Background Bali Province was affected by avian influenza H5N1 outbreaks in birds in October 2003. Despite ongoing circulation of the virus, no human infection had been identified by December 2005. Objectives To assess behavioral patterns associated with poultry rearing in Bali, and to identify potential risk factors for H5N1 infection in humans and in household chickens, ducks and pigs. Methods A behavioral, virological and seroepidemiologic survey in 38 villages and three live bird markets was completed in December 2005. A multi‐stage cluster design was used to select 291 households with 841 participants from all nine districts in Bali. Specimens were collected from participants as well as a maximum of three pigs, chickens and ducks from each household. Eighty‐seven market vendors participated, where specimens were collected from participants as well as chickens and ducks. Results Twenty out of the 38 villages sampled had H5N1 outbreaks. Despite exposure to H5N1 outbreaks, none of the participants from villages or markets were seropositive for H5N1. None of the pigs tested were positive for H5N1. Virus isolation rate in ducks and chicken in markets was higher than in households. Transport of poultry in or out of villages was a risk factor for outbreaks in household chickens and ducks. Conclusions The study highlighted that the market chain and associated behaviors may play a role in maintaining the virus in household flocks. The study adds evidence that transmission of H5N1 to humans remains a rare event despite high level handling of both healthy and sick birds.
Epidemiological studies against human rabies have been conducted in Bali using data were obtained from Bali Provincial of Health Office reporting system, and then the data were analyzed by descriptive statistics, the results show domestic dog are main vectors of human transmission while cats, monkeys, and bats do not play an important role in the spread of human rabies in Bali. Similarly, there is no indication of human to human transmission during the incubation period after dog bites and rabies victim treatment in hospital. The frequency and the number of dog bites are likely related to the highly of dogs population density in the residential sector in the region. Dog bite cases showed the highest in 2010 (24.4%) and are likely to increase following the frequency of cycle dog breeding season occurs in March, and then give birth in July when approaching the peak of the dry season in August, following the mating season in October and breeding season in March, so the next cycle of the breeding season in July and mating season in October. The cases of dog bites resulting in fatalities, during the years 2008 to July 2015 recorded 161 people died, or an average of 20 people per year. A number of fatalities occurred in all districts /municipality, but most occurred in 2010 (82 people), spread over 8 districts/municipality covering 33 subdistricts (57.9%) and 74 villages (10.3%). There is an actively infected village that occurred in the districts of Badung,
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