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  • Undiagnosed deaths in Bali; Rabies confirmed

    In a recent indonesian language report, the story ended with suddenly reporting a suspect bird flu patient, tested negative.

    The diagnosis "Rabies" seems rather vague.



    Badung culls suspect rabid dogs, after four deaths

    Andra Wisnu , The Jakarta Post , Uluwatu | Fri, 11/28/2008

    The Badung regency culled 11 reportedly rabid dogs from the village of Ungasan in Uluwatu district, Bali on Thursday after two adults and two children in the area who were bitten died of undetermined causes.

    Officials from the animal husbandry agency and representatives from the Yudisthira Swarga Foundation for wild dog welfare captured the animals, extracted cranial fluids for testing, then administered lethal injections to prevent a possible outbreak. The dogs were then buried.

    Ungasan village chief and agency official, Wayan Suarkana, said most of the dogs culled were wild, though some belonged to villagers who were willing to hand over their pets.

    He said it would take a few days to determine whether the culled dogs had rabies.

    Suarkana said the agency might decide to cull more dogs in the village before waiting for lab results on the dogs' cranial fluids.

    "It's hard to tell whether the disease is actually here or whether the dogs we culled today have rabies, but we just can't take the risk," he said.

    This is the first case of mass culling of reportedly rabid canines. Bali has been rabies free for several decades, but the number of deaths forced the agency to act quickly, Suarkana said

    In September this year dogs bit Made Artana, 32, and Ketut Wirata, 28. Two months later they both died, with officials believing the cause to be rabies. Artana died on Nov. 14 at Kasih Ibu Hospital in Badung; Wirata died on Nov. 23 at Sanglah Hospital in Denpasar.

    Suarkana declined to identify the two toddlers, though their deaths were confirmed to have occurred "recently".

    "They died of unknown causes, but they may have contracted rabies. They were bitten before they died," Suarkana said.

    Sixteen other villagers have also been bitten, though none of them have complained of illness. Village records record 170 families living there.

    Balinese tend to let wild dogs roam free and domesticated dogs are rarely kept on a leash.

    In a separate interview, Tinneke Indrajaya from the Bali Animal Welfare Association said it would be a major concern if the dogs were infected with rabies because no vaccine for the disease is stored on the island.

    "Bali has been free of rabies for decades, we haven't had any need for a vaccine in the island.

    "But there's no need for panic, nothing's been confirmed yet," she said.

    Rabies is a disease that causes acute inflammation in the brain. The disease can be carried by dogs, monkeys and bats, among other mammals.

    A bite from an infected animal is fatal for humans if left untreated. However, immediate immunization is 100 percent effective in preventing the onset of the disease. There has been 31,000 deaths in Asia from rabies according to a 2006 report from the World Health Organization.

    The Badung regency culled 11 reportedly rabid dogs from the village of Ungasan in Uluwatu district, Bali on Thursday after two adults and two children in the area who were bitten died of undetermined causes

  • #2
    Re: Undiagnosed deaths in Bali; Rabies?

    Human cases of rabies are characterized by well known neuropsychiatric symptoms and almost all cases are fatal.

    If two children were bitten by rabid dogs and other people also were in contact with diseased animals, then one may expect other cases as incubation period for rabies varies greatly, from two weeks to several months and in some instance, years.

    Typical anatomo-pathological evidences of rabies should be found through necroscopics examination of brains and through nucal biopsies.

    Rabies is caused by a Lyssavirus (Rhabdovirus family).

    The only known life-saving treatment is immuno-prophylaxis and vaccination after contact with diseased animals and before onset of symptoms.

    Comment


    • #3
      Re: Undiagnosed deaths in Bali; Rabies?

      28-Nov-2008

      Balinese residents died of rabies

      Provincial Government pursued the wild dog


      Denpasar, Detik: the Government of the Balinese province went hunting the wild dog that was expected to be infected with rabies in the Ungasan village, Jimbaran, Badung, yesterday.

      A dozen dogs sagged limp after a deadly injection of the official.

      The hunting of the wild dog was carried out in the Giri Dharma series, the Ungasan village. In this village, four people died after being bitten by the dog. Two people among them from the Giri Dharma series, that is Ketut Wirata and Kadek Artana.

      The joint team of the dog hunter consisted of the official of Livestock Breeding and Kabupaten Badung fisheries and the Yudisthira Swarga Foundation of the Service. They caught several wild dogs that were marked beforehand.

      The resident who had the dog, we suggested so that wil go to the doctor, the Giri Dharma Village headword, Wayan Arka quoted the Detik News.

      After succeeding in being arrested with the net, this wild dog disuntik died by the official with Xylazine medicine, Ketamine, and Lethabab. After this dog died, the official took the sample of the brain liquid to be checked in the laboratory. The dog that has died we the grave, said Arka.

      Arka tell about, his resident, Ketut Wirata was bitten by the wild dog tonight will head toilet in the page of the house.

      Two months after being bitten by the dog, casualties died. The official will come back destroyed the wild dog in the other village in the Ungasan village.

      Comment


      • #4
        Re: Undiagnosed deaths in Bali; Rabies?

        I had always thought rabies killed in a few days


        Rabies (from Latin: rabies, ?madness, rage, fury.? Also known as ?hydrophobia?) is a viral zoonotic neuroinvasive disease that causes acute encephalitis (inflammation of the brain) in mammals. It is most commonly caused by a bite from an infected animal, but occasionally by other forms of contact. If left untreated in humans it is almost invariably fatal. In some countries it is a significant killer of livestock.


        The rabies virus makes its way to the brain by following the peripheral nerves.<sup id="cite_ref-0" class="reference">[1]</sup> 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.<sup id="cite_ref-1" class="reference">[2]</sup>
        <sup id="cite_ref-1" class="reference">
        </sup>
        In the beginning stages of rabies, the symptoms are malaise, headache, and fever, while in later stages it includes acute pain, violent movements, uncontrolled excitements, depressions, and the inability to swallow water (hence the name hydrophobia)<sup id="cite_ref-2" class="reference">[3]</sup>. In the final stages, the patient begins to have periods of mania and lethargy, and coma.<sup id="cite_ref-3" class="reference">[4]</sup> Death generally occurs due to respiratory insufficiency.<sup id="cite_ref-4" class="reference">[5]</sup>
        <sup id="cite_ref-4" class="reference">
        </sup>
        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. There are only six known cases of a person surviving symptomatic rabies, and only two known cases of survival in which the patient received no rabies-specific treatment either before or after illness onset.<sup id="cite_ref-5" class="reference">[6]</sup>

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        • #5
          Re: Undiagnosed deaths in Bali; Rabies?

          In fact, rabies kills humans after brief and painful course but only AFTER onset illness.

          The incubation period could be longer than six month, although head injuries by rabid animals may cause a much more rapid onset (weeks).

          Comment


          • #6
            Re: Undiagnosed deaths in Bali; Rabies?

            Govt orders culling of stray dogs | The Jakarta Post
            Govt orders culling of stray dogs

            Ni Komang Erviani , Contributor , Denpasar | Mon, 12/01/2008 10:58 AM | Bali

            Bali Governor Made Mangku Pastika has ordered the Balinese people conduct a mass culling of stray dogs on the island to help the administration prevent a rabies outbreak.


            The order was made Saturday in response to four deaths believed to be caused by rabies transmitted through dog bites in Ungasan village, Uluwatu.

            As of Friday, 17 wild and domesticated dogs have been put down using lethal injection by the Yudhistira Swarga foundation for wild dog welfare, while 76 residents of Ungasan who were bitten by dogs, have been vaccinated by officers of the Badung Health Agency.

            "The residents can just go ahead by taking the initiative to kill stray dogs. If the mass dog culling relied only on administration officers, it would take too long to get rid of," said Pastika at an open house session with the Balinese people.

            The existence of stray dogs along the streets, he said, had sped up the spread of the deadly rabies virus.

            Laboratory tests showed the four -- two elderly and two children -- died because of dog bites, but it was still unclear whether they died because of rabies.

            "But there is an indication, the four died because of bites by rabies-infected dogs. So we have to respond to it as quickly as possible to curb its spread," Pastika said, adding rabies could only be controlled by killing the stray dogs.

            The governor also urged dog owners to pay attention to the health of their pets and not to let them play with stray dogs.

            "Domesticated dogs have also undergone health checks to detect whether they are healthy or are infected with rabies."

            Pastika ordered port officials to strengthen custom checks of goods entering Bali to prevent the illegal entrance of dogs from outer islands.

            He said he believed the rabies infection was the result of dogs being smuggled into Bali from other islands.

            Aside from dogs, Pastika also demanded the strict supervision of the entrance of other animals into Bali, like monkeys and cats, which transmit diseases to human beings.
            -
            <cite cite="http://www.thejakartapost.com/news/2008/12/01/govt-orders-culling-stray-dogs.html">Govt orders culling of stray dogs | The Jakarta Post</cite>

            Comment


            • #7
              Re: Undiagnosed deaths in Bali; Rabies?

              76 vaccinated for rabies after dog bites

              Luh De Suryani , The Jakarta Post , Denpasar | Sat, 11/29/2008

              The Badung Health Agency as of Friday vaccinated 76 residents of Ungasan village, Uluwatu, who were bitten by dogs following four fatalities in the area officials suspect were caused by rabies.

              Gede Agung Mayun Dharma Atmaja, the agency's head, said his office had ordered the vaccines from Jakarta immediately upon hearing reports the deaths might have been caused by the rabies virus, a disease that has not been seen in Bali for several decades.

              "We are treating this as an extraordinary event, we don't want to be careless in handling this matter because Bali has been rabies free so far," he told The Jakarta Post on Friday.

              "Furthermore, there has been an increasing number of dog bite cases, so we had the vaccines delivered from Jakarta immediately and the people who have been vaccinated are in a healthy condition."

              Recently, two adults and two children from the same village of Ungasan died of suspected rabies infection. In response, local officials and the Yudisthira Swarga foundation for wild dogs welfare conducted a mass dog culling sweep of the village.

              As of Friday, 17 wild and domesticated dogs had been tested positively for the disease and been put down using lethal injection. In the test, a small amount of the animal's brain fluid is extracted under anesthetic.

              Mayun said the agency was awaiting test results of dogs in the area from the Bogor Veterinary Hall in West Java.

              "It will take about 21 days before they have the results," he said.

              He said the agency, in cooperation with the Badung Fisheries and Animal Husbandry Agency, had been visiting families in the village to inform them of the possible endemic, and to ask them to keep their dogs on leashes.

              "This has been done at the request of the villagers. That way we can tell which dogs must be culled because the domesticated ones have been tied to their owners' homes," said Gede Ashrama, deputy head of the Badung Fisheries and Animal Husbandry Agency, who was present during the interview.

              When asked why the agencies had not conducted a mass vaccination on the village's 170 families, Ashrama said such a move would only be prompted if the test subjects were found positive for the disease.

              "If the results come back positive, then we will have to conduct a quarantine," he said.

              "The most important thing right now is to continue observing the population of wild dogs in the area and to continue to identify the people who have suffered dog bites."

              Rabies, a virus that causes inflammation of the brain, can be transmitted through saliva and blood and is typically carried by dogs, bats and monkeys.

              The disease has an incubation period of two weeks. Within two months of infection at the latest a subject will develop a fear of sunlight and a reluctance to drink water.

              In the final stages, the disease induces periods of mania, lethargy and eventually coma. Death from rabies generally occurs due to respiratory failure.

              RABID FEAR: A doctor from the Yudisthira Swarga Foundation for Wild Dogs Welfare administers a lethal injection to a dog suspected of carrying the rabies virus at the village of Ungasan in the Uluwatu District, on Thursday

              Comment


              • #8
                Re: Undiagnosed deaths in Bali; Rabies?

                Tested positive for rabies; also negative testresults.

                Two residents died, Balinese Warning on Rabies Dogs

                on Monday, December 1 2008 -

                Denpasar - the Government of the Balinese Province stated his area in the KLB status (the extraordinary incident) rabies. The determination followed the discovery of two residents who died after being bitten by the dog pengidap rabies.

                The plague of the rabies then received direct attention of the Department of the Health of the centre.

                We have taken the step like by destroying the wild dog and the mass vaccination, said Plt Dirjen of the Control of the Illness and Sanitation of Lingkungan Department of Health Tjandra Yoga Aditama in the Office of Dinas Kesehatan Bali Street Melati Denpasar, on Monday (1/12/2008).

                Kesehatan Bali Dewa Section Head Ketut Oka explained, till at this time has had 80 residents who had been bitten by the dog in a year for the last year received the vaccination.

                They especially are villagers Ungasan and Kedonganan, Kecamatan Kuta Selatan, Kabupaten Badung. Two villages were the most serious territory resulting from the rabies attack.

                In two territories also, two residents who died some time before it was confirmed teserang rabies. The two casualties were Ketut Wirata (28), and Kadek Yudha, the child eight years.

                From results of the testing of the Besar Penelitian Veteriner Hall in Bogor, West Java, casualties were stated positive contaminated with the rabies virus.

                Whereas three residents more who just recently also died as a result of being bitten by the dog for the time being were stated by the rabies negative.

                The rabies dog also attacked at least nine other residents in two villages. Resulting from the dog attack in several places, the government with members of sultan's family a last week destroyed at least 75 tails.

                Most were the wild dog and sisanaya the dog belonging to the resident who willingly was handed over to be destroyed because of being expected terjangkit rabies. Like that died, the dogs were gathered et cetera was buried.



                TT

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                • #9
                  Re: Undiagnosed deaths in Bali; Rabies?

                  Dog tested positive for rabies; testresults human victims still pending.

                  Stray Dogs Destroyed to Avoid Rabies

                  Governor Bali Made Mangku Pastika appealed to the Ungasan Village community and Kedongan, Kabupaten Badung, combatted the wild dog in their area.

                  The appeal had a background the findings from the blood inspection of three biting dogs of three residents in two areas, that one tail including being stated positive rabies.

                  As is known, during November this already three villagers Ungasan and Kedongan died after being bitten by the dog. They were Muhammad Oktav Rahmana Putra, 3, pre-schoolers from the Ungasan Village, Kuta Selatan, Badung; Kadek Artana, 32, and Ketut Wirata, 28.

                  We asked the resident to destroy the wild dog in the two villages. Because of three samples of the dog that was taken by the Peternakan Service for the laboratory test, evidently one of them positive contracted rabies, said Mangku Pastika in Denpasar, yesterday.

                  This action, according to him, to prevent and decide the cycle of the rabies illness in order to not spread to humankind. At first Bali was the area of the aim of tourists of going on holiday.

                  If this until happened, will disrupt the sector of tourism, he said. To anticipate the spreading of the rabies illness from outside Bali, Mangku Pastika instructed all the port to enter Bali for the time being was closed for the animal kind penular the rabies virus, that is the dog, the cat, and the monkey. Hoped authorised apparatus took decisive actions against three animal kinds that will enter Bali, he said.

                  Other efforts anticipated the spreading of the rabies virus in Bali, Peternakan Bali Ida Bagus Alit Section Head explained his side has accepted the vaccine sedative for the dog totalling 3 kg and 20 thousand pcs the vaccination from the government of the centre.

                  In the meantime, Section Head Kesehatan of the Balinese Province DrDewa Oka said results of the sample of casualties's affected blood the dog bite was in the process of the testing of the laboratory to know whether the relevant patient positive rabies or not.

                  Berita Terkini Seputar Opini, Berita Terbaru Indonesia, Berita Hari Ini, Berita Terpopuler, Media Indonesia | Referensi Bangsa

                  Comment


                  • #10
                    Re: Undiagnosed deaths in Bali; Rabies?

                    Stray Dogs and Cats Raid in Jakarta

                    On Friday, November 28 2008 | 20:00 WIB

                    Jakarta, on Friday - the Livestock Breeding Service, fisheries and Marine (Disnakkanla) the Special Capital District of Jakarta will carry out the cat raid and the wild dog that it was considered disturbed and disrupted comfort, and the cleanliness of the environment in the Capital territory.

                    This raid was carried out especially in several important places like the hospital and the Community Health Centre, the Peternakan Service headword, Perikanan and Marine (Disnakkanla) Special Capital District of Jakarta Edy Setiarto, in Jakarta, on Friday (28/11).

                    He said, his side formed the special team to handle the problem of the capture and the cleaning of the cat and the wild dog that often roamed about. According to the note of Disnakkanla Special Capital District OF Jakarta, the number of the two wandering animal kinds spread all over the Special Capital District of Jakarta territory this 2008 has reached approximately 200 thousand tails.

                    The wandering animals were often seen in several hospitals, the Community Health Centre, the office of the government agency, in fact through to the Negara Palace complex. The existence of the two wandering animal kinds free that could not be kept still just like that. Immediately must have the real action to clean, said Edy.

                    Disnakkanla (Livestock Service,ed) has also prepared the observation house to accommodate the cat and the wild dog that were caught. There the two animal kinds will especially the wild dog be checked whether having the illness that was dangerous like rabies.

                    Especially several wild dogs, when several dogs were found had the rabies illness immediately will be vaccinated, said Edy. After being finished the vaccination stage and was stated clean from the illness, just was brought to the house of animal care that was in Ragunan, Southern Jakarta.

                    On the other hand when his illness was difficult to be cured then the road that was taken was to kill this animal so that did not endanger. However, if still was treated and his illness could not be cured, must be killed, he explained.

                    Comment


                    • #11
                      Re: Undiagnosed deaths in Bali; Rabies.

                      Senin, 01/12/2008

                      Bali Status KLB Rabies

                      Denpasar - Two Balinese residents who died were stated positive contaminated with rabies. Bali was then stated in the KLB status (the extraordinary incident) rabies.

                      The "government" of the "Balinese Province stated Bali in the KLB status, the" Service" headword of Kesehatan Bali Dewa Ketut Oka in his office the Jasmine road, Denpasar, on Monday (1/12/2008).

                      Two villagers Ungasan, Jimbaran that died terjangkit rabies was Ketut Wirata (28) and Kadek Yudha (8). They were stated positive contaminated with rabies from the testing of the Besar Penelitian Veteriner Hall in Bogor, West Java.

                      The biting dog casualties then terjangkit rabies. Whereas three residents more who also died after being bitten by the dog were stated by the rabies negative. The rabies dog also attacked at least nine other residents in the village.

                      Oka said as many as 80 residents who had been bitten by the dog were vaccinated in a year. Some of the they villagers Ungasan and the Kedonganan Village, Kecamatan Kuta Selatan, Kabupaten Badung.

                      Two villages were the most serious area resulting from the rabies attack. In a week, the government with the resident destroyed at least 75 wild dogs as well as property residents Ungasan. The dog died injection afterwards was buried.

                      Info berita terbaru hari ini baik peristiwa, kecelakaan, kriminal, hukum, berita unik, Politik, dan liputan khusus di Indonesia dan Internasional

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                      • #12
                        Re: Undiagnosed deaths in Bali; Rabies.

                        Local doctor denies rabies diagnosis, says it is encephalitis.

                        Bali in Emergency Status on Rabies

                        December 1st, 2008

                        Local newspapers have previously reported that three people living in Southern Kuta died after bitten by dogs.

                        However local officials in Badung as well as in Sanglah General Hospital denied relationship between their deaths and rabies. Whilst the symptom was admitted as close to rabies, brain infections have been concluded.

                        The delay in rabies has once complained by a member of Badung House of Representatives Diesel Astawan. The information has somehow reached the central government which immediately instructed authorities in Bali to conduct a check, which resulted in negative conclusion, no evidence of rabies found.

                        The joint force including Veterinary Office of Bali, Veterinary Office of Badung, and Yudhistira Foundation had field assessment in Ungasan area under the command of Bali Veterinary Office I.B. Raka.

                        At Banjar Sari Karya of Ungasan village the team identified six cases of human bitten by the dogs, with the last case happened back in November 13th 2008. The joint team which previously planned to take the dog for observation in their office has cancelled the plan and have the owner a cage for on-spot observation.

                        Dog attack has also been happened at Banjar Bakung Sari of Balangan village, but no death resulted. Suspicion arose when the dog died a few days afterward. Meanwhile a resident of Banjar Giri Dharma of Ungasan village died on Sunday (November 24th) after one night hospitalization in Sanglah General Hospital.

                        . He was suspected for rabies as he had been bitten by dog one month before being hospitalized. Five days before another residents has has also been bitten by dog and died afterward.

                        With regard to their deaths officials of the hospital refused rabies infection. Head of Emergency Unit of Sanglah General Hospital, dr. Kuning Atmadjaya, Sp.B. said that they are suspected for rabies at first considering their background. “However blood tests have proven that there were no rabies infection,” said Kuning.

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                        Edit: possibly this article is based on this Indonesian article in Bali Post from today;


                        - snip -

                        On the death of this resident, Kasi Yanmed Rawat Street RS Sanglah Dr. Ken Wirasandhi, on Sunday (23/11), denied casualties were attacked by the rabies illness. The same thing was said by the IRD RS Sanglah Head Dr. Yellow Atmadjaya, Sp.B. Menurutnya, the patient initially indeed it was suspected was affected by rabies saw the background of the illness. But after being carried out by the blood test in the laboratory, results of rabies and the patient of the negative positive contracted the inflammation of the brain, said Kuning .



                        http://www.balipost.co.id/mediadetai...kid=10&id=8231

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                        • #13
                          Re: Undiagnosed deaths in Bali; Rabies?

                          Human infection with rabies virus causes fatal ENCEPHALITIS.

                          Lyssavirus are neurotropic...

                          Comment


                          • #14
                            Re: Undiagnosed deaths in Bali; Rabies?

                            On Wednesday, December 03 2008 |



                            [How to] Recognise the Rabies Dog


                            Bali no longer was free of rabies. Several residents became casualties after being bitten by the dog that was ill rabies.

                            These mad dogs because of his bite could spread the quite dangerous illness, it was known had several special characteristics, in part often or continually menjulurkan the tongue.

                            Peternakan Provinsi Bali Ida Bagus Alit Section Head mentioned, apart from menjulurkan the tongue, the rabies dog was also known kelewat stern and often possessed.

                            Besides this, the rabies dog also appeared to issue the excessive saliva, liked was in the dark or frightened place the clear condition. For the position of the tail, said Alit, the mad dog often slipped his tail below penis or to the bottom of the stomach.

                            He said, with more knew the characteristics of the mad dog, the resident could it was hoped avoid the attack or the fauna bite that could spread the rabies. (kmb)

                            Comment


                            • #15
                              Re: Undiagnosed deaths in Bali; Rabies?

                              Friday, 05/12/2008 16:04 WIB

                              KLB rabies in Bali

                              Team Origin investigators Proposal rabies Formed

                              Elvan Dany Sutrisno - detikNews

                              Jakarta - Historically, Bali is a region free of rabies. However, God Island has been declared in the status of KLB (extraordinary event) Rabies. The team also formed to investigate the origin rabies outbreak.

                              "Bali is a historical region previously free of rabies. To know the origin outbreaks, I have formed a team investigating to find out the origins of rabies virus," said Director General of the Ministry of Agriculture, Animal Husbandry, Tjeppy D Soedjana.

                              This was delivered in Building C Department of Agriculture, 6th Floor, Jalan Harsono, Pasar Minggu, South Jakarta, Friday (5/12/2008).

                              The team consists of Balai Besar Veterinary elements Denpasar, Bali Provincial Animal Husbandry Department and the Badung and the Director General of Animal Husbandry.

                              He said, 8 villages were attacked have been outbreaks of rabies. This is known based on the results of testing by laboratories in the Great Hall and the Veterinary Denpasar confirmed back on the Great Central Veterinary Denpasar Cleveland on 28 November 2008 on the brain specimens wild and pet dogs that bite people.

                              Village, among other Ungasan Village, Village Kadonganan, and the village of Jimbaran and Kuta sub district of South Kuta Badung, Bali.

                              Animals Infected

                              In addition, Tjeppy said, the Governor of Bali Made Mangku Pastika has issued a circular to close the infected area of animals penular traffic Rabies is cats, dogs and primates.

                              In addition, he continued, will be conducted in strict supervision of traffic infected animal rabies.

                              Info berita terbaru hari ini baik peristiwa, kecelakaan, kriminal, hukum, berita unik, Politik, dan liputan khusus di Indonesia dan Internasional

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