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Jakarta Post

Urgent: Rabies serum for Bali, doctors say

Doctors are urging the government to quickly supply rabies serums

Luh De Suryani (The Jakarta Post)
Denpasar
Tue, February 3, 2009

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D

octors are urging the government to quickly supply rabies serums.

Patients who had been bitten and vaccinated began showing recurring symptoms of rabies.

I Wayan Suarjana, 34, was admitted to Sanglah Hospital after he began feeling cramps in several parts of his body on Friday evening.

Suarjana, whose left forearm was bitten by a dog two months ago during a rabies prevention seminar in south Kuta and received immediate vaccination, appears to still be infected.

According to a relative, I Wayan Mangkok, Suarjana began showing symptoms similar to those of rabies-infected patients, including fever, pain and cramps around the bite-wound, and an overreaction to sensory stimulation.

"Though that might be just fear factor after watching so much news on TV of how rabies patients were suffering the same symptoms," Mangkok added.

Suarjana remains in stable condition at the hospital. However, doctors are urging the Bali administration to supply rabies serums to help prevent any possible deaths occurring from an incomplete vaccination.

Rabies serums are meant for people who suffer larger and more open dog-bite wounds, and are administered by repeatedly injecting the drug as much as possible around the wound, followed by a vaccination injection.

The call by the doctors is due to the fact that Bali doctors have never had to anticipate a possible outbreak of this magnitude. The Bali Health Agency's vaccination program has only started and has yet to prove its effectiveness.

Prof. Dr. Anak Agung Raka Sudewi, a medical expert working for Sanglah Hospital's rabies task force, said Suarjana might not be at that much of a threat.

"The cramps might have been due to the patient's ailing immunity system when he was vaccinated, meaning that the vaccination itself was not working optimally," Raka said.

She said doctors are still conducting observations to prove whether the vaccination program was enough to fully eradicate rabies in Bali, but urged the govern-ment to supply rabies serums to prevent any possible worst-case scenarios.

"The serum is very important to Bali right now, but the island itself doesn't currently have any. The last time I checked, there were some but those are still being labeled," she said.

I Ketut Suwi Adnyana , head of the Badung Health Agency's disease observation and prevention division, said the government had allocated funds to procure the serums.

"Serums are actually more expensive than vaccines, but it's important *to have them* because dog-bite cases appear nearly every day in south Kuta," he said.

To make matters worse, Adnyana reported a shortage of rabies vaccines in Badung, with only 200 doses left for about a week of use.

Adnyana said the agency had requested an additional Rp 1.2 billion (US$103,200) from the Bali administration to buy 10,000 vaccines for 2,500 people.

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