A Rabies Outbreak in Paradise

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Made Nagi

An Indonesian agricultural official vaccinates dogs in a neighborhood in Denpasar, Bali, on Jan. 10, 2009

Bali, whose mythic resorts have been struggling to fill their beachside villas during the global financial meltdown, has been hit by another unexpected crisis this month: rabies. The death toll from an outbreak on the island of 3.1 million people rose to six on Monday, adding to the woes already faced by the Indonesian province after the downturn in the world's economy.

Doctors at Bali's largest hospital told the press they suspected that rabies was the cause of death for a resident admitted to the hospital last week convulsing and foaming at the mouth. The number of patients bitten by infected animals jumped from 15 in December to 10 each day since the beginning of January, according to officials. "It could be that in the past few months, there were a number of cases that weren't reported," Ken Wirasandhi, the hospital's director of services, told the Kompas daily. (See the top 10 animal stories of 2008.)

As the severity of the problem comes to light, the island is gearing up for a mass dog vaccination this weekend to help prevent the virus from spreading beyond the districts of Denpasar and Badung, where the first cases were reported in November. Since then, more than 6,200 dogs have been vaccinated and more than 280 stray dogs put to sleep. Bali Governor I Made Mangku Pastika has closed the island's borders to all dog traffic from outside, where the virus is believed to have originated.

About half the world's 75,000 annual rabies deaths are in Asia, and most of those are in India. Though this is not the first time Indonesia has grappled with rabies — several parts of Java and Flores have reported outbreaks in the past — the fact that Bali has never before reported rabies makes it unusual. "They need to react rapidly before it becomes established in the population, after which time it will become very difficult and costly to eradicate," said a U.N. Food and Agriculture Organization official who asked not to be named. Part of the reason the disease is complicated to control is its long latency. Rabies symptoms manifest within two to three weeks if a person has been bitten on the face, or as late as 12 months if the bite is on the leg. Generally, if an infected person is not vaccinated immediately, there is little chance of survival.

Tourism operators report that they have yet to see any cancellations as a result of the outbreak but admit that the problem needs to be dealt with quickly if they are to avoid losses. "It's another problem we didn't need," says Jack Daniels of Bali Discovery Tours. "But the government has been very aggressive in tackling it." In the meantime, visitors have been warned not to touch any animals that look as though they may be sick, including monkeys, which also carry the disease. "There is no need to be scared, but we are asking people to keep their dogs in cages and take responsibility for their animals," says Ida Bagus Alit, the local Agriculture Ministry official in charge of animal husbandry. Though World Health Organization officials say they are monitoring the situation, it's Indonesian health officials who are preparing vaccinations for doctors, veterinarians and anyone else handling sick animals. The outbreak has prompted the U.S. Embassy in Indonesia to issue a warning, and the Australian government has issued a similar advisory and provided $100,000 to the local government for testing and vaccinations.

Past health scares, along with the two terrorist attacks on the island in the past six years, have already kept tourists away from this popular destination. During the regional SARS outbreak in the last decade, for instance, Japanese tourism to the island dropped dramatically. For now, the island's some 330,000 canine residents are being eyed with a new wariness. In the popular Legian area, where a foul stench permeates the strip of bars and clubs along the Double Six Road, the roaming gangs of dogs that have been fixtures in that area pose a new threat. "Now the risk is to stray dogs because they are more aggressive," says Dr. Wita Wahyu, director of the Bali Street Dog Foundation. "And if they are infected, they will bite anything that moves."

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