They are cute. Yes. But what happens if you get bit while trying to get them to sit on your shoulder?

I post this as a public service to others who will go through that stress if they get bit.

On our trip to the Monkey Forest we had a bit of a fright with a monkey bite. One of the problems with the internet is that it is filled with opinions. From what I can ascertain from the International SOS clinic and reading, here are the facts:

• Cases of rabies in Bali: All are in a different district than the forest. There have been 17 deaths, and they all appear to be attributed to rabid dogs. Beware of the dogs.
• According to the Doctor at International SOS, he treats travelers who have been bitten at the forest daily and has not had any follow-up from international doctors who have had issues with patients. He has received no notice of a rabid monkey being found in Bali or of a patient being confirmed with rabies. Nothing.

Online forums are filled with “I was bit by a monkey” questions, panic and forum answers, with nothing of value. The reality is that if you have not been vaccinated for rabies, the protocol according to the World Health Organization is:

• Wash the bite are as soon as possible aggressively with soap, water and an anti-bacterial if you have it. This has a significant impact as anything that is transmitted would be done via saliva into the blood stream and it can reduce the chances of transmission by up to 80%.
• Seek medical attention right away.
• A shot of rabies immunoglobulin is given based upon body weight. This is an immediate immune boost to the system to provide rabies anti-bodies. A shot is given around the scratch/bite mark and the rest administered normally. This can be quite painful depending on where the bite/scratch is. Many people do not get this shot as it is very expensive (I have seen estimates ranging from $1500-2000). Again – that is why we always travel with insurance.
• Rabies vaccines is administered at day 0, 3, 7 and 14. These vaccines are like a standard inoculation shot. The old days of the 12 inch needle are long behind us. A small shot into the shoulder.
• A standard anti-viral (We received Aciclovir) is prescribed from day 0. It is 2 pills, 5 times a day for 14 days. The alternative is Valaciclovir 3 times a day. We had a difficult time acquiring Valaciclovir in Bali (due to the Hindu holiday), but were able to switch to the much easier medicine when we returned to Tokyo.

Full WHO document here.

The moral of the story – what would we do differently this time?

• We have all of our vaccines except rabies. The only time that you really need to worry is if you get bit and I would only get the vaccine if going to somewhere remote. The thing you need to watch out for is dogs.
• Always have insurance.
• Should have checked it out that same night on the web. Had it been more serious, we would have.
• We would absolutely do the Monkey Forest again. Just remember stay calm, watch your fingers, don’t make threatening eye contact and buy lots of bananas .. from the locals. Support the locals.

Hope it helps someone else “calmly” determine what to do.