Rabies Vaccine

[davita]

I read from a letter to editor Jakpost that there has been NO vaccine against rabies in Bali hospitals for the last 6 weeks and none arriving soon. Anyone else heard this info?
If true I think that's as scary as all those Mini Haj returning from Saudi during Ramadan and the possibility of bringing MERS. I don't think Indonesia can cope as well as Korea if there was an outbreak here.
A couple of days ago it was reported there was one case in Bangkok and the tourism industry (Hotels & Airline) lost 6% of its stock value...cancellations galore apparently.

 

[Markit]

That is the case. No vaccine to be found. Our Pembantu's son was bitten on the cheek by one of their family dogs that spends its "life" on a 1.5 meter chain 10 days ago in the family compound. No matter how we tried to explain to her and her husband that the likelyhood of that dog (which is still there) having rabies was practically null they insisted that, since here in Karangasem there is really no vaccine, that they rent an expensive car (naturally the whole tribe has to go) for a trip to DPS where they were assured that since the uncle lives there and his KTP (citizenship card) is from there they could get the vaccine for cheeky even though he came from Karangasem.

All wrong, of course. No vaccine, wouldn't have gotten it anyway as cheeky lives in K and since the stupid dog exhibits no symptoms they couldn't have it anyway.

It's almost impossible to convince people whose belief system stems from the bronze age and that believe implicitily in black magic that the least contact with a dog isn't death bringing and therefore deserving of vaccine.

I'm convinced that that's where it's all gone.

Nevertheless they should have some for us.

 

[davita]

Whilst I agree with your black-magic logic Markit medical opinion says that if bitten the only real remedy is to be vaccinated.
A test for human rabies is laborious and takes too much time, so most doctors recommend the vaccine immediately...here is an excerpt from the Mayo clinic...

"It is possible to prevent rabies if you get the vaccine soon after the bite. To date, no one in the United States has developed rabies when they were given the vaccine promptly and appropriately.
Once the symptoms appear, the person rarely survives the disease, even with treatment. Death from respiratory failure usually occurs within 7 days after symptoms start."

Given the fatal nature it seems irresponsible that the hospitals don't have vaccines.....especially as Bali has been designated as a rabies infected area.

 

[Markit]

I may have not made myself clear: The dog never was allowed out of the family compound so it's likelihood of meeting a wild infected dog were null. I agree that vaccine should be administered in the case of reasonable suspicion of the offending animal being infected. See first sentence.

I'm simply convinced that the phrase "reasonable suspicion" has no effect on people that believe in black magic since the part "reason" is completely absent from their world view. Hence my further conviction that the masses of vaccine that were originally available have been largely wasted on "unreasonable" suspicions such as those of my Pembantu.

But what do I know?

 

[Gurkha]

Waste of vaccine!

 

[davita]

A report in today's jakpost page 4 says that Vice President Kalla has urged all haj pilgrims to Mecca during this holy month be vaccinated against MERS.
This information stuck out like dogs ball, or markit's beast, as I understood there isn't a vaccine for MERS nor any treatment. google...WHO | Frequently Asked Questions on Middle East respiratory syndrome coronavirus (MERS?CoV)

"Is there a vaccine against MERS‐CoV? What is the treatment?
No vaccine or specific treatment is currently available. Treatment is supportive and based on the patient’s clinical condition."

He also suggested that pilgrims do not fraternize with camels....:icon_e_biggrin:

 

[ronb]

Well you have to give him some lee-way - he's getting long in the tooth - just turned 73 (about my age )

 

[Markit]

Well you have to give him some lee-way - he's getting long in the tooth - just turned 73 (about my age )

Yeah but Ron you're a fairly juvenile 73, not to say almost childish. Whereas this other guy is clearly an ancient 73.

As a matter of fact (or supposition) I do actually think its possible to see the difference in aging here - many of my Indonesian friends and acquaintances are showing some very early signs of aging like rheumatism, stones of various types, liver and kidney problems, etc. but have the luck of great skin and black (aided?) hair to superficially hide behind.

 

[davita]

Well you have to give him some lee-way - he's getting long in the tooth - just turned 73 (about my age )

A fairly young guy then....he should call me pak :icon_e_biggrin:

I have to laugh at Markit's observation of how Indonesian Generals (Polisi and TNI) seem to use the same hair dye...:cupcake:

.... and how's about all them medals...I'd think that, looking at their stomachs, they get a medal for every day they MISS the gym.

 

[davita]

Good news, according to Bali Discovery, is that the Bali Medical Dept. has sufficient rabies vaccines for 2-3 months.

What is interesting is....
'Drug stores in Bali are also now allowed to sell VAR, providing an alternative supply should, for any reason, the stock of VAR at public hospitals and health centers prove insufficient.'

I'll be asking pharmas if available and price.....but would appreciate info from members if they know anything.

I can't imagine using it on myself as most dogs in my area seem relatively tame...but yappy. My driver says the dogs near his Kost are vicious and one neighbor beat one to death when it bit his daughter...my driver said the owner was warned..."You'll be next!":icon_e_surprised:

 

[mugwump]

I had the vaccine 3 years ago and later a follow up, and same with my dog. Since it is now available, anyone that wanders outside in Bali shouldn't be without it (IMHO).

 

[tintin]

I may have not made myself clear: The dog never was allowed out of the family compound so it's likelihood of meeting a wild infected dog were null.

Rabies is also transmitted by infected bats andmonkeys, among other potential carriers, and according to some epidemiologists, it is most likely how the whole thing started in Bali, few years back.

On another subject related to rabies. In 2008, I was bitten by a wild cat I was trying to bring in my house, after about 1/2 a year I had been feeding him daily (he turned out to be the sweetest cat ever!). Since there is rabies around my area (foxes, racoons, etc) as everywhere else in the country, I ended up at the hospital for the treatment. The first shots are a rabies immune globulin + the first of a series of 4 rabies vaccines. One month later, I received a copy of the bill that was sent by the hospital to my insurance company for these first two shots: US$5,520.04 (Please, not the "precision," of the cost, $0.04)!!!! Out of curiosity, I called the hospital's accounting dept., thinking it most likely was a mistake. "No, sir", I was told, "this is a very expensive vaccine!" Talking about rip-off. I wonder what Louis Pasteur must think, if he is still awake in his tomb? I still keep the bill which came to around US$6,200, with the doctor and other hospital charges.

PS. The cat, not showing any signs of infection over the next 4-5 days, I stopped the treatment after the second shot. And Mimi has been part of my household ever since.

 

[Markit]

The vaccine that is widely available (or not) in Bali IS NOT the immunoglobulin. To get that you will need to pay extra that's if you can find it.

As to "wandering outside" or not I'm told that the majority of bite victims are on motorcycles. Not sure what that means but good to stay in a car then aint it?

But what do I know?

 

[davita]

The vaccine that is widely available (or not) in Bali IS NOT the immunoglobulin. To get that you will need to pay extra that's if you can find it.

As to "wandering outside" or not I'm told that the majority of bite victims are on motorcycles. Not sure what that means but good to stay in a car then aint it?

But what do I know?

Markit's point is well taken.
I'd hate to be under the illusion, if bitten, that the vaccine I'd received was appropriate. Will check if the pharmas sell the RIG vaccine to see if I can purchase as a standby for ourselves and visitors. Does anyone know if it has a shelf life?


Alternately, getting the pre-vaccine treatment when I return to Canada for holiday may be wise.

 

[tintin]

The vaccine that is widely available (or not) in Bali IS NOT the immunoglobulin. To get that you will need to pay extra that's if you can find it.

For people who have never been vaccinated against rabies previously, post-exposure anti-rabies vaccination should always include administration of both passive antibody and the vaccine. The Human Rabies Immune Globulin HRIG) injection is used to prevent or treat the disease, should your body has a weak immune system, until the actual vaccine itself takes over (usually within 2 or 3 days).

 

[tintin]

Alternately, getting the pre-vaccine treatment when I return to Canada for holiday may be wise.

If you opt for a pre-exposure vaccination and you are later contaminated, you would not need the immunoglobulin and only 3 i.s.o. 4 rabies shots.

 

[mugwump]

The vaccine that is widely available (or not) in Bali IS NOT the immunoglobulin. To get that you will need to pay extra that's if you can find it.

As to "wandering outside" or not I'm told that the majority of bite victims are on motorcycles. Not sure what that means but good to stay in a car then aint it?

But what do I know?

Or maybe only riding your motorcycle in the house.

 

[davita]

If you opt for a pre-exposure vaccination and you are later contaminated, you wouldn't not need the immunoglobulin and only 3 i.s.o. 4 rabies shots.

Thanks tintin...I'm learning more and more. So...if the treatment that the Bali Medical dept. have is NOT HRIG and if anyone not pre-immunized gets bitten, what's the point of being immunized post-bite....does the vaccine still work?

 

[tintin]

Thanks tintin...I'm learning more and more. So...if the treatment that the Bali Medical dept. have is NOT HRIG and if anyone not pre-immunized gets bitten, what's the point of being immunized post-bite....does the vaccine still work?

Absolutely, it works. I am not a medical doctor, just one who was "lucky" to experience first hand the procedure. My information comes from the info. I obtain in several conversations with the treating MDs following the incident, and also what I read afterwards from reliable sources on the Web, such as the website of the Mayo Clinic or the Institut Pasteur. The HRIG is there to re-enforce the first rabies shot, which take few days to take effect, so it is just an extra precaution. The simple rule, of course, if one gets bitten by an animal which one suspects in infected with rabies, is to get immunized a.s.a.p.

 

[davita]

Re post #19

Thanks again tintin...I get what you say. The HRIG immediately supports the VAR vaccine as it takes a while for the vaccine to instruct the immune system to respond to the virus. Pre-immunization will already have 'taught' the immune system.

All the more reason to keep a vial of HRIG in the 'frig...is that feasible...anyone?