12 December 2008

Rabies health warning for Australians travelling to Bali

The Indonesian Government has formally declared that rabies is present in Bali, with two dogs having been diagnosed with the virus. Previously Bali was considered rabies free; hence this presents a new risk to Australians visiting Bali.

The Indonesian media have also reported that several people with rabies-like clinical signs and symptoms have died after being bitten by dogs. There is at present no indication that the disease has spread to animals other than dogs. However any animal should be considered to pose a potential risk.

NSW Health recommends that all adults and children visiting Bali should avoid contact with wild and domestic animals, including dogs, cats and monkeys, even if the animal appears well.

“Anyone who is bitten or scratched by an animal in a rabies-affected area, including Bali should immediately wash the wound well with soap and water, apply an antiseptic such as povidone iodine to the wound and see a doctor as soon as possible,” Dr Andrew Marich, Acting Director of NSW Health's Communicable Diseases Branch, said.

“A course of injections is sometimes needed to prevent rabies infection developing after a bite or scratch,” he said.

NSW Health advises that anyone who has been bitten or scratched by any animal in Bali since 1 August 2008 should see their general practitioner for advice. People bitten or scratched by an animal before this time are not thought to be at risk of rabies.

Rabies is transmitted when viruses in a rabid animal’s saliva get into nerve cells through a wound - usually following a bite or a scratch. While many rabid animals will be sick and may go on to die, some appear well.

Symptoms in humans may include headache, fever, feeling unwell, sensory changes around the site of the bite or scratch, excitability, an aversion to fresh air and water, weakness, delirium, convulsions, and coma.

If rabies infection has occurred, symptoms in humans normally begin within several weeks but sometimes the symptoms begin years after infection. Death usually follows several days after the onset of symptoms.

There is no treatment for rabies once the symptoms have started however treatment of infected people before they develop symptoms can be effective.

The Governor of Bali has temporarily banned the import or export of dogs, cats, monkeys and other animals declaring the island under official quarantine until further notice. Officials are also endeavouring to create a perimeter of vaccinated animals in the areas immediately surrounding those areas in which rabies has been confirmed, aiming to isolate and eventually eliminate the disease.

For a copy of the NSW Health fact sheet on rabies go to http://www.health.nsw.gov.au/factsheets/infectious/rabiesbatinfection.html.

For a range of health information, go online to www.health.nsw.gov.au