June 6, 2023
JAKARTA – The government has issued a warning against the danger of rabies infection in humans, which has killed nearly a dozen people this year amid an uptick in the number of rabid dog bite cases that have been blamed on coronavirus pandemic-induced disruption to animal vaccination campaigns.
The Health Ministry recorded 31,000 cases of people who had been bitten by suspected rabid animals, mostly dogs, up until April of this year. Of that number, some 23,000 people immediately received anti-rabies shots, while 11 had died. Most of these cases were reported in Bali, East Nusa Tenggara (NTT) and South Sulawesi.
Last year, there were 104,000 cases of people who were bitten by rabid animals, resulting in 102 deaths from rabies, the highest in the past few years. The number of deaths from rabid animal bites last year almost doubled from 2021, when people mostly stayed home during the height of the COVID-19 pandemic.
“[In 2020 and 2021] most people were at home, so there were less [cases of rabid animal bites],” Health Ministry’s Infectious Disease Control and Prevention Director Imran Pambudi said in a press conference recently. “But in 2022, as [pandemic curbs] were relaxed and people started going out of their homes, there was a big spike.”
That was when authorities saw a correlation between rabid animal bites and the coronavirus pandemic, which disrupted animal vaccination programs. This resulted in a waning in the effectiveness of canine rabies vaccines since last year, making dogs more prone to being infected with the rabies virus and transmitting the virus to humans through a bite or scratch.
Imran said some 95 percent of rabies infection in humans in Indonesia were caused by rabid dogs, while foxes, raccoons and rats accounted for a small number of cases.
Rabies is endemic in 28 provinces, or nearly 75 percent across the country. Two regencies in NTT, Sikka and South-Central Timor, have declared “extraordinary health occurrences” (KLB) of rabies.
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Unlike Sikka, the South-Central Timor regency, located on Timor island, which neighbors Timor Leste, had never reported a rabies infection before this year, according to the Health Ministry.
“On Timor Island, there have never been cases of rabies before. So, the people there don’t even know about the symptoms of rabid dogs or people [being infected with rabies]. That’s why we need to increase awareness,” Imran said.
The symptoms of a rabies infection among humans includes a fever, headache, insomnia and muscle aches. In the later stages of a rabies infection, patients will start experiencing hydrophobia and photophobia, the fear of water and light, respectively, before they succumb to death.
People who were bitten by suspected rabid animals are urged to immediately seek medical attention at a local clinic, where they can get an anti-rabies vaccine or serum. The Health Ministry earlier this year distributed 227,000 vaccines and 1,500 serums for post-exposure treatments nationwide.
Rabies in humans has one of the highest fatality rates of any disease, at nearly 90 percent once symptoms appear, according to M. Syahril from Sulianti Saroso Infectious Diseases Hospital (RSPI), who is also a spokesperson at the Health Ministry.
Death is preventable if the anti-rabies vaccine or serum is administered after a bite but before symptoms occur.
In a bid to realize the government’s target of eliminating rabies by 2030, Imran said authorities will prioritize vaccinating domestic, free-roaming and stray dogs, because annual vaccinations of dogs can eliminate canine rabies, thus stopping almost all human rabies cases.
The Health Ministry is working with the Agriculture Ministry and the Environment and Forestry Ministry in doing so.
“Following our discussions with the Agriculture Ministry, [we realize that] the [current] target of vaccinating 70 percent of the dog population will not be enough. So, we have to increase it to 90 percent,” Imran said.
But the coverage of vaccinated dogs in provinces where rabies is endemic remains low. The vaccination rate in NTT, for instance, is at 27 percent.
“We hope that dog-owner communities will also take part in the dog vaccination initiative,” Syahril said.
The Health Ministry also urged local administrations to take measures in controlling the stray dog population in their areas, either by ensuring that the dogs do not roam freely or by culling the dogs.