More than 100 human rabies deaths were reported in the Indonesian tourist destination of Bali from December 2008 and February 2011 and part of the government efforts to get the outbreak under control included mass culling of dogs and emergency vaccination.
Prior to 2008, the island was listed as rabies-free.
It got so bad in Bali that the US Centers for Disease Control and Prevention issued a travel notice for US travelers to the island paradise and advised on pre-exposure rabies vaccination prior to travel.
The Indonesian government efforts, particularly the mass vaccination of dogs, brought the number of reported cases down to only one human case in all of 2013, according to the Global Alliance for Rabies Control (GARC).
Rabies is back in Bali and by mid-2015 another 12 human deaths had been recorded, the Bali Animal Welfare Association (BAWA) reports.
In response, the government has been euthanizing dogs and according to a Daily Mail report, dead dogs are piling up on Bali streets.
They report: To euthanize the animals, government officials use strychnine darts – a type of poison which can cause a slow death that includes seizures and paralysis of breathing functions.
This has prompted critics of this methodology to say that mass sterilization and vaccination is more effective.
During the outbreak in 2008, the government’s initial response was to use the strychnine darts.
A wide-scale cull of Bali’s intelligent and genetically unique street dog killed around 150,000 Bali dogs, many of which died slowly in extreme pain.
Fear engulfed Bali and many healthy dogs were brutally killed in other ways. Rabies spread around the island as people moved their pets to avoid the culling, unaware or unconcerned that unvaccinated dogs could already be incubating the disease.
Rabies then spread to all districts of Bali.
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.