Rabies Vaccine Rushed In to Curb Spreading Outbreak

DENPASAR ~ Bali’s provincial government has allocated Rp1 billion (US$100,000) for anti-rabies vaccines to protect people in three districts – Denpasar and the regencies of Badung and Tabanan – where the killer disease is now known to exist in dogs.

The announcement this week followed the death of a second Tabanan resident from the disease and a panic rush to local health clinics by people seeking non-existent vaccine.

Provincial health authorities said five people had previously died of rabies since the outbreak began in the Bukit-Jimbaran area last September.

Bali’s health chief, Dr. Nyoman Sutedja, said in a statement issued at the provincial government headquarters in Renon, Denpasar, that there were plans to conduct mass vaccinations of people in affected areas.

Meanwhile Tabanan regency has announced it will spend Rp500 million ($50,000) to combat the rabies outbreak there by giving free vaccinations to people who have been bitten by dogs.

This followed the death of a second rabies victim in the regency, Ni Kadek Dewi Kartika Sari, of Banjar Buahan Seletan, the mother of a two-year-old child, who died at Sanglah Hospital in Denpasar last Sunday.

Her husband, Agus Eka Adnyana, 26, said this week his wife had been badly bitten by a dog on July 23 but did not have immediate access to the anti-rabies vaccine and was incorrectly treated for other illnesses.

Her left leg, which was torn to the bone, was stitched by a nurse at Tabanan Hospital, where she was also given an anti-tetanus vaccination. The wound was re-stitched two days later when she went back to hospital with a badly swollen foot and in severe pain.

Adnyana had then twice taken his wife to a doctor at Banjar Meliling, Kerambitan, where on the second visit she was treated for suspected typhoid.

Enteric drugs did not help his wife’s fever and stomach cramps and Adnyana took her back to Tabanan Hospital on September 2, where she was given medication and sent home. They returned again to the hospital that evening because of she was suffering severe stomach pain but did not receive treatment.

Adnyana said his wife was then examined by a doctor on September 3 and referred to Sanglah Hospital, where she died three days later.

“My wife’s body was paralysed,” said her husband. “She had a seizure and salivated.”

She had started a three-part course of anti-rabies vaccinations in late August but died before completing the treatment. At that time anti-rabies vaccine was not available in Tabanan but only at Sanglah.

Sanglah rabies team leader Dr. Raka Sudewi said the victim’s symptoms were consistent with paralytic rabies and laboratory tests would confirm her condition.

She had most likely not started the anti-rabies vaccinations soon enough, he said.

Tabanan Vice-Regent Putra Wirasana said this week the local legislature had budgeted the Rp500 million in its disaster relief fund and Rp70 million (US$7,000) of that had been immediately released last week in response to the crisis.

The local health department held Rp50 million ($5,000) of the budget and Animal Husbandry held Rp20 million ($2,000), he said.

Tabanan legislators are angry that people have been unable to get anti-rabies vaccines because they cannot afford the charges levied by hospitals for the drugs.

The vice regent said this week that if a patient’s treatment was associated with the rabies outbreak, charges would be scrapped and the treatment would be free.

Tabanan’s legislative chairman, Ketut Suryadi, said he would speak to the head of the regency health department to ensure the government met the costs of vaccinating dog bite victims.

“The government should take responsibility for costs because the rabies outbreak has been classified as a disaster,” he said.

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