Rabies toll plateaus as public awareness grows

Rabies toll plateaus as public awareness grows

Luh De Suriyani , The Jakarta Post , Denpasar | Fri, 04/09/2010 12:14 PM | Bali


Forty-two people have died of rabies or rabies-related ailments since the outbreak of the viral disease in Bali in November 2008, the latest figures show.
Sanglah General Hospital in Denpasar has treated 67 patients for suspected rabies.
Thirty-four have died from the disease, while the rest were diagnosed with encephalitis, which has similar symptoms.
The other fatalities from the outbreak have been recorded at hospitals in Tabanan and elsewhere across the island.
Sanglah rabies prevention program secretary Dr. I.G.N. Ken Wirashandhi said the 33 patients diagnosed with mild encephalitis showed all the classic rabies symptoms, except hydrophobia.
"However, some of these patients had previously been bitten by dogs, so our concern, and that of the families, was that they may have contracted rabies," he said.
Patients with suspected rabies or encephalitis must undergo a series of laboratory tests, including on their saliva, urine and cerebrospinal fluids.
Around 70 percent of rabies cases at Sanglah have been diagnosed through saliva tests.
Eight patients died from the disease before the tests were completed.
"At the time, we faced opposition from the families when trying to get permission to do the cerebrospinal tests," Wirashandhi said.
"Thus we weren't able to diagnose it in time to treat them."
The majority of those who died from the disease were taken to hospital in the later stages of the disease, he added.
"Patients in these stages are almost certain to die during treatment, because the viral infection is so advanced," he said.
"They oversalivate and panic at the sight of water or light."
Wirashandhi stressed it was important for patients and families to seek medical advice as soon as any of the classic rabies symptoms were exhibited, such as joint pain, severe headaches, and pains on the affected bitten area.
"They should get anti-rabies vaccines *VAR* immediately," he said.
"The problem is Sanglah has often run out of VAR supplies in the past, but patients can come back the next day to get inoculated."
Sanglah contagious diseases ward head Ni Wayan Ayuningsih said the public was opening up to more proactive prevention and treatment by doctors, following months of an intensified awareness campaign.
"Previously a patient or their family would insist they didn't have rabies, because they lacked any understanding of the disease's symptoms or causes," she said.
She added that if detected early on, the disease could be treated properly and the patient cured completely.
The two latest patients at Sanglah initially tested positive for the virus.
"When they came to us they were in the sensory stage," Ayuningsih said.
"The doctors gave them VAR to boost their antibody count."
Wirashandhi said this method could take long depending on the bite wound.
"An open wound could accelerate the penetration of the rabies virus into a patient's blood and organs."