financial downturn, Bali has struggled to attract visitors. The number of tourists has failed to reach the levels experienced before the bombings in October 2002, which killed 202 people. A further setback has been the banning of Indonesia?s main carrier, Garuda, from European territory, because of safety concerns.

The Foreign Office has joined the United States and Australia in issuing a warning to travellers about rabies in Bali. Rabies has been reported on the Indonesian islands of Java and Flores, but this is the first time it has been recorded on Bali.

The World Health Organisation estimates that more than 40,000 people die from rabies every year. Most deaths take place in developing countries, particularly in South-East Asia. Since 1946, there have been 23 deaths among Britons infected with rabies abroad.

Lisa McMurray, from Belfast, was the last Briton killed by the virus. She died earlier this month in hospital.

* Foreign Office advice: www.fco.gov.uk

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Source: http://www.thejakartapost.com/news/2009/02/03/urgent-rabies-serum-bali-doctors-say.html

Urgent: Rabies serum for Bali, doctors say

Luh De Suryani , Contributor , Denpasar | Tue, 02/03/2009 3:40 PM | Bali

Doctors are urging the government to quickly supply rabies serums.

Patients who had been bitten and vaccinated began showing recurring symptoms of rabies.

I Wayan Suarjana, 34, was admitted to Sanglah Hospital after he began feeling cramps in several parts of his body on Friday evening.

Suarjana, whose left forearm was bitten by a dog two months ago during a rabies prevention seminar in south Kuta and received immediate vaccination, appears to still be infected.

According to a relative, I Wayan Mangkok, Suarjana began showing symptoms similar to those of rabies-infected patients, including fever, pain and cramps around the bite-wound, and an overreaction to sensory stimulation.

"Though that might be just fear factor after watching so much news on TV of how rabies patients were suffering the same symptoms," Mangkok added.

Suarjana remains in stable condition at the hospital. However, doctors are urging the Bali administration to supply rabies serums to help prevent any possible deaths occurring from an incomplete vaccination.

Rabies serums are meant for people who suffer larger and more open dog-bite wounds, and are administered by repeatedly injecting the drug as much as possible around the wound, followed by a vaccination injection.

The call by the doctors is due to the fact that Bali doctors have never had to anticipate a possible outbreak of this magnitude. The Bali Health Agency's vaccination program has only started and has yet to prove its effectiveness.

Prof. Dr. Anak Agung Raka Sudewi, a medical expert working for Sanglah Hospital's rabies task force, said Suarjana might not be at that much of a threat.

"The cramps might have been due to the patient's ailing immunity system when he was vaccinated, meaning that the vaccination itself was not working optimally," Raka said.

She said doctors are still conducting observations to prove whether the vaccination program was enough to fully eradicate rabies in Bali, but urged the govern-ment to supply rabies serums to prevent any possible worst-case scenarios.

"The serum is very important to Bali right now, but the island itself doesn't currently have any. The last time I checked, there were some but those are still being labeled," she said.

I Ketut Suwi Adnyana , head of the Badung Health Agency's disease observation and prevention division, said the government had allocated funds to procure the serums.

"Serums are actually more expensive than vaccines, but it's important *to have them* because dog-bite cases appear nearly every day in south Kuta," he said.

To make matters worse, Adnyana reported a shortage of rabies vaccines in Badung, with only 200 doses left for about a week of use.

Adnyana said the agency had requested an additional Rp 1.2 billion (US$103,200) from the Bali administration to buy 10,000 vaccines for 2,500 people.

Health agency data shows that of the estimated 53,500 dogs in Badung, as many as 6,302 have been vaccinated, while 587 others have been culled. In Denpasar, 13,118 have been vaccinated and 33 culled.

 

[Gert van der Hoek]

Re: Undiagnosed deaths in Bali; Rabies

Re: Undiagnosed deaths in Bali; Rabies

Rabies claims its eighth fatality in Denpasar

Luh De Suriyani , The Jakarta Post , Denpasar | Wed, 03/25/2009 1:09 PM | Bali

The eighth victim of rabies, a 46-year-old man, died on Monday afternoon after being treated at the Sanglah General Hospital in Denpasar since Sunday morning, a hospital official said Tuesday.

The victim, I Wayan Jama Asmara, was bitten in November and was a resident of Pecatu, South Kuta district in Badung district, which had been declared a rabies-infected area by the Bali provincial administration late last year.

"The suspect had shown acute clinical symptoms and could not be saved," IGB Ken Wirasandhi, the secretary of the hospital's rabies handling team, said.

"We cannot confirm that Jama positively died of rabies because the results of his blood tests are not in yet."

The previous seven suspected victims died after being bitten by rabid dogs.

The first victim was Putu Linda, 4, who died on Sept. 17. Other victims were Made Artana, 32; Oktaf Rahmana, 3; Made Wirata; Ketut Tangkas, 3; Thomas Aquino, 32, and Ni Made Ruken, 45.

Yet, only Wirata, Aquino and Ruken were confirmed, through blood tests, to have suffered from rabies.

On Monday, Ken said Jama showed indications of the clinical symptoms of rabies like the past suspected victims.

"One thing is certain, the victim's diagnosis was encephalitis," he said.

Jama's family has refused to divulge any information.

Head of the isolation ward, Ni Made Ratni, said Monday that Jama's wife had been hysterical since her husband was declared a rabies suspect.

"She kept on crying hysterically while her husband was being treated," she said.

Badung Health Agency head AA Gede Agung Mayun confirmed the victim suffered from the clinical symptoms of rabies.

Ironically, Jama had received two antirabies vaccinations (VARs) after being bitten by a rabid dog. The first shot was given on Nov. 27.

"Unfortunately, he did not continue with the third and fourth vaccinations after he felt much better," Mayun said.

"A complete four-shot antirabies vaccination is mandatory, especially if a victim is bitten on the arm or above."

Mayun said the case was very surprising because biting cases in South Kuta were actually decreasing, but he did not give exact figures.

Health authorities have yet to identify which dog bit Jama.

There have been proposals, expressed during various discussions on how to handle rabies in Bali, that dog owners should be punished if their dogs bite people. The aim is to involve the public in preventing the spread of rabies.

The health agency also said that only Wirata, of the previous victims, had shown rabies' unique clinical symptoms, such as hydrophobia and hypersalivation.

Meanwhile, the Badung Animal Husbandry, Fisheries and Maritime Agency is finding it difficult to administer the booster vaccinations for dogs, scheduled for April.

http://www.thejakartapost.com/news/2009/03/25/rabies-claims-its-eighth-fatality-denpasar.html

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies confirmed

Source: http://www.thejakartapost.com/news/...tion-issue-bylaw-control-rabies-outbreak.html

Provincial administration to issue bylaw to control rabies outbreak

Mon, 03/30/2009 8:56 PM | Bali

Bali Governor Made Mangku Pastika said Sunday his administration would issue a new regulation to control the island's rabies outbreak, following a recent surge in rabies cases.

The administration is currently drafting the details of the bylaw, he added.

Pastika also urged the cooperation of Bali residents to fight the outbreak. The governor had previously issued an executive order imposing tighter restrictions on the transportation of certain animals from and into the resort island, including dogs and monkeys, which are believed to be the primary possible carriers of the deadly rabies virus.

A bylaw has more legal standing than an executive order, since it carries legal sanctions, including imprisonment and fines. The proposed bylaw will detail the authority and responsibilities that the administration's agencies, the law enforcement bodies and the general public should assume in the rabies mitigation effort.

Pastika said he hoped the bylaw would provide the administration with the legal umbrella it desperately needed to enforce various measures to control and contain the disease.

In the past, Pastika repeatedly lashed out at the large number of dog owners unwilling to leash or cage their pets, and thus raising the risk of their dogs getting infected. A bylaw stipulating that pet dogs be leashed and caged was thus deemed necessary to force dog owners to take greater responsibility to prevent the spread of rabies.

"And what about the owner of a dog that has bitten people? We need a legal measure to make owners more responsible for their pets," the governor said previously.

"The procedure to issue a bylaw needs time, as we have to have further discussions with the Bali legislature. However, I really expect the bylaw to be issued very soon," Pastika said.

The bylaw would control, among others, the movements of pet dogs, with owners obliged to cage their pets and ensure they do not roam the streets unsupervised. Otherwise, the owners face disciplinary measures, Pastika warned. The Bali administration has been working intensively to raise public awareness of anti-rabies measures, including how to get the rabies vaccine.

But the administration still needs residents' cooperation to bring sick pets or humans suspected of having been infected with the virus to the nearest medical center immediately.

Pastika also said he expected measures to be taken to prevent the spread of the virus to the island's monkey colonies, particularly since those colonies were among the island's most prominent tourist attractions. Among the more popular monkey colonies are Uluwatu, Sangeh and the Monkey Forest in Ubud. In Denpasar, the administration will start a rabies vaccination drive and stray dog cull shortly after the Galungan, Nyepi and Kuningan festivals - the Balinese Hindu holidays marked on March 18, 26 and 28, respectively. Dewa Made Ngurah, head of the Denpasar Maritime and Animal Husbandry Agency, said his office planned to organize a mass vaccination drive targeting all dogs and cats in the municipality. Culling, he said, was still an open option, particularly for stray dogs and cats. The Bali administration has allocated Rp 875 million from its 2009 provincial budget to finance the mass vaccination drives.

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies confirmed

Source: http://www.news.com.au/travel/story/0,28318,25267865-5014090,00.html

Bali steps up dog culling program to halt rabies outbreak
By Marian Carroll in Denpasar, Bali
AAP
March 31, 2009 06:42am

BALINESE authorities have intensified an island-wide dog culling program and flagged a new law targeting dog owners, after another two human deaths from rabies.

The deaths last week of a man and woman, both aged 46, from different villages brought the human death toll to nine, five of which had been confirmed through laboratory testing.

The latest victims were from villages on the southern Bukit peninsula near the epicentre of the outbreak, which first appeared in September at Kedonganan, near Jimbaran Bay.

The man, Nyoman Jama Asmara, died on March 23 despite receiving an anti-rabies vaccine after a stray dog bit him three months ago.

He refused to get the needle again because he felt he was okay, and the wound had healed, said Andre Dita, a doctor at Sanglah Hospital, which provided free rabies vaccinations.

"People don't understand, if they only get one vaccination, it's useless. They need to complete the course over three weeks."

A second woman, identified only as Tukimah, died on March 26 at Sanglah. She was bitten five months ago but refused vaccination because she had a phobia of needles, Dr Dita said.

Made Badra, head of Livestock, Fisheries and Oceans for Badung Regency which includes the tourist hubs of Jimbaran, Kuta and Seminyak, said the deaths were not cause for panic among tourists, but rather highlighted a lack of education amongst villagers who did not seek or follow medical advice.

"Actually this rabies outbreak is under control", said Mr Badra. "The problem is that many traditional people don't recognise that rabies is very dangerous and they don't know they need to get the vaccine three times."

He said the Government was stepping up efforts to educate villagers about the disease, its symptoms and treatment, and encouraging anyone bitten in the last year to get a vaccine, even if they felt well.

Governor Made Mangku Pastika also flagged a new law to control the movement of pet dogs, which were often allowed to roam around freely.

If a dog owner is found to be negligent, he could be tried and fined or jailed, Mr Pastika said.

Mr Badra said the law would help prevent the disease spreading further. People will have to keep their dog in the house or a cage, and use a leash if they take it out on the street.

Animal welfare organisations said it would foster cruelty.

"We are only going to see a lot more animal abuse with dogs chained up in small cages," said Janice Girardi from the Bali Animal Welfare Association.

She said she had received more than 50,000 letters of complaint from the international community over the governments culling program, which had eliminated about 2200 dogs across the island using strychnine-laced baits.

But Badra was unapologetic.

"Just this morning, we killed 122 stray dogs near Uluwatu temple (on the Bukit)", he said. "Our aim is to have no dogs on the streets."

The Government was also preparing to give the second of three, free anti-rabies boosters to about 40,000 pet dogs in south Bali, he said.

The outbreak is the first time rabies has shown up in Bali. The Government has blamed an increase in imported animals, tracing the strain to Flores, the third island east of Bali in East Nusa Tenggara province.

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies confirmed

Source: http://www.balipost.co.id/mediadetail.php?module=detailberita&kid=2&id=19228

04 September 2009 | BP
Eight Students SMPN 1 Penebel Bitten Dog
Patients Keluhkan BRSU Tabanan
Tabanan (Bali Post) --
Case of mad dog in Tabanan absolutely insane. After one person died of rabies virus, are now dozens of people in the house because didigit dog saki. In fact, eight students SMPN 1 Penebel bitten dog into the school. ''All the same bitten by dogs at the same time,''Head said Satria Tenaya Penebel AAN.

He said, eight students SMPN 1 Penebel bitten during a dog school. Because residents of emotions'', the dog was immediately killed,''he explained.

Meanwhile, a citizen of Banjar Cepag, Jegu also bitten by a dog. Dogs that bite directly tied to observable.

Outbreak of rabies cases in the Tabanan regency of Tabanan to react immediately. Hundreds of dogs have been eliminated. Head of Public Relations and Tabanan regency protocol Wayan Sarba, Thursday (3 / 9) yesterday, said the dog in Tabanan has been eliminated to reach 714 tails. Eleminasi conducted in Subamia village, Denpasar, and Wanasari Buahan.

Perbekel Subamia I Wayan Sudiana said after a case of rabies positive dogs, residents agree to elimination.

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79239

Archive Number 20090915.3242
Published Date 15-SEP-2009
Subject PRO/AH/EDR> Rabies, canine, human - Indonesia (10): Bali, susp.


RABIES, CANINE, HUMAN - INDONESIA (10): (BALI) SUSPECTED
********************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 15 Sep 2009
Source: The Bali Post [in Indonesian, machine trans., edited]
<http://www.balipost.co.id/mediadetail.php?module=detailberita&kid=2&id=20038>


A 3rd victim of suspect rabies, a 47-year-old woman, died on Mon 14
Sep 2009 in Sanglah Hospital [Tabanan Regency]. She had been bitten by
her own dog when it suddenly ran amok in her kitchen on 20 Jul 2009.
She was bitten on her right arm and was rushed to the health clinic in
Kediri where she received a tetanus injection. The dog was 3 years old.

A month after she had been bitten, the victim reported feeling unwell.
On Sat 12 Sep 2009 she experienced symptoms such as drastic sweating
around her head, chest pains, and difficulty in breathing. She was
then taken to Tabanan Hospital at 23.00 hr and received emergency
treatment and 2 types of medication. Afterwards she was told to rest
at home.

When her condition did not improve she was taken to Sanglah Hospital
on Sun 13 Sep 2009, where she was placed in an isolation room. It
appears that she was already paralyzed and could not be resuscitated,
finally dying on 14 Sep 2009. Her husband revealed that a few weeks
after having been bitten, that his wife became scared of water and
drafts, but was always thirsty and feverish.

On Mon 14 Sep 2009, 6 officials of the Tabanan Health Department
visited the woman's home and interviewed her husband, but the reason
for this is unclear.

As of today [15 Sep 2009], there have been 3 fatal cases of suspect
rabies: 2 victims came from Desa Buahan, Tabanan, and one from Kediri,
Tabanan.

--
Communicated by:
Merritt Clifton
Editor, ANIMAL PEOPLE
PO Box 960
Clinton, WA 98236
USA
<anmlpepl@whidbey.com>
<http://www.animalpeoplenews.org>

[The island of Bali is divided into 8 regencies (Badung, Gianyar,
Tabanan, Bangli, Karangasem, Jembrana, Buleleng, and Klungkung, and
one municipal city (Denpasar); see
<http://www.2indonesia.com/regency.html>.
Three of these, Badung, Denpasar and now Tabanan, all adjacent, must
now be considered confirmed or probable rabies epidemic areas. Little
progress appears to have been made in containing the outbreak. The
case described above appears to be the 3rd human case of suspected
rabies in Tabanan Regency. Official confirmation of the diagnoses is
awaited. The situation regarding the control and treatment of rabies
virus infection in the island of Bali remains dire.

A map of Tabanan Regency in the Indonesian island of Bali can be accessed at
<http://www.bali-maps.com/tabanan_bali_map.html>,
and maps of the whole island of Bali can be accessed at
<http://www.baliguide.com/bali_map.html>. - Mod.CP]

[see also:
Rabies, canine, human - Indonesia (09): Bali, susp. 20090907.3152
Rabies, canine, human - Indonesia (08): comment on vaccination 20090405.1317
Rabies, canine, human - Indonesia (07): comment on vaccination 20090404.1300
Rabies, canine, human - Indonesia (06): (BA) 20090331.1247
Rabies, canine, human - Indonesia (05): (BA) 20090326.1181
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]
........................................cp/mj/jw

 

[morningperson]

Re: Undiagnosed deaths in Bali; Rabies confirmed

What a truly horrific way to die. For those who haven't been there, it helps put this problem in perspective to know that there are about one million street dogs in Bali-they seem to be everywhere, in very close proximity to humans, and always hungry.


http://www.thejakartapost.com/news/2008/06/02/street-dogs-threaten-bali039s-tourism-foundation.html

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies confirmed

Source: http://www.metrotvnews.com/index.ph...Seorang-Warga-di-Bali-Meninggal-Akibat-Rabies

Google translation:

Again, A Person in Bali Died Due to Rabies
Headline News / Archipelago / Sunday, October 11, 2009 02:12 pm

Metrotvnews.com, Badung: A citizen of District Kedonganan, South Kuta District, Badung regency, Bali, Saturday (10/10), died from rabies infected with the disease.

Although the time being treated at Sanglah Hospital, Denpasar, Bali, Wayan lives Masri, 57 years, finally was rescued from diseases caused by infected wild dog that bites.

The hospital said, Wayan positive rabies disease or a mad dog. Child victims, Wayan Suandi stated that his parents had injured dog gigtan about six months ago. But because it is just a small wound, the victim tried to do a serious treatment such as antirabies vaccine.

Lurah Kedonganan, Nyoman Mudiarta, states, until now residents who had been bitten by dogs in the region reached 50 people. Those who reported themselves then given an injection of antirabies vaccine.

Currently in Kedonganan, as many as 400 of the 1000 population of dogs has been eliminated. Rabies disease in Bali began to spread since November 2008. Wayan Masri was a victim to the 12 who died from the disease. (Riz)

 

[Shiloh]

Re: Undiagnosed deaths in Bali; Rabies confirmed

Source: http://www.balidiscovery.com/messages/message.asp?Id=5553

Rabies Deaths Mount, Officials Scramble for Serum
Bali's Sanglah Hospital Unable to Stock Sufficient Anti-Rabies Serum to Treat Bali's Dog Bite Victims.

Bali News: Rabies Deaths Mount, Officials Scramble for Serum
(10/12/2009) Human deaths continue to mount in Bali ongoing epidemic of rabies with another fatality confirmed on Thursday, October 8, 2009, of a 54 year-old Balinese at the Sanglah General Hospital. The man, from the Kedongnan area of South Kuta, died after reporting to the hospital with symptoms consistent with the rabies virus. The man was bitten by a dog two month's earlier at his residence.

The latest death is fueling growing criticism of the seemingly haphazard way in which Bali officials are dealing with the disease, including the inoculation of local dogs and insufficient supplies of human anti-rabies vaccine to treat those suffering dog bits with a one-treatment four-injection regime.

NusaBali reports that tens of patients reporting the Sanglah General Hospital in Denpasar for anti-rabies vaccine are being turned away due to the lack vaccine supplies.

The Secretary of the Rabies Control Team at Sanglah Hospital, Dr. IGB Ken Wirasandhi, blamed supply problems on the large number of dog-bite cases that can equal 150 in a single day and the fact that all anti-rabies serum must be imported into Indonesia.

Each anti-rabies serum kit for treating humans costs the government US$120 dollars each and consists of four ampoules. Two shots are administered at the site of the bite and the two remaining dosages in each arm of the patient.

Health regulations mandate that people bitten by potentially rabid animals be treated without charge.

On Wednesday, October 7, 2009, NusaBali reported that there were no anti-rabies serum stocks available at Sanglah General Hospital, the second time this has occurred in recent weeks.

The hospital has treated some 10,432 suspect-rabies patients since December 2009 with 12 patients succumbing to the disease at the hospital.

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79650

Archive Number 20091016.3564
Published Date 16-OCT-2009
Subject PRO/AH/EDR> Rabies, canine, human - Indonesia (15): Bali


RABIES, CANINE, HUMAN - INDONESIA (15): BALI
********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 16 Oct 2009
Source: Janice Giardi, Bali Animal Welfare Association [edited]
via Merritt Clifton <anmlpepl@whidbey.com>


Rabies outbreak spreads to the north coast of Bali
--------------------------------------------------
We now have a confirmed case of rabies in East Bali, at Kubu, which is on
the coast, just north of the tourist diving resorts Tulamben and Amed. We
also had positive cases north of Ubud in Petang, about half way from the
original case on the south coast to the north coast. Thus, a year after
rabies was identified on the isolated Bukit peninsula, south of the
Denpasar airport, cases have now been identified throughout the heavily
populated south east and eastern portions of Bali.

So far no cases have been identified within the major cities of Ubud and
Gianyar, and only a few on the outskirts of Denpasar the capital city, but
cases now have occurred on all sides of these densely populated and
trafficked communities.

These latest cases are of particular concern because my dog-counting
canvases done in August and September 2008, just before the 1st rabies
cases were identified, found far more dogs relative to humans in the
semi-rural residential areas in the hills than in the cities. There were
open areas with no dogs or people between villages, but within the villages
the conditions were precisely those under which rabies becomes most
dangerous: lots of people and animals living in very close proximity.

It suspects that the Kutu case may have resulted from dog trappers
transporting dogs through there to Singaraja, where there are some
notorious dog meat restaurants. This is possible. Transportation of dogs
from known rabies areas to the dog meat restaurants has continued nonstop
since the arrival of rabies.

Dog vaccination against rabies was prohibited throughout Bali before the
1st cases were identified, was then allowed only in areas with identified
outbreaks, and only within the past few weeks has been permitted throughout
the island. However, there is still a critical shortage of vaccines, and
the vaccines deployed by the government during the 1st 9 months of the
outbreak required revaccination within 3 months. The 3-year vaccines have
only just begun to be used.

The following are 16 of the 17 known human deaths so far:

Age / Date of death / Place of residence
6 / 10 Oct 2009 / Tabanan
49 / 7 Oct 2009 / Tabanan
78 / 16 Sep 2009 / Tabanan
47 / 14 Sep 2009 / Tabanan
24 / 6 Sep 2009 / Tabanan
21 / 6 Sep 2009 / Tabanan
62 / 22 Aug 2009 / Tabanan (age also stated as 55)
46 / 26 Mar 2009 / Ungasan peninsula
46 / 23 Mar 2009 / Uluwatu
45 / 30 Jan 2009 / Ruken
32 / no date / Bukit
3 / no date / Kutuh
28 / 23 Nov 2008 / Ungasan
3 / no date / Ungasan
32 / 13 Nov 2008 / Ungasan
4 / 17 Sep 2008 / Ungasan
The 17th was recent. I am expecting the details soon.

A man, originally from Flores was the 1st person to be bitten by a rabid
dog, in July 2008. The dog belonged to a friend, who was also from Flores.
Whether the dog was transported to Bali from Flores, and when exactly the 2
men arrived, I have not yet been able to find out.

--
Merritt Clifton
Editor, ANIMAL PEOPLE
PO Box 960
Clinton, WA 98236
<anmlpepl@whidbey.com>

[The rabies situation in the Indonesia island of Bali continues to worsen
with more human deaths and spread of the disease from the south to the
north coast of the island. ProMED-mail thanks Janice Giardi and Merritt
Clifton for making this information generally available.

The HealthMap/ProMED-mail interactive map of the island of Bali can be
accessed at <http://healthmap.org/r/006M>. - Mod.CP]

[see also:
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]

..................cp/ejp/sh

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80254

Archive Number 20091126.4061
Published Date 26-NOV-2009
Subject PRO/AH/EDR> Rabies, canine, human - Indonesia (19): Bali

RABIES, CANINE, HUMAN - INDONESIA (19): BALI
********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 26 Nov 2009
From: Merritt Clifton <anmlpepl@whidbey.com>


The Bali rabies outbreak human death count has apparently now reached
20. Particulars of 21 cases are listed below.

Age / Date of death / Residence
------------------------------------
28 / 24 Nov 2009 / Karangasem
12 / 23 Nov 2009 / Karangasem
13 / 13 Nov 2009 / Kesiman, Denpasar
7 / 11 Oct 2009 / Kedonganan, Badung
54 / 8 Oct 2009 / South Kuta
49 / 7 Oct 2009 / Tabanan
6 / 2 Oct 2009 / Tabanan
78 / 22 Sep 2009 / Tabanan
78 / 16 Sep 2009 / Tabanan
47 / 14 Sep 2009 / Tabanan
24 / 6 Sep 2009 / Tabanan
62(or 55) / 22 Aug 2009 / Tabanan
46 / 28 Mar 2009 / Ungasan peninsula
46 / 23 Mar 2009 / Jalan Uluwatu
45 / 30 Jan 2009 / Nusa Dua
32 / 17 Jan 2009 / Jimbaran
3 / 30 Dec 2008 / Kutuh
28 / 23 Nov 2008 / Ungasan
3 / 21 Nov 2008 / Ungasan
32 / 14 Nov 2008 / Ungasan
4 / 17 Sep 2008 / Ungasan

There are several caveats to the above:

1) The most recent victim may still be alive at this hour, but
according to the Bali Post was in extremis yesterday [25 Nov 2009].
2) The 78-year-old who died on 16 Sep 2009 is a mystery. No death
record for this person exists, but his name was mentioned in at least
one press account. Apparently, he requested but did not receive
post-exposure treatment.
3) The Bali government does not recognize the death of the 3-year-old
who died on 30 Dec 2008 as being from rabies. This was a case in
which the father of the victim sought but was unable to obtain
post-exposure treatment. Detailed press accounts of the symptoms
appear to establish that this was a rabies death.

--
Merritt Clifton
Editor, Animal People
P.O. Box 960
Clinton, WA 98236
<anmlpepl@whidbey.com>

[Four days ago on 22 Nov 2009, the human rabies death toll of the
Island of Bali was given as 17 (see: Rabies, canine, human -
Indonesia (18): Bali 20091122.4014). It is clear that the outbreak
has not yet been brought under control and that cases are occurring
in widely separated parts of the island.

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

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80643

Archive Number 20091229.4373
Published Date 29-DEC-2009
Subject PRO/AH/EDR> Rabies, canine, human - Indonesia (21): Bali

RABIES, CANINE, HUMAN - INDONESIA (21): BALI
********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 27 Dec 2009
From: Merritt Clifton <anmlpepl@whidbey.com> [edited]


Bali deaths list update
----------------------------
I have just received updated information from Levin Kalalo of the
Bali Animal Welfare Association about human rabies deaths since the
present outbreak was identified in mid-2008.

There have now been 27 human deaths in total. All of those previously
listed as actual or suspected are now confirmed as rabies deaths. The
ages of several of the victims have been corrected.

A 32-year-old man, originally of Flores [Island], and only recently
arrived in Bali, appears to have been the 1st victim to be bitten, in
July 2008. He was apparently bitten by a dog brought from Flores and
died on 17 Jan 2009. However, 5 other people had died before his
death.

Levin Kalalo's table listed the victims by regency. I am continuing
to list them by community, where possible, to provide more specific
information about where rabies has occurred and where it is moving.
[The names of the victims have been removed in the interests of
patient confidentiality].


Age / Date of death / Residence
-------------------------------
37 / 24 Dec 2009 / Denpasar
28 / 24 Dec 2009 / Tabanan
35 / 20 Dec 2009 / Gianyar
28 / 14 Dec 2009 / Buleleng
45 / 12 Dec 2009 / Tabanan
4 / 5 Dec 2009 / Tabanan
28 / 24 Nov 2009 / Karangasem
12 / 23 Nov 2009 / Karangasem
13 / 13 Nov 2009 / Kesiman, Denpasar
7 / 11 Oct 2009 / Kedonganan, Badung
54 / 8 Oct 2009 / South Kuta
49 / 7 Oct 2009 / Tabanan
6 / 2 Oct 2009 / Tabanan
78 / 22 Sep 2009 / Tabanan
7 / 16 Sep 2009 / Tabanan
8 / 14 Sep 2009 / Tabanan
47 / 6 Sep 2009 / Tabanan
24 / 22 Aug 2009 / Tabanan
62 / 28 Mar 2009 / Ungasan peninsula
46 / 23 Mar 2009 / Jalan Uluwatu
45 / 30 Jan 2009 / Nusa Dua
32 / 17 Jan 2009 / Jimbaran [the 1st case]
3 / 30 Dec 2008 / Kutuh
28 / 23 Nov 2008 / Ungasan
3 / 21 Nov 2008 / Ungasan
32 / 14 Nov 2008 / Ungasan
4 / 17 Sep 2008 / Ungasan

--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
<anmlpepl@whidbey.com>
<http://www.animalpeoplenews.org>

[The number of human rabies deaths has increased to the 27 listed
above from the 24 confirmed (and one suspected) cases listed on 17
Dec 2009. So far all the those affected have been local Bali
inhabitants, but tourists and other visitors to the island should be
forewarned of the risk and take precautions accordingly.

Flores and Bali, both part of the Lesser Sunda Islands can be located
on the map of Indonesia at
<http://www.un.org/Depts/Cartographic/map/profile/indonesi.pdf>.
A map of the island of Bali can be accessed at
<http://www.baliguide.com/bali_map.html>.
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 (20): Bali 20091217.4265
Rabies, canine, human - Indonesia (19): Bali 20091126.4061
Rabies, canine, human - Indonesia (18): Bali 20091122.4014
Rabies, canine, human - Indonesia (16): Bali alert 20091031.3765
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
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]
...................................cp/mj/lm

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82180

Archive Number 20100409.1157
Published Date 09-APR-2010
Subject PRO/AH/EDR> Rabies, human - Indonesia: (Bali)

RABIES, HUMAN - INDONESIA: (BALI)
*********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Fri 9 Apr 2010
Source: The Jakarta Post [edited]
<http://www.thejakartapost.com/news/2010/04/09/rabies-toll-plateaus-public-awareness-grows.html>


Rabies toll plateaus as public awareness grows
----------------------------------------------
The latest figures show that 42 people have died of rabies or
rabies-related ailments [?] since the outbreak of the viral disease
in Bali in November 2008. Sanglah General Hospital in Denpasar has
treated 67 patients for suspected rabies. A total of 34 have died
from the disease, while the rest were diagnosed with [non-rabies]
encephalitis, which has similar symptoms. The other fatalities from
the outbreak have been recorded at hospitals in Tabanan and elsewhere
across the island.

Sanglah rabies prevention program secretary Dr. I.G.N. Ken
Wirashandhi said the 33 patients diagnosed with mild encephalitis
showed all the classic rabies symptoms, except hydrophobia. "However,
some of these patients had previously been bitten by dogs, so our
concern, and that of the families, was that they may have contracted
rabies," he said. Patients with suspected rabies or encephalitis must
undergo a series of laboratory tests, including on their saliva,
urine and cerebrospinal fluids. Around 70 percent of rabies cases at
Sanglah have been diagnosed through saliva tests.

A total of 8 patients died from the disease before the tests were
completed. "At the time, we faced opposition from the families when
trying to get permission to do the cerebrospinal tests," Wirashandhi
said. "Thus we weren't able to diagnose it in time to treat them."

The majority of those who died from the disease were taken to
hospital in the later stages of the disease, he added. "Patients in
these stages are almost certain to die during treatment, because the
viral infection is so advanced," he said. "They oversalivate and
panic at the sight of water or light."

Wirashandhi stressed it was important for patients and families to
seek medical advice as soon as any of the classic rabies symptoms
were exhibited, such as joint pain, severe headaches, and pains on
the affected bitten area. "They should get anti-rabies vaccines *VAR*
immediately," he said. "The problem is Sanglah has often run out of
VAR supplies in the past, but patients can come back the next day to
get inoculated."

Sanglah contagious diseases ward head Ni Wayan Ayuningsih said the
public was opening up to more proactive prevention and treatment by
doctors, following months of an intensified awareness campaign.
"Previously a patient or their family would insist they didn't have
rabies, because they lacked any understanding of the disease's
symptoms or causes," she said. She added that if detected early on,
the disease could be treated properly [by post-exposure vaccination]
and the patient cured completely.

The 2 latest patients at Sanglah initially tested positive for the
virus. "When they came to us they were in the sensory stage,"
Ayuningsih said. "The doctors gave them VAR to boost their antibody count."

[Byline: Luh De Suriyani]

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

[Since the previous report concerning the rabies situation in the
island of Bali, dated 27 Dec 2009, the number of rabies deaths has
increased from 27 to 42. While recognition of the extent of the
problem and the post-exposure treatment of patients may have improved
there is no indication that the outbreak is being contained.
Information on the accuracy of the saliva test in rabies diagnosis
would be welcomed.

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

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://promedmail.org/pls/apex/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82577

Archive Number 20100505.1465
Published Date 05-MAY-2010
Subject PRO/AH/EDR> Rabies, human - Indonesia (02): (Bali)


RABIES, HUMAN - INDONESIA (02): (BALI)
**************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue 4 May 2010
From: Merritt Clifton
<anmlpepl@whidbey.com>


Bali rabies deaths list: update
-------------------------------
Chronic shortages of post-exposure vaccines continue. Case reporting
continues to be erratic. Unofficially, the Bali human rabies death toll is
now approaching 80. Officially, about half of the victims died of
"encephalitis" rather than rabies.

The Bali Animal Welfare Association is now vaccinating up to 870 dogs per
day, averaging more than 500, but still, less than half of the dog
population has been vaccinated.

The government is still putting much of their effort into culling dogs, but
the culled total is still less than the dog birth rate, as some recent
newspaper articles have finally acknowledged. A local newspaper, Nusa Bali
(Tue 4 May 2010) states that there are now rabies cases and 43 fatalities.
Denpasar, NusaBali records another fatality, [that of] a 69 year old
resident, caused by rabies virus [from] dogs, cats [or] monkeys. (note that
so far there have been no cases, not even vaguely suspected, involving cats
and monkeys. Many people in Bali are obsessed with the alleged risk that
rabies might infect the temple monkeys, which are a major tourist draw, but
the monkeys don't hang out where dogs do -- if both are in the same
courtyard or alley, they keep to opposite sides and keep a wary eye on each
other. As to cats, they exist in Bali, of course, but are not highly
visible, since dogs tend to monopolize any food sources that they can,
leaving a relatively narrow niche for mousers who go where dogs cannot.)

The following information was gathered by Sanglah Hospital as of Mon 3 May
2010), According to Dr Ken data for suspect Rabies patients who were
treated in the Sanglah Hospital, from October 2008 is recorded 77 rabies
cases and 43 fatalities, 27 of them were rabies positive. (Deciphering this
last sentence requires a degree of clairvoyance. The remains of many people
who are believed to have died from rabies have not been tested, and there
is some dispute as to the accuracy of the testing method used in
postmortems in Bali.)

Case / Age /Date of death / Residence
46 / 69 / 3 May 2010 / Abang, Karangasem
45 / 40 / 1 May 2010 / Kapal, Mengwi
44 / 40 / 30 Apr 2010 / Bebandum, Karangasem
43 / 30 / 30 Apr 2010 / Tembuku, Bangli
42 / 43 / 8 Apr 2010 / Karengasem (death officially attributed to epilepsy)
41 / 70 / 2 Apr 2010 / Tabanan
40 / 27 / 18 Mar 2010 / ?
39 / 45 / 8 Mar 2010 / Tabanan
38 / 36 / 7 Mar 2010 / Mengwi
37 / 5 / 21 Feb 2010 / Bangli
36 / 25 / 15 Feb 2010 / Ungasan (negative lab test; was bitten in 2006)
35 / 80 / 18 Jan 2010 / Kubu
34 / 11 / 18 Jan 2010 / Kubu
33 / 10 / 17 Jan 2010 / Tuban
32 / 81 / 17 Jan 2010 / Kubu
31 / 46 / 14 Jan 2010 / Tabanan
30 / 65 / 9 Jan 2010 / Ungasan
29 / 64 / 29 Dec 2009 / Karangasem
28 / 37 / 24 Dec 2009 / Denpasar
27 / 28 / 24 Dec 2009 / Tabanan
26 / 35 / 20 Dec 2009 / Gianyar
25 / 28 / 14 Dec 2009 / Buleleng
24 / 45 / 12 Dec 2009 / Tabanan
23 / 4 / 5 Dec 2009 / Tabanan
22 / 23 / 27 Nov 2009 / Tabanan
21 / 28 / 24 Nov 2009 / Karangasem
20 / 12 / 23 Nov 2009 / Karangasem
19 / 13 / 13 Nov 2009 / Kesiman, Denpasar
18 / 7 / 11 Oct 2009 / Kedonganan, Badung
17 / 54 / 8 Oct 2009 / South Kuta
16 / 49 / 7 Oct 2009 / Tabanan
15 / 6 / 2 Oct 2009 / Tabanan
14 / 78 / 22 Sep 2009 / Tabanan
13 / 7 / 16 Sep 2009 / Tabanan
12 / 8 / 14 Sep 2009 / Tabanan
11 / 47 / 6 Sep 2009 / Tabanan
10 / 24 / 22 Aug 2009 / Tabanan
9 / 62 / 28 Mar 2009 / Ungasan peninsula
8 / 46 / 23 Mar 2009 / Jalan Uluwatu
7 / 45 / 30 Jan 2009 / Nusa Dua
6 / 32 / 17 Jan 2009 / Jimbaran (Victim was actually the 1st person to be
bitten by a rabid dog, in June 2008, but he developed active symptoms much
later than the 1st 5 victims.)
5 / 3 / 30 Dec 2008 / Kutuh
4 / 28 / 23 Nov 2008 / Ungasan
3 / 3 / 21 Nov 2008 / Ungasan
2 / 32 / 14 Nov 2008 / Ungasan
1 / 46 / 17 Sep 2008 / Ungasan

--
communicated by:
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
<anmlpepl@whidbey.com>

[Since the last report posted on ProMED-mail on 9 Apr 2010 the number of
human deaths from rabies virus infection has increased from at least 42 to
at least 47 currently (although unofficially the toll is estimated to be at
least 80). The list of officially confirmed cases illustrates a widespread
geographic distribution of cases, the wide span of ages of the victims, and
the apparent absence of any non-native inhabitants.

 

[alert]

Re: Undiagnosed deaths in Bali; Rabies confirmed

http://hisz.rsoe.hu/alertmap/woalert_read.php?glide=EH-20100515-26103-IDN

Amlapura (The Bali Post) has reported that a 22-year-old resident of Celagi village, Peladung, Karangasem is the 16th rabies fatality in Karangasem. She died on early Wednesday (5 May 2010), after being treated briefly in Sanglah Hospital. Three months ago, the victim tried to separate her chickens and suddenly got bitten by her dog. There were 3 wounds on her right arm, she suffered cramps on the arm ever since. She went to local puskesmas (health center). Since they didn't have vaccine her wound was treated as a normal bite wound. At that time the victim was advised to go to the Karangasem Hospital to be vaccinated. Due to her lack of knowledge on rabies, the victim did not follow this advice. A few days ago the victim fell ill, and was taken to Karangasem Hospital. The hospital medical team could not save her as she had already developed symptoms of rabies virus infection. The most recent 2 victims were a 30-year-old resident of Saren kangin and another from Budakeling, Karangasem. No vaccine was available at either Puskesmas or in Karangsem to treat these patients. The 49th death reported by Bali media with the name and/or description of victim, description of symptoms, and identification of dog bite history, was officially identified as the 37th death. In fact this would have been the 78th death, counting reports of deaths not identified by specific details that permit confirmation.