Rabies FAQS

What is Rabies?
Rabies is a viral disease of mammals most often transmitted through the bite of a rabid animal. Domestic animals reported rabies cases are cats, cattle, and dogs most often reported rabid. Human fatalities associated with rabies occur in people who fail to seek medical assistance, usually because they were unaware of their exposure.

Does Rabies affect humans?
Rabies virus infects the central nervous system, causing encephalopathy and ultimately death. Death usually occurs within days of the onset of symptoms. The rabies virus makes its way to the brain by following the peripheral nerves.

The incubation period of the disease depends on how far the virus must travel to reach the central nervous system, usually taking a few months. Once the infection reaches the central nervous system and symptoms begin to show, the untreated infection is almost inevitably fatal within days. From the source of wound of entry, the rabies virus travels quickly along the neural pathways to the central nervous system. There the virus further spreads to other organs. The salivary glands located in the tissues of the mouth and cheeks receive high concentrations of the virus, thus allowing for it to be further transmitted. Fatality can occur within anywhere from 2 days to 5 years from the time of initial infection.

How can prevent the onset of Rabies?
In non-vaccinated humans, rabies is almost invariably fatal after neurological symptoms have developed, but prompt post- exposure vaccination may prevent the virus from progressing

How is Bali situation?
Starting 2008, Bali is not rabies free. From Bali Health Office data, since 2008 there are 17.624 cases of rabies suspected animal bite. There are 120 cases of human rabies every month. Of the total cases were, as many as 12 people died in the period from January to July 2015.

How to prevent the disease?
Avoid exposure from suspected animals is the best, but it is difficult to do. Rabies can be prevented by vaccination, both in humans and other animals. In human, rabies prevention using 2 strategy,

• Pre-exposure vaccination, by giving 3 injections of Human Diploid Cell Vaccine (HDCV) or Purified Chick Embryo Cell Vaccine (PCEC) or Purified vero cell vaccine (PVRV) at day 0, 7, 28. Booster for 1 and 5 years later.

• Post-exposure vaccination (after confirmed or suspected exposure), by giving injections, vaccine at day 0, 3, 7, 14, 28 and human rabies immune globulin (HRIG) at day 0 (in different syringe and side). The wound must be wash by a large quantity of water and soap or detergent then apply with Povidone Iodine solution or 70% alcohol. Exposed mucous membranes such as eyes, nose or mouth should be flushed well with water. Patient needs adequate treatment in hospital if expose by suspected dog or animal. The dogs must be quarantined for 10 days for observation to prove rabid animal (according to WHO recommendation). Pregnancy and infancy are never

What medications are available to treat Rabies infection in humans?
Person suffer from rabies must be treated in rabies care center or hospital.

What travel precautions should I take?
You should take note of the following measures to minimize your risk of acquiring swine flu:
- Avoid contact with persons with symptoms of influenza
- Avoid crowded areas and maintain good ventilation.
- Observe good personal and environmental hygiene. Wash hands thoroughly with soap and water frequently and when
   they are contaminated by respiratory secretions e.g. after sneezing.
- Maintain good body resistance through a balanced diet, regular exercise, having adequate rest, reducing stress and
   not smoking.

Does influenza vaccination help in preventing Swine Flu?
Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine is unlikely to protect against H1N1 swine flu viruses.

Is it safe to come into contact with live pigs in nature reserves and the wildlife reserves?
Proper hygiene practices, such as washing of hands after contact with animals including pigs, should be maintained.