Rabies remains a pressing public health concern requiring serious attention and response. Recently, on Timor Island, East Nusa Tenggara, including the city of Kupang, 130,000 of the 200,000 dogs on the island have yet to be vaccinated. As a preventive measure, the local government has initiated mass vaccination for thousands of dogs. Timor Island is one of Indonesia’s rabies-prone regions, and many other areas face similar risks unless large-scale and continuous vaccination is carried out.
Veterinarian and lecturer at the Faculty of Veterinary Medicine, Universitas Gadjah Mada (FKH UGM), Dr. Heru Susetya, explained that Timor Island is highly vulnerable to rabies due to its long history of recorded cases. Based on his research, Dr. Susetya classified regions in Indonesia into three categories.
First, endemic areas where rabies cases are still widely reported, such as East Nusa Tenggara, North Sumatra, West Sumatra, Bali, West Kalimantan, North Sulawesi, and Maluku.
Second, rabies-free areas following eradication efforts, such as Jakarta, Yogyakarta, Central Java, and East Java.
Third, historically rabies-free areas where cases have never been recorded, such as Bangka Belitung Province and most of Papua.
According to Dr. Susetya, in rabies-free areas, particularly historically rabies-free regions, vaccination of stray dogs is not necessary. However, in the endemic areas, vaccination coverage for dogs and cats must be intensified.
“This is especially crucial when many animals are allowed to roam freely,” he said on Friday (Sep. 12) at FKH UGM.
Dr. Susetya detailed that rabies is an acute and progressive infectious disease of the central nervous system caused by the rabies virus (Lyssavirus).
It can infect all mammals, including humans, and is almost always fatal once clinical symptoms appear. Transmission generally occurs through the bite of an infected animal, particularly dogs, though it can also spread through cats, monkeys, or wild canids.
“In rare cases, rabies may spread through airborne transmission in bat caves, organ transplants from infected donors, or handling meat from rabies-positive animals,” he added.
If someone is bitten by a dog in a rabies-endemic area, Dr. Susetya emphasized that the first crucial step is to wash the wound with soap and running water for at least 15 minutes. This immediate action significantly reduces the risk of viral infection.
Medical treatment is then provided according to the wound category.
For Category II (minor bites or scratches without bleeding, or licks on abraded skin), the patient must promptly receive rabies vaccination.
For Category III (deep bites causing bleeding, multiple wounds, or bites in high-risk areas near the brain), the patient must receive rabies vaccination along with Anti-Rabies Serum (ARS) or rabies immunoglobulin (RIG).
Human rabies vaccination is typically administered in multiple doses, on days 0, 7, and 21 or 28, depending on the vaccine type used.
He further explained that animals suspected of rabies must be observed. According to WHO standards, the observation period is 10 days, while in Indonesia it is extended to 14 days.
If the animal remains healthy during this period, post-exposure prophylaxis (PEP) for humans may be discontinued before the final dose (day 21/28), as transmission is ruled out.
However, if the animal shows rabies symptoms or dies, vaccination must be completed in full.
Dr. Susetya also reminded that human vaccination must not be delayed while awaiting animal observation results.
If the biting animal cannot be observed because it has disappeared, the bitten person must undergo the full vaccination schedule.
“Never delay vaccination in humans, because rabies is almost always fatal once symptoms appear. Prevention must begin immediately,” he stressed.
To prevent rabies outbreaks, Dr. Susetya emphasized that animal vaccination is the key strategy. Vaccination not only protects pets but also prevents transmission to humans.
“Therefore, government support and community participation are crucial in implementing mass vaccination,” he said.
Nevertheless, rabies prevention requires not only vaccination but also vigilance. Communities should report or be alert to pets showing sudden behavioral changes, such as aggression, sensitivity to light or sound, refusal to eat, or excessive salivation.
“Children must also be taught not to approach or disturb unfamiliar animals,” Dr. Susetya advised.
Author: Hanifah
Editor: Gusti Grehenson
Post-editor: Rajendra Arya
Illustration: Freepik