Arsip Tahunan: 2018

RABIES MEDICAL SERVICE SEMINYAK

What is rabies?
Rabies is a deadly disease caused by a virus that is spread in the saliva of infected animals. All mammals can get rabies. People usually get rabies from licks, bites, or scratches from infected dogs and other mammals
Rabies affects the central nervous system, ultimately causing brain disease and death. Once symptoms of rabies appear, the disease is nearly always fatal, so prevention is especially important.

Who is at risk?
Travelers who may come into contact with wild or domestic animals are at risk for rabies. This includes travelers spending a lot of time outdoors and long-term travelers and expatriates.
In Africa, Asia, and Central and South America, rabies in dogs is still a problem, and access to preventive treatment may be hard. In Bali, Human and animal rabies cases have been confirmed near popular tourist destinations throughout the island. Efforts, including vaccinating dogs for rabies, have been made to control the outbreak. These efforts appear to be helping to manage the outbreak on the island.
What can travelers do to prevent rabies?
Avoid animal bites:
Avoid touching all animals, including wild animals and pets. Pets in other countries may not be vaccinated against rabies.
Supervise children closely, especially around dogs, cats, and wildlife such as monkeys.
If you are traveling with your pet, supervise your pet closely and do not allow it to play with local animals, including local pets and especially avoid stray animals.
Avoid bringing animals home. Dogs and cats may be infected with rabies but not show signs until several days or months after you first encounter them.
Get a rabies vaccine, if recommended:
Who should get rabies vaccine and when?
Preventive vaccination (no exposure)
The vaccine should also be considered for international travelers who are likely to come in contact with animals in parts of the world where rabies is common.
The pre-exposure schedule for rabies vaccination is 3 doses, given at the following times:
Dose 1: As appropriate
Dose 2: 7 days after Dose 1
Dose 3: 21 days or 28 days after Dose 1
Vaccination after an exposure
Anyone who has been bitten by an animal, or who otherwise may have been exposed to rabies, should clean the wound and see a doctor immediately. The doctor will determine if they need to be vaccinated.
A person who is exposed and has never been vaccinated against rabies should get 4 doses of rabies vaccine one dose right away, and additional doses on the 3rd, 7th, and 14th days. They should also get another shot called Rabies Immune Globulin at the same time as the first dose.
ACT QUICKLY IF ANIMAL BITES OR SCRATCHES YOU !

Immedietly, Wash the wound well with soap and clear tap water directly
ASAP, see a health care provider right away even if you don’t feel sick or wound doesnt look serious
To prevent rabies, you need to have wound toilet properly at medical service center and may need to start a series of vaccinations immedietely

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Reference
https://wwwnc.cdc.gov/travel/diseases/rabies

Klik untuk mengakses rabies.pdf

Travel Vaccines for Bali – What vaccines do I need for Bali?

https://wwwnc.cdc.gov/travel/notices/watch/rabies-bali-indonesia2008

What is Bali Belly?

Many people who travel from developed to developing countries experiemce diarrhea. This illnes can occur at any time during the trip, or oven after the person gets home. It is ussually a self-limiting condition that clears up after a few days. This symptom usually occur together with vomiting,before or after diarrhea. It is often caused by eating contaminated food or water. The micro-organisms that trigger the illnes may appear to be harmless to the local population, presumably because local people have acquired immunity to them.

In medical term, this issue is referred to as Acute Gastroenteritis. However there are several other names beside Acute Gastroenteritis which include Montezuma’s revenge, Bali Belly and Rangoon runs. Due to this article discusses about Bali Belly, we will use the term “Bali Belly” in the entire contents of this article. In Dr.’s clinic Adi & associates Bali Belly is one of the main complaints that bring people to come for medical help.

The risk of Bali Belly is higer where sanitation and hygine standards are poor, such as in the developing nations of Latin America, Africa, the Middle East and Asia particulary. Bali Belly is more common in young adults than older adults, probably because younger people tend to choose more adventurous destination or styles of travel, like backpacking. The initial symptoms if this situation include:

1. Abdominal bloating, cramps and pain
2. Neusea or vomiting
3. Urgency to go to the toilet
4. Loose, watery stools (feces or poo) passed frequently (with or without blood)
5. Mild high temperature (sub-fever)
6. General malaise (weakness or discomfort)

The main micro-organisms that can cause Bali Belly drom more frequent are:

1. Bacteria (Escherichia coli), primarily enterotoxigenic strains (ETEC)
2. Parasites
3. Virus
4. Unknown cause.

As the previous explanation, the cintamination risk foods caused by foor sanitation and hygine should be avoided by trevelers such as:

1. Raw, rare or under-cooked meats of any kind
2. Sauces and mayonnaise
3. Spicy food
4. Unpasteurised dairy foods, including milk
5. Unboiled or tap water
6. Food from street vendors, etc

Besides diarrhea and vomiting as the main issues complaint by the patients,dehydration status is also needed to figure it out. According to the prior explanation, there are some advice that we can share if you have this issue while enjoying leisure time in Bali:

1. First, as long as there is no vomiting yet, you should drink a lot of water from bottle only. Ideally if you have some hydration sachets/tablets add them to your water to prevent you to dehydration and electolyte imbalance. Dose of water and electrolyte you need is actually depends on your body wight, but commonly 2 L minimum.
2. If you have someone and there is no imvropement yet in 1×24 hours, ask hem to go to the doctor, private clinic,or hospital nearby for the comprehensive management. This is due to Bali Bally not just only about stomach infaction, but also impair your hemodynamic status gradually (dehydration state)
3. If you come to see doctor, they ussualy give you some medical advises regarding with this situation. They are included with giving an intravenous infution (in moderate-severe dehidration), anti-vomiting and cramping drugs administration into vein, as well as several oral tablets as primary medication for diarrhea and vomiting (include antibiotic and electrolyte replacement therapy).

After the medication consumption, you can have anything at all but make sure this is plain meatless food and should not spicy as that will only upset your stomach again. In addition, please keep away from tea, coffee, soda/coke, and alcohol for a while. Less solid food, like porridge and chiken soul, is recommended in this circumstances for medication, the symptoms usually relieve in 1-2 days, but take 3-4 days for full recover. Do not wait until this issues getting worse, please come to the doctor for appopriate treatments.

RISK FOR TRAVELER’S DIARRHEA ON SELECTED FOODS AND BAVERAGES