Travel Vaccinations My Bali Rabies Story

We Westerners love to travel, and often we do so with little knowledge of what diseases may be lurking in our destination of choice. In June I travelled over to Bali, and as I was already covered for Hep A and B, I didn’t think I needed to get any other vaccines, but I was truly misinformed! As you read this article, Travel Vaccinations My Bali Rabies Story, you will find out why it really does pay to take those extra precautions.

My Bali Holiday Cut Short By Rabies

On June the 27th of this year, my lovely Bali holiday was cut short by 6 days and I was promptly flown back to Australia. Upon landing at Melbourne Airport, I immediately jumped into a taxi, and headed straight over to The Royal Melbourne Hospital for some immediate, immunoglobulin injections.

This all occurred not because I was bitten by some vicious, rabid monkey, in the forests of Ubud, but because I was licked on the mouth and accidentally scratched on the leg, by one very happy, very friendly, very clean looking, collar wearing, pup on the main beach of Legian.

I Didn’t Know There Was A Rabies Problem In Bali

This was not my first trip to Bali. Over the last 20 years I have visited six times, and never had I heard of Bali having a rabies problem.

Like most tourists, I would naturally always steer clear of interacting with the Bali street dogs, not because I thought they carried rabies, but just because I really didn’t want to get bitten. Sadly, many of these stray dogs are often in very poor health, and although I didn’t know what diseases they carried, I was not willing to take a risk by getting too close to them.

The Situation With Dogs In Bali Seemed Different

However, this trip to Bali things were different. I was staying in Legian and the last time I had visited Legian Beach, was over 15 years ago.

The first thing I noticed (being an avid animal lover), was that there were now lots of Westerners and Europeans living in Bali who owned pet dogs. Everyday I would see them on the beach with their very healthy looking dogs.

Not only did the foreigners have pet dogs, but the local Balinese Surf Instructors, stationed on the beach, also had their own pack of healthy looking, collared dogs. I was told that the surf clubs communally looked after these beach dogs; e.g feeding them.

In fact nearly every dog I saw on the beach in Bali was wearing a collar, and I was thrilled to see that such good care is now being taken of these beautiful, local Balinese dogs.

Seeing this and being such a huge dog lover, I really didn’t think twice about petting and playing with these dogs.

*The dog you see on my lap in the picture, is a gorgeous young female named Oolu.

Oolu and I bonded quickly, and one day as I lay on my sun-lounge, Oolu decided to jump up onto my lap, accidentally scratching my bare leg a little, but I didn’t worry about it. Nor did I worry too much, when two days later, she was again sitting on my lap, and while I was petting and talking to her and another dog, she turned abruptly and either nosed or licked me right on my open, chatting away, mouth. Of course my first thought was, “yuk, I should go and wash my mouth with disinfectant” but I did not for one minute think, “oh no, I am now at risk of catching rabies!”

Facebook Used For Good

I shared a photo of sweet Oolu sitting on my lap on Facebook, and my friend Gabby (who had recently been to Bali), happened to see my photo, and I was just very fortunate that she did.

Gabby wrote a comment under my photo post, warning me to be careful as there had been a recent alert about a rabies outbreak in Bali. I actually missed my friend’s comment, but luckily my mother saw it, and as her and my Dad where in Bali with me, she alerted me to this warning.

Initially I really wasn’t too worried, but I thought I better check into it anyway. So later that night after dinner I did some googling. It turned out that Gabby’s warning was very warranted, there was indeed a rabies outbreak in the dogs of Bali.

Further research led me to find out that rabies is transferred by saliva and not just from a bite. Now I was getting a little concerned. To date there is no cure for rabies, but if you are exposed to the virus you have a small window of time to get the vaccinations, so you don’t develop the virus.

Armed with this information, I thought I ought to play it safe. I decided to place a call through to the international hospital in Denpasar Bali. I spoke with a doctor and explained my situation (being the leg scratch and the mouth lick), all the while feeling like a hypochondriac.

It turned out my fears were valid. I was told by the doctor, that absolutely, yes, I definitely must have immediate treatment, as rabies can be contracted from either a bite, a scratch and from a lick to an open wound, or to the mucosal membranes; e.g. the eyes, nose and mouth. Bingo mouth for me and a scratch!

At Risk And Needing Treatment

I double checked the validity of the advice I had been given with another 2 doctors in Bali and received the same answer. I needed treatment and pronto, as you simply can’t take a risk when it comes to rabies!

It was midnight by this time and the Denpasar hospital was all out of rabies vaccines and also the rabies human immunoglobulin, which I would also need to have. With the help of the hotel concierge, I finally tracked down a medical clinic, 15 minutes cab ride from my hotel. It was the only clinic on this side of Bali who currently had stock of the vaccine and the immunoglobulin.

All the doctors told me that I would I need a series of rabies vaccines spaced over a few weeks, but as I had been potentially exposed to the virus over 24 hours ago, I would also need injectable human immunoglobulin, and the amount I would need would be determined by my body weight.

In Bali this immunoglobulin treatment costs a whopping one thousand US dollars per unit, and how many units you need depends on your body weight.

The doctor suggested I contact my travel insurance to make sure they would cover me.

I immediately placed a call to my insurance company, here in Australia and explained my situation. I was put onto their medical advisor and told the same thing, that yes I needed the treatment immediately. They advised me that so long as the clinic I was going to, sent them through a costing and a medical report, and provided it was approved by their claim supervisor ( which I was told shouldn’t be a problem), then I would be covered.

I was told by the insurance company that rabies is one of the most common claims they get when people travel!

Treatment Too Expensive To Have In Bali

I arrived at the clinic at 12.30am and it seemed that I was to be their only patient for the night, but at around 3am, as I sat there waiting to get approval from my insurance company to have the treatment, the door to the clinic opened and a young couple walked in. The girl had a nasty bite wound on her leg from a dog. The couple had been on a motorbike and had slowed down to avoid hitting a dog. It turned around and chased after them and bit her!

Yes, I did feel slightly foolish telling her that I too was at risk of rabies, but not from a vicious bite, but because I had been on the receiving end of a doggy kiss! The clinic doctor and his nurse found my situation quite amusing, with the doctor telling me that I was their very first patient to come in for treatment because of a lick!

Finally around 4.30am, my insurance company had called through with their decision on whether they were going to cover my treatment. They told me that the quote for my immunoglobulin injections came to $7,000 Australian dollars, as I needed 5 units.

Because of the exhorbitant cost to have the treatment done in Bali, they had decided that no, they would not pay for me to have the immunoglobulin treatment done at the clinic, but instead I was to have a tetanus shot and the 1st shot in the series of rabies vaccines I needed, that night at the clinic, and then they said it was much cheaper for them to fly me home later that same day, and to reimburse me for the remainder of my holiday, so I could have the immunoglobulin treatment for rabies in Australia where it is covered by the government.

Alternatively, they said the other choice I had was, to pay the $7000 to have the treatment done at the clinic in Bali, and then submit a claim to them and continue on with my holiday, yet they said they couldn’t guarantee that they would cover and reimburse me if I took this option.

So my planned stay up in Ubud was cancelled, and instead I left Bali that night. I flew back to Melbourne and taxied straight from the airport to The Royal Melbourne Hospital for my “free” immunoglobulin injections.

I am one of the lucky ones. It doesn’t matter I missed out on the rest of my holiday, as I am alive to tell my story. There are plenty of people dying from rabies that could have been prevented through vaccination.

Next Time I Travel I Will Be Prepared

Of course in hindsight, I wish I had known about Bali having rabies. If I had known, I could have either steered cleared of the dogs, or opted to have the rabies vaccine before I left. Yes, I wish my travel agent had advised me about what vaccinations I needed, but when I contacted her to relay what had happened, she also hadn’t realized that Bali had a rabies problem, and she had been there countless times.

So my advice to anyone travelling to any foreign country, is to ALWAYS consult an experienced travel doctor and to find out what precautions you need to take before you go.

PREVENTION IS BETTER THAN A CURE!

Bali Dogs and Rabies

According to the clinic I visited, patients coming in for rabies treatment is a daily occurrence in Bali. People are constantly get bitten by monkeys up in the Monkey Forest in Ubud, and often bitten or scratched by a stray dog or cat.

Bali has always had a huge population of dogs and it is very much ingrained in the Balinese culture to have free roaming dogs around.

The sad fact is that Bali never used to have a rabies problem in their dog population. It was not until 2008 that there was the first confirmed case of rabies in humans and dogs – read here

From 2008 onwards, 130 people on the island of Bali have died due to rabies. It was believed to have been brought across to the Island by fishermen from a neighbouring Indonesian island.

Since then the Balinese Government has introduced both a rabies vaccination program for dogs and a culling program. Sadly, there has been over 150,000 dogs culled to prevent the spread. Find out more by visiting The Bali Street Dog

So, at this stage the only dogs safe to interact with in Bali, are the ones that have had the vaccinations and are wearing a distinctive yellow collar to signify they are vaccinated against the disease.

An Important Word About Rabies Transmission

It is important to realize that the rabies disease can lie dormant in a dog for a few weeks or months. A healthy looking dog can still be infected and can transmit the virus as early as ten days before it starts to show symptoms.

Read more on rabies in dogs by the ASPCA

To date only Australia and Antartica are free of rabies. Each year more than 50,000 people and millions of animals die from rabies.

Any animal that is a mammal can transmit rabies; e.g cats, dogs, monkeys, rabbits, squirrels etc.

There is no cure for rabies.

Once symptoms manifest, it is usually 1 week till death.

This is why it is super important to not dismiss a lick, bite, or scratch from any animal when travelling in other countries.