Rabies is a zoonoses disease which is still a health problem to society in Indonesia. Rabies has spread to the areas that were originally rabies-free areas such as Bali Island (2008), Nias Island-North Sumatra (2010), Larat Island-Maluku (2010) and West Kalimantan (2014). Considering the impact of rabies on health and psychological condition of the community that quite large and has an impact on economy, especially for tourism regions in Indonesia that is infected with rabies, then disease control efforts need to be implemented as intensively as possible to realize Rabies Free Indonesia.        

Rabies is a zoonoses disease which is still a health problem to society in Indonesia. Rabies has spread to the areas that were originally rabies-free areas such as Bali Island (2008), Nias Island-North Sumatra (2010), Larat Island-Maluku (2010) and West Kalimantan (2014). Considering the impact of rabies on health and psychological condition of the community that quite large and has an impact on economy, especially for tourism regions in Indonesia that is infected with rabies, then disease control efforts need to be implemented as intensively as possible to realize Rabies Free Indonesia. The rabies free program is a global, regional and national agreements. Indonesia's efforts to be free from rabies are carried out by Ministry of Agriculture (Directorate General of Animal Husbandry and Animal Health), Ministry of Health (Directorate General of Disease Prevention and Control) and the Ministry of Home Affairs (Directorate General of Autonomy Area). Based on 5 years data (2011 – 2015) it can be seen that the average annual case of animal bites that transmit rabies is 78,413 with 131 deaths. Death cases occurred due to delays in getting to health service facilities to receive treatment. This shows that efforts to handle cases of animal bites are very important for rabies prevention in humans.

The preparation of this book is one such effort from the Ministry of Health to help health workers in handling cases bites from rabies-infecting animals and control attempts in the field. Rabies is also called mad dog disease is an acute infectious disease of the central nervous system caused by the rabies virus. This disease is zoonotic, it is a disease can be transmitted from animals to humans through the bite of a rabid animal. This disease has been known for centuries and is a frightening disease for humans because it is a disease that always ends with death. This disease causes sufferers to be tormented by taste thirsty but at the same time feeling afraid of water (hydrophobia). Rabies is fatal in animals and humans, almost all patients who show clinical symptoms rabies (encephalomyelitis) will end with death. Until now there is no treatment which is effective in curing rabies, but this disease can be prevented by treating cases of animal bites that transmit rabies as early as possible. Rabies is spread on almost all continents except the Antarctic continent, more than 150 countries have contracted this disease. Every year more than 55,000 people died from rabies and more than 15 million people worldwide get anti-rabies vaccine prophylactic treatment to prevent the development of this disease. A number 40% of all people are bitten by suspected rabies animals are children under 15 years. How rabies is transmitted is through bites and non-bite (scratches or licks on the open skin/mucosa) by infected rabies virus animal. The rabies virus will enter inside body through open skin or mucosa but cannot enter through intact skin. In the world as many as 99% of deaths are due to rabies is caused by dog bites. In many developing countries, dogs are the main reservoir for rabies while wild animals that become the main reservoir for rabies is foxes, ferrets and wild dogs. In Indonesia, animals that can be the source of human rabies transmission are dogs, cats and monkeys however dogs is the main source of infection, around 98% of all rabies sufferers are infected through dog bites. The incubation period for rabies are very long varies between 2 weeks to 2 years, but generally 3 – 8 weeks. According to WHO the average incubation period are 30 – 90 days. Definition of rabies surveillance according to Depkes (2008) is a systematically analytical activity through rabies data collection, processing and dissemination of information to decision recipients to take countermeasures action on evidence-based. Rabies surveillance activities are carried out regularly and integrated between human health and animal health sectors. Each case of exposure/Animal bites that seek treatment at the facility health will be coordinated with service officer to carry out the assessment to the animal for indicated rabies or not. The results will be communicated back to health worker to determine further management of the patient. Apart from that, if an animal is indicated to be rabid, it must immediately search for other bite cases to get immediate treatment. For Central level (Ministry of Health), information generated from surveillance activities can be the basis evaluation of rabies control policies in National level. There are also a Provincial/Regency/City and Puskesmas (health facility) established by the Regional Government as a "Rabies Center" which functions as an Information Center regarding  rabies control/ prevention.

1. Ministry of Health of the Republic of Indonesia. Pocket Book of Technical Instructions for Management of Animal Bite Cases Transmitting Rabies in Indonesia. Jakarta: Ministry of Health of the Republic of Indonesia, Directorate General of Disease Prevention and Control, Directorate of Prevention and Control of Vector-Borne and Zoonotic Diseases. 2016.
2. Depkes RI. Modul Pelatihan Penanggulangan Rabies. Jakarta: Subdit Zoonosis, Depkes RI. 2008.