Rabies remains endemic in Bali, officials said this week, as they revealed confirmed deaths from the outbreak had reached 131 people and most people still do not seek treatment when bitten by dogs.
With rabies still present at a “high level” in two villages, despite sustained eradication efforts, the Food and Agriculture Organisation (FAO) has said public education about rabies in Bali is inadequate.
Speaking on Monday, the head of Communicable Diseases and Environmental Health at the Bali Health Department, Ketut Subrata, said at least 131 people had died of rabies in Bali since November 2008.
He said 95 percent of the victims had failed to seek medical care after being bitten by dogs.
“They thought things were still as they used to be, and so they didn’t realise that you must get vaccinated if you’ve been bitten by a dog. They think it’s no big deal, because in the past being bitten by a dog was nothing to worry about,” Subrata said.
Around 5 percent of rabies fatalities had sought initial medical treatment, but had not completed the full post-bite vaccination courses, according to Subrata.
Subrata said the numbers of people reporting to hospitals for vaccination after dog bites had tailed off in recent months but was still high. An average of around 130 people a day are being bitten by dogs, he said, down from more than 200 a day last year.
Meanwhile, two villages have proved particularly resistant to eradication efforts.
Padangsambian in Denpasar municipality and Gianyar village in Gianyar regency remain “active” in terms of rabies infection, despite repeat efforts at vaccination and culling by the Animal Husbandry Department.
Department head Putu Sumantra said that monthly checks at the two villages consistently revealed new rabies cases.
Sumantra said that officials were uncertain as to why these two communities remained so susceptible to rabies.
“Perhaps rabies is brought back in by dogs from outside, but what we don’t know is whether those dogs are brought in by people or just wander in. What is clear, however is that these very active villages are our priority for control measures,” he said, adding that a total of 22 villages across Bali were regarded as active centres of rabies transmission.
Elsewhere, Ester Hutabarat, communications coordinator for the FAO in Indonesia, said public awareness about rabies in Bali was still unsatisfactory, and that this was hampering efforts to control the disease.
Hutabarat said that more effort seemed to have been spent on urging calm than on publicising practical anti-rabies measures.
“In Bali more has been done to get on top of the panic caused by the deaths of so many people,” she said, pointing out that many people still allowed their pet dogs to roam freely. Hutabarat added that many local-level health workers appeared unsure how to deal with rabies treatment, and that many clinics still often ran out of vaccines for people bitten by dogs.