Human deaths from rabies in Bali are on the rise, and experts are worried by the knee-jerk response and the shortage of vaccine for post-bite treatment.
Source:
AAP
4 Aug 2015 - 12:13 PM  UPDATED 4 Aug 2015 - 12:16 PM

As Australians made their winter retreats to Bali, unknown to them, hundreds of dogs were being poisoned and left to die in agony in the streets.

The indiscriminate killing of the island's ubiquitous canines follows a worrying upswing in human deaths from rabies.

There have been 12 deaths so far this year compared with only two in all of 2014.

Experts are concerned not only by the panic culling, but the departure from the strategy proven to eliminate rabies, and the shortage in Bali of post dog-bite treatment.

Bali government teams are responding with mass vaccination of dogs, but in some areas, they are also poisoning scores at a time with strychnine darts.

Photos on social media show some of the dogs left dead in the streets have collars, indicating they are vaccinated pets.

Bali's Animal Husbandry Department head Putu Sumantra says it's necessary because of the high number of abandoned puppies and dogs.

"That's why, in places where cases are active, apart from vaccination, we're also doing euthanasia," he said.

But the proven way to defeat rabies is by vaccination, not culling.

Dogs that have been vaccinated against rabies - ideally 70 per cent of the dog population - are the best weapon in eradication.

These dogs are then in the path of the virus, which will die out when there are no other dogs to catch it.

Before this year, mass vaccination was working.

The human rabies toll declined - from 23 in 2011, to eight in 2012 and one in 2013.

The UN Food and Agriculture Organisation has noted the change.

"It is of concern to us that the vaccination strategy has not been carried out as effectively in 2014 as it was in previous years, in order to boost herd immunity to the level needed to cut transmission," James McGrane of the FAO said.

The World Health Organisation is now investigating whether there's a link between the spike in cases and Bali authorities' decision to change the vaccine used on dogs.

The WHO's Dr Khanchit Limpakarnjanarat said for a period last year, the product used was not "pre-qualified", or quality assured.

But Mr Sumantra doubts the switch is responsible for the return of rabies.

He also denies that budget issues are behind Bali's shortage of post-bite treatment, which ideally should be given on the same day as a dog bite.

Tourists have been forced to fly to Jakarta - or in the case of Australians, back home - for treatment.

Sadly, locals don't always get the right advice, or alternatives.

One of this year's victims was a 12-year-old boy who died a month after being bitten on the thigh. His family reportedly did not seek the life-saving vaccine.

The FAO's Mark Smulders says no person needs to die from rabies.

"Prompt post-exposure vaccine treatment, following WHO guidelines, will save your life," he said.

Among those who strove to get mass vaccination successfully under way in Bali was Janice Girardi.

Now the Bali Animal Welfare Association president fields phone calls from villagers, distraught after discovering their dogs were poisoned in the night.

"We were almost there, we were reducing human and dog rabies cases for years, using scientific methods, and high quality and long-lasting vaccines," she says.

"Now we're going back to what we know doesn't work."