Asia, Travel Tips

Monkey Bite In Bali

What to do if you get a monkey bite in Bali. Also applicable for dog bites in Bali. If you have just been bitten or attacked and are frantically searching for what to do you have come to the right place! Below I will share exactly what the doctor said and how much the treatment will cost….And then below all that I will share what happened to me.. as well as a short clip of the cheeky monkeys (nope the attack wasn’t caught on camera)!

What to do:

  1. Wash the wound out, soap and water for at least 10minutes; get some antibacterial soap if possible (Dettol bars are available at most marts).
  2. If the animal bit you from the shoulders and above then go to the doctor as soon as possible. If the animal did have rabies then the closer the wound to the brain the sooner it will take hold.
  3. With wounds below the shoulders and if the animal looked healthy then you can wait until you get home from your holidays to start the rabies vaccine treatment as long as it is within 7days-10days (MAX) of the bite occurring.
  4. If you are still travelling (like I was/am) then it’s best to get to the clinic and start the treatment as soon as possible.

The wound will be categorised from Category I to III

Category I – Doesn’t break the surface;

                   II– Scratch/bite mark that breaks the surface;

                   III- Puncture to the skin, saliva contact and draws blood.

This is a picture of my bite…category III.

TREATMENT

Here is a picture of the WHO (World Health Organisation) fact sheet for monkey bite in Bali treatment, provided to me by the doctor.

WHO organisation fact sheet for monkey/dog bites

  1. IF YOU HAVE A CATEGORY II or III bite you need to get the Post Exposure Rabies Prophylaxis injections (PEP). This is the vaccine for rabies. It consists of 4 injections over the course of 2 weeks. An injection on Day 0, Day 3, Day 7 and Day 14.
  1. With a category III bite if you have not previously been vaccinated for rabies you will also need to get the Immunoglobulin injection. If the animal did have rabies you 100% need to get this injection in order for it to start working immediately, otherwise the vaccines alone may not be enough to protect you. It’s an injection to increase the amount of antibodies in your system to start fighting the rabies immediately. Here’s the rough part- the needles are HUGE and how many you need is determined by your bodyweight. You will get 1 normal sized needled injected into/near the wound and the rest into your butt. That meant 1 in each cheek for me!! You MUST get the immunoglobulin injection within 7 days of the first vaccine for it to be effective.
  1. Valtrex will also be prescribed because apparently the monkeys can carry simian Herpes B. From the research I did it is incredibly rare for monkey to human transmission given how many people are bitten. There have been about 40 cases worldwide with most from laboratories where people deal with them daily. So I was really unsure if I wanted to take the pills ( 2 pills every 8hrs for 2 weeks). I took them for 5 days but they made me feel queasy so I stopped. My usual doctor said that was fine as it was so unlikely.

Monkey bite in Bali, Sun Surf Soul

COSTS

The rabies vaccine is about $40AUD a pop, add on the doctors fee and you’re looking at about $50 each visit (more for the first consultation.) If you can’t always return to the same doctor you’ll most likely have to pay the consultation fee each time too. Then you have the immunoglobulin injection…that one cost me 40 million Rupiah…that’s about $4,000 Australian dollars. All up for the immunoglobulin, vaccines and Valtrex it’ll be roughly $5,000 AUD.

So let’s hope you have travel insurance. If you are looking for a travel insurance policy (of course you should get travel insurance before every trip!!!) we always get at a minimum full medical insurance. We recommend World Nomads, click here to get a quote -> World Nomads Travel Insurance

From what I recall the immunoglobulin was only available at the International SOS clinic in Kuta.

Mumma monkey cuddling her baby under her arm

TREATMENT IF YOU ARE ALREADY VACCINATED FOR RABIES

For those already vaccinated against rabies you will just need the booster shots- an injection on day 0 and day3.

WHAT IS THE ACTUAL RISK??

Dog Bite

Dogs in Bali have 100% tested positive to rabies. From a dog bite you absolutely must get the vaccines and immunoglobulin injection. While not every single dog will have rabies how could you ever know which ones do?! The incubation period is anywhere from 2 weeks onward.

Monkey Bite Rabies Risk

In places like Monkey forest and the temples it is a very very very low risk.  About a 95% chance that you will be fine. The monkeys in monkey forest have not tested positive to rabies. Who knows who regulates these tests and how often they are done. You also don’t know if monkeys from other parts of Bali where rabies is present (further north) have made their way to the forest. Honestly, it’s not worth the risk, do it for the peace of mind.

Bear in mind that THERE IS NO CURE FOR RABIES ONCE YOU HAVE IT!!!

A quick clip Daniel put together of some of the monkey footage they got in Monkey Forest!

 

Here’s my story:

We were staying in Ubud for 3nights..there are lots of monkeys around the area, the kinda famous monkey forest is there..We went there and I got too close to a baby monkey that was climbing over Dan. Unknowingly mama monkey was hiding in the bushes, I walked back she leapt out and bit me. I threw the camera because I thought that’s what it wanted! Luckily the camera survived the impact.

It all happened very quickly, it bit me through my dress so I thought that might’ve provided a bit of a buffer but no. I wiped it with an antibacterial wet wipe (we always travel with them!). We carried on with the day, stopped into a pharmacy and bought some betadine and betadine band aids (which ironically had pictures of monkeys on them) and I tried not to let it bother me.

That night I messaged my brother who was also in Bali to warn him of the monkeys and told him what happened. By a stroke of luck he was travelling with a doctor who said I need to get the PEP treatment. Off I went to the 24hr Ubud clinic and we started on the treatment course. Yay, human pincushion! The Ubud doctor didn’t mention the immunoglobulin or the Valtrex.

Close up of a monkeys hands and feet, so similar to a humans

So it was when I was due to get my second needle that a bit of luck came into it. We just arrived in Sanur from Nusa Lembongan and I set off in search of a medical clinic to get jab #2. I walked to the nearest one who (luckily) didn’t have it in stock..They recommended the royal hospital.

Jared, Daniel, Jana and Tracy a monkey sitting on Jared and Daniels shoulders

I had also messaged a lady who runs a clinic in Sanur asking if she had the vaccine. Also out of stock but they recommended the International SOS clinic. I called the SOS clinic, they confirmed they had stock. I decided I would just go straight there instead of trying my luck at the hospital.

Male monkey laying on his back holding his feet with his hands being groomed by two monkeys

Luck came into it here as I found out about the immunoglobulin injection. I only had 2 days left to get the jab! They provided me with the WHO fact sheet and brought up the immunoglobulin injection. The doctor said double check with your insurance provider and come back tomorrow if they approve. So the next day we returned and that’s when I found out how expensive and how huge the needles where. Big thanks to Jana & Jared and of course Daniel who came in and distracted me by pinching my arms and doing stupid stuff while I was getting stabbed! Haha! Anyway bloody glad to be getting my final vaccine today! What an ordeal. Now to submit all the documents and have my travel insurance reimburse us!

 

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