Bali Travel Safety Tips: First Aid for Rabies

The rabies endemic in Bali has resulted in the establishment of 103 rabies centers, stockpiling of anti-rabies vaccine (VAR) and serum (SAR), and holding a workshop on SARE (Stepwise Approach Rabies Elimination). In addition, efforts to vaccinate stray dogs to prevent the spread have been made to control the outbreak on the island.  

What is Rabies?

Rabies is a fast-moving virus that infects animals, which can cause death for those who the infected animal has bitten. Aside from that, rabies can also spread if the rabid animal’s saliva gets into the eyes, nose, mouth, or broken skin. 

Humans can be infected by rabies if they get bitten by rabid animals. In most cases, monkeys, dogs, or certain wildlife, such as raccoons, foxes, and bats, are the primary reasons why humans can get infected. 

What Should You Do to Avoid Getting Rabies?

As cited by the Centers for Disease Control and Prevention, it is essential to consider getting a rabies vaccine before traveling to Bali. If your activity in Bali involves interaction with animals such as cats, dogs, and monkeys, getting a pre-exposure rabies vaccination, consisting of a three-dose series on days 0, 7, and 21 or 28 before traveling is advisable.

Avoid touching animals at all costs. Those stray cats or dogs on Bali’s street might be cute, but it's worth calculating the risk before you touch them. If you bring your children with you on your vacation to Bali, supervise them whenever you go outside to avoid getting bitten or touching the stray animals.

What Should You Do If You Get Bitten?

Rabies is a serious viral disease that affects the nervous system and can be fatal if left untreated. If you are bitten or scratched by an animal, it's essential to act quickly to reduce the risk of infection. Follow these steps to prevent yourself from rabies:

1. Wash the Wound Immediately

• - Why is this important?
  Rabies is transmitted through the saliva of infected animals. Washing the wound helps remove saliva and reduces the concentration of the virus at the site of the bite. Soap disrupts the virus, while water rinses it away.

• - How to wash the wound effectively:

  1. Use plenty of soap and clean running water.
  2. Scrub the wound gently for at least 15 minutes.
  3. Avoid using harsh substances like alcohol or hydrogen peroxide directly on the wound as they may irritate the skin further.

2. Stop the Bleeding

• Apply gentle pressure with a clean cloth or bandage to control bleeding.
• However, do not tightly bandage the wound, as it’s better to keep it exposed to air after cleaning.

3. Seek Medical Attention Immediately

• - Why see a doctor?
  Rabies has an incubation period (the time before symptoms appear) that can range from days to weeks. Once symptoms begin, the disease is almost always fatal. Early medical treatment is critical to stop the virus before it spreads through the nervous system.

• - What happens at the doctor’s office?

  • The healthcare provider will assess the wound and determine the risk of rabies transmission based on the animal's behavior, vaccination status, and whether it can be observed or tested.
  • You may need stitches if the wound is deep or large, but this depends on the location and severity of the injury.

4. Post-Exposure Prophylaxis (PEP)

• - What is PEP?
  PEP is a series of rabies vaccinations given after exposure to the virus. It consists of:
•  
• • 1. Rabies Immune Globulin (RIG): This is injected around the wound to provide immediate antibodies to neutralize the virus locally.
  •  
  • 2. Rabies Vaccine Series: A series of four or five shots given over a few weeks to stimulate your immune system to fight off the virus. These are given in your arm, not in the stomach as older practices may have suggested.

• - Why is it important to start PEP immediately?
  Rabies vaccinations are nearly 100% effective when administered promptly. Delaying treatment increases the risk of the virus entering the nervous system, where it becomes untreatable.

Additional Tips:

• - Avoid trying to catch the animal yourself. Let professionals or animal control handle this.

• - What if the animal is domestic?
  If a pet dog or cat bites you, confirm its vaccination status with the owner. Even if vaccinated, observation of the animal for 10 days is usually recommended.

• - Watch for signs of rabies in the animal:
  Symptoms include erratic behavior, excessive salivation, or aggression.

Remember: Acting quickly after an animal bite or scratch can save your life. Even if you don’t feel sick, rabies prevention is about being proactive, not reactive. Don’t take chances with this deadly disease!