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Travel notice for Bali: rabies outbreak
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The Centers for Disease Control and Prevention (CDC) has issued outbreak notice for travelers going to the tourist destination of Bali, Indonesia. So far this year there has been 15 reported deaths from the viral disease.
According to the outbreak notice, most cases have been confirmed near popular tourist destinations on the southern tip of Bali.
But because this situation is constantly evolving, the CDC is advising travelers to take precautions for the entire island.
The CDC offers the following advice to travelers to the area:
Avoid animal bites.
• Avoid touching all animals, including wild animals and pets. Pets in other countries may not have been vaccinated against rabies.
• Resist the urge to rescue animals with the intent to bring them home to the United States. Dogs and cats may be infected with rabies but not show signs until several days or weeks after you first encounter them.
• Supervise children closely, especially around dogs, cats, and wildlife such as monkeys. This is important since children are more likely to be bitten by animals, may not report the bite, and may have more severe injuries from animal bites.
• If you are traveling with your pet, supervise your pet closely and do not allow it to play with local animals, especially strays.
Act quickly if an animal bites or scratches you.
• Wash the wound well with soap and water.
• See a doctor right away, even if you don’t feel sick or your wound is not serious. To prevent rabies, you may need to start a series of vaccinations immediately.
• To get vaccinated, be prepared to travel back to the United States or to another area. (Adequate vaccination for exposure to rabies is not available in all parts of the world.)
• After you return home, tell your doctor or state health department that you were bitten or scratched during travel.
Rabies is an acute viral infection that is transmitted to humans or other mammals usually through the saliva from a bite of an infected animal. It is also rarely contracted through breaks in the skin or contact with mucous membranes.
According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.
Some infected animals can appear very aggressive, attacking for no reason. Some may act very tame.
The symptoms of rabies are as follows. Initially, like in many diseases, the symptoms are non-specific; fever, headache and malaise. This may last several days. At the site of the bite there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.
The only treatment for human exposure to rabies is rabies-specific immune globulin and rabies immunization. Appropriate treatment started soon after the exposure will protect an exposed person from the disease.
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