Bali: Vaccinated against Rabies?

[outpost31]

Hi,

I'm going to Bali in April and have heard of the rabies risks from stray dogs. I'll be just diving and eating out in Tulamben and PadangBai and wanted to know if any divers decided to get vaccinated against Rabies...In the UK it'll cost me £130 for the vaccines!

Has any divers here actually been scratched or bitten by a dog...I'm not going to see the monkeys.

Cheers
Chris

 

[SelkieDVM]

I would ask a physician trained in travel medicine. My question would be just how often do tourists actually get bitten by stray dogs in Bali? While it is theoretically possible to be infected with rabies through other means, bite wounds are by far the most common route.

I have been vaccinated for rabies because I am a vet and rabies is still common here in the US, but I personally wouldn't bother with the vaccine just for a dive vacation. In the unlikely (I presume) event that you are bitten, you could always receive post-exposure prophylaxis treatment, though it would likely be more expensive and more painful.

PS: Maybe this is too obvious, but I would avoid interacting with any dog while there regardless, even if they appear perfectly normal.

 

[outpost31]

Hi Selkie,

Thanks for the reply.

I've had some great advice from SOS Medika in Bali regarding the rabies situation there and what to do but, after a bit of searching on here, I couldn't find any diver stories about their encounters so I've posted this to see if anyone has been bitten or seen problems. I have no intention of going anywhere near these dogs but unforeseen accidents can happen.

What do you mean by painful? Are you just talking about an injection or are they going to give me a suppository the size of a small pony? :nailbiter:

 

[SelkieDVM]

What do you mean by painful? Are you just talking about an injection or are they going to give me a suppository the size of a small pony? :nailbiter:

LOL, just injections in the muscle. However, for post-exposure prophylaxis in an unvaccinated individual, you need a series of four vaccine injections, plus a dose of rabies immunoglobulin given IM or infused into the wound itself.

Hopefully some folks with more knowledge of the stray dog situation in Bali will chime in here to give you a better idea of the risk.

Cheers,
Lilla

 

[Mossman]

Hi Selkie,

Thanks for the reply.

I've had some great advice from SOS Medika in Bali regarding the rabies situation there and what to do but, after a bit of searching on here, I couldn't find any diver stories about their encounters so I've posted this to see if anyone has been bitten or seen problems. I have no intention of going anywhere near these dogs but unforeseen accidents can happen.

What do you mean by painful? Are you just talking about an injection or are they going to give me a suppository the size of a small pony? :nailbiter:

Some good information here: Chapter 2 - Rabies - 2010 Yellow Book | CDC Travelers' Health

And less information, but more specific to Bali:

Rabies in Bali, Indonesia | CDC Travelers' Health

Thanks for the warning. I had no intention of playing with stray dogs when we're there for a few nights' stopover in May, but revisiting the monkey forest was on my potential agenda. Now it's not. I'll miss those monkeys, but it ain't worth it!

 

[Mike Veitch]

i have lived in Indonesia and Bali for 3 years.. never had a run in with a dog.. even riding my bike to work in Bali for a year.

 

[AlanWald]

I have worked in Nepal where Rabies is still a major problem. Best defense is carry a walking stick to repel any rabid dog who might attack.

I got the full pre-exposure series in the US before going to Nepal (I worked in an office in Nepal with a vet, but we were doing research and I was never exposed to any animals except those in the city) but it did not cost me anything as I worked at hospital in the US before going to Nepal

If bit by an animal that might have rabies, best to try and capture the animal and quarantine it to see if develops signs of rabies and then have a competent lab confirm it by examination of the animals brain.

The vaccination for me was not painful, just mild soreness. It is not like the old vaccines of yesteryear.

The big advantage of the pre-exposure vaccination is that you require less shots after exposure as you already have some immunity and generally don't need to get the very expensive rabies immune globulin (RIG) which may be difficult to obtain in some areas.

So those who work in veterinary medicine or other occupational exposure or might be out in the wilderness for a long time, pre-exposure vaccination is imperative, but for the average person probably not.

In any case, wash any bite with as soap and water as well as povidone iodine solution (brand name is Betadine in USA) if available get and seek medical attention immediately.

 

[AlanWald]

I have worked in Nepal where Rabies is still a major problem. Best defense is carry a walking stick to repel any rabid dog who might attack.

I got the full pre-exposure series in the US before going to Nepal (I worked in an office in Nepal with a vet, but we were doing research and I was never exposed to any animals except those in the city) but it did not cost me anything as I worked at hospital in the US before going to Nepal

If bit by an animal that might have rabies, best to try and capture the animal and quarantine it to see if develops signs of rabies and then have a competent lab confirm it by examination of the animals brain.

The vaccination for me was not painful, just mild soreness. It is not like the old vaccines of yesteryear.

The big advantage of the pre-exposure vaccination is that you require less shots after exposure as you already have some immunity and generally don't need to get the very expensive rabies immune globulin (RIG) which may be difficult to obtain in some areas.

So those who work in veterinary medicine or have other occupational exposure or might be out in the wilderness for a long time, pre-exposure vaccination is imperative, but for the average person probably not on short vacation.

In any case, wash any bite with as soap and water as well as povidone iodine solution (brand name is Betadine in USA) if available get and seek medical attention immediately.

 

[OnTheSpot]

Right now a segement on the news on my TV is saying there is a lot of rabbies in Bali with many people bitten everyday and some deaths.

I know the news reports are usually exagerated but after watching this if I were you I would do some research and check the situation.

There is an alert here - Radio Australia News.

 

[divewench1]

There is an article about Rabies in this weeks Bali Advertiser, telling what to do if you get bitten, but no mention of ANY deaths. Its the monkeys, bats, chickens and cats you want to watch out for, rather than the dogs!