xt77m03xtv9m https://exploreuk.uky.edu/dips/xt77m03xtv9m/data/mets.xml   Kentucky Agricultural Experiment Station. 1963 journals 128 English Lexington : Agricultural Experiment Station, University of Kentucky Contact the Special Collections Research Center for information regarding rights and use of this collection. Kentucky Agricultural Experiment Station Progress report (Kentucky Agricultural Experiment Station) n.128 text Progress report (Kentucky Agricultural Experiment Station) n.128 1963 2014 true xt77m03xtv9m section xt77m03xtv9m "
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E  

 
 I F O R E W O R D
The organization of classroom teaching received priority over other activities
during the first years of the University of Kentucky's affiliation (which began in 1957)
with the College of Agriculture and the College of Veterinary Medicine and Animal
Husbandry, University of Indonesia. Later, professors working together under the
affiliation were able to turn some of their attention to the exploration of research
' needs and to fields of possible public service.
At the College of Veterinary Medicine and Animal Husbandry in Bogor (1960-62).
Drs. Titkemeyer and Ressang together reviewed the public health implications of com-
municable diseases in Indonesia transmitted by animals to men, notably rabies, anthrax,
and food poisoning. This publication is a status report on the current situation, and it
sets the stage for continuing efforts in public health and research and in the development
, ‘ of control programs by specialists at the institutions concerned.
Dr. Ressang is head of the Department of Pathology, College of Veterinary Medi-
cine and Animal Husbandry. Dr. Titkemeyer is Professor of Anatomy, Michigan State
University. The affiliation involved was arranged by contract within the system of co-
operation between the American International Cooperation Administration, later the
United States Agency for International Development, and overseas universities estab-
lished by the United States.
This report is printed by the University of Kentucky Agricultural Experiment
Station in cooperation with the Kentucky Research Foundation.
Howard W. Beers
Chief of Party,
Kentucky Research Team
Bogor, Indonesia
August 1962
..3..

 CONTENTS _ V
Page
Rabies 5 l
Importance in Public Health 5 "
Jointly Conducted Research on Rabies 6 _
Aid from A. I. D. 6
Rabies and Its Control In Man 6
Rabies and Its Control In Animals 7
Vectors in Rabies Dissemination 8
Diagnostic Tests 8
Recommended Measures for Rabies Control 9
Anthrax 10 I
Importance in Public Health 10
Customs Which Contribute to Its Dissemination 10  
Environmental Contributory Factors 10 Q
Jointly Conducted Research on Anthrax 11 I
Recommendations 11
Work in Progress 11
Food Poisoning and Food Intoxicating Agents 12
Importance in Public Health 12
Jointly Conducted Research on Food Poisoning 13
Food Poisoning in the Krawang Regency 13
Work in Progress 14 A
Conclusions and Suggestions 15
References Cited 17 p
-4-

 COMMUNICABLE DISEASES AND THEIR EFFECTS
ON PUBLIC HEALTH IN INDONESIA
By C. W. Titkemeyer, D. V. M., Ph. D, and A. A. Ressang, D. V. M. , Ph.D
Communicable diseases are those diseases of which the causative agent may be
transmitted from one susceptible host to another. Because of the magnitude of the prob-
‘ ` lem, this report will cover only the three most important diseases in Indonesia which
are transmitted from animals to man, either directly by contact or indirectly through
contamination of animal products.
In addition as is the case in most tropical areas, living is comparatively easy.
T Weather is such that minimal housing affords little discomfort. Since no significant
seasonal changes occur, crops can be grown throughout the year obviating the need for
elaborate storage facilities. An abundance of rain assures adequate currents in most
streams, thereby reducing the necessity for modern sewerage systems. These ideal
natural conditions lead to complacency and to an apathy toward modernizing existing
_ facilities. When this apathetic attitude is combined with such factors as tropical cli-
matic conditions, dense population, insufficient facilities (transportation, communi-
. cation, refrigeration), and the retention of ancient unsanitary customs, the problem of
disease reaches giant proportions. In order of their importance in Indonesia, rabies,
anthrax, and food poisoning are the three most important disease conditions transmitted
from animals to man.
RABIES
Importance in Public Health
In spite of its relative unimportance as the causative agent of human mortality,
rabies ranks foremost among diseases communicable from animals to man in Indonesia.
Incomplete statistics indicate that 103 persons succumbed to this malady in the 12-year
period from 1949 through 1960 (10, 15)’Y The significance of rabies is measured not in
the human deaths it causes, but in its pyschological effect on exposed individuals, in the
inconvenience and danger associated with the Pasteur treatment, and in its potential as
a lethal agent in heavily populated areas (16). During the same 12—year period, 33, 312
persons received the Pasteur treatment (10, 15). It is impossible to measure the panic,
anxiety, and worry experienced by these people or the pain, inconvenience, and time
loss caused by the inoculations. Not to be ignored is the potential that rabies has for
causing deaths, especially in certain areas. The Island of Bali, a world—famous tourist
attraction, has a very large population of susceptible stray dogs. At the present time,
it is rabies—free. One rabid dog, however, could change this island paradise into a
major disaster area.
*Numbers within parentheses refer to reference citations. See page 17.
-5-

 Economic losses from rabies among animals are great. In the 5—year period from -
1954 through 1958, 5, 855 cases of rabies in dogs were positively identified (10). Many ` _ ,»
cases were also reported among the meat, milk, fiber—producing animals, and some
wild—animal species in Indonesia. c
Jointly Conducted Research on Rabies
Aid from A. I. D. In order to facilitate this very important project, the Kentucky I
Contract Team under the Agency for International Development has purchased essential
equipment for rabies research. A Strycher autopsy saw for removal of the brain, a
large Spencer sliding microtome for making brain microsections, and numerous other
pieces of laboratory equipment have been purchased. Dr. Soehardjo Hardjosworo, a "
graduate student in the Pathology Department, has been sent, by the Agency for Inter-
national Development Participant Program, to the University of Georgia to obtain ad-
vanced training in viral pathology. Upon the completion of his Master‘s Degree, he will
be sent to the Communicable Disease Center at Chamblee, Ga. , to specialize in rabies
research.
‘ =,:.·r`_  ¤’·~- .. . — · " ~"*'ji. I `     .·g.,<.=3 ‘
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. I:   fx
. `" i T   ·-»;—   A
L »»`.i` =   ~   .... . i
I   ·· ` . _...  » ‘ 
Fig. l·DR, NANI SAWARNT CUTTING BRAIN MICROSECTIONS ON A M1cRoToM12 PUR-
CHASED THROUGI-{ THE KENTUCKY CONTRACT TEAM. DR. SAWARNT iS Now
IN THE UNITED STATES, STUDYING SA1.MoN1;LLoS1S AT TR1; UNIVERSITY or
MINNESOTA.
Rabies and Its Control in Man. All rabies vaccine for human use in Indonesia is
produced at the Pasteur Institute at Bandung (Semple vaccine). The base tissue for
this vaccine is monkey brain rather than the sheep brain commonly used in other
countries. Post—vaccinal side effects have rarely been observed in Indonesia as com-
pared with findings elsewhere. During the past IO years, only three post—vaccinal
complications have been recorded, one of which was a mild case of meningitis (10).
..6..

 All three cases reponded to treatment. The reason for this low incidence of compli-
cations is not understood. It is felt that the use of monkey brain instead of sheep brain
may have certain advantages. Other possible causes are the decreased psychoneurotic
` effect (most Indonesians do not know the possible danger) and a racial tolerance to the
vaccine. The routine regimen of daily subcutaneous injections of 2 milliliters of the
vaccine for 14 days is followed. Investigations are being conducted on purification of
the vaccine to decrease even further possible side effects.
= The greatest stride made in rabies control in Indonesia has been the recent es-
tablishment of rabies control centers. Before 1945, all Pasteur treatment was ad-
ministered at Bandung. It was almost impossible to transport individuals from the outer
islands to this one center for treatment. Rabies centers have been established in
Dj akarta, Surabaja, and Djogjakarta in Java; in Medan and Padang in Sumatra and in
. Makassar in the Celebes Islands. These centers will ship the vaccine to other cities
provided qualified medical personnel and adequate refrigeration facilities are available.
Rabies and Its Control in Animals. Rabies vaccine for animals is produced at the
Central Veterinary Institute at Bogor. It is the Flury strain and is attenuated by chick
embryo passage. Our experimental tests indicate that this vaccine confers immunity for
d only 1 year. The same strain produces immunity for from 3 to 5 years in the United
_ States. Tests are now underway to determine the cause of this reduced period of im-
munity. It is hoped that this will lead to the production of a vaccine which will confer
· a longer period of immunity or, ideally, a lifetime immunity.
As is the case in most countries, dogs and cats are the most important source of
rabies. In Djakarta, a plan is in effect whereby a mobile rabies vaccination station
moves from area to area within the city throughout the year. All areas of the city are
covered biannually to give dog owners the opportunity of having their pets vaccinated at
a minimal cost. Unfortunately, the Semple vaccine, effective for only 6 months, is
sometimes used. We have highly recommended that this vaccine be replaced by the
_ longer-acting Flury strain, and that such plans be instigated in all of the larger cities.
Our research work on rabies in the domestic cat is still in progress. Findings to
date indicate that it is very difficult to challenge a cat with the virus except intracere-
brally. Intramuscular injections with normal dosages do not routinely produce an in-
fection as they do in the dog and monkey. In diagnosing rabies in cats, emphasis should
b€ placed OH th€ anamnesis since negri-like bodies may be found in the normal cat brain
(18). Inoculation of white mice is very important for positive diagnosis in this species
(4).
Wild animals, as reservoirs of rabies infection, are of great importance in the con-
trol of this disease (5, 7). In West Java are wild dogs which might significantly contri-
bute to its dissemination. This species, which resembles a jackal, is either the original
wild dog or is a domestic species gone wild. It is exceedingly wary and elusive, thus
very difficult to trap for wildlife rabies investigation. Other wild animal species which
-7-

 may be involved in rabies dissemination include tigers, civet cats, and wild monkeys. - A
Wild monkeys are almost as important as are dogs in the spread of rabies. Thousands
of them live in the wooded areas of Indonesia and are susceptible to the disease. They
constitute a serious reservoir of infection because they frequently come in contact with A
human communities in their quest for food.
Vectors in Rabies Dissemination. Considerable work is in progress on those species l
which show few if any symptoms but which might serve as hosts for the infection. Some
very interesting work on bats as vectors has been nearly completed. In the United States,
South America, and in some European countries, both the vampire and the insectivorous
bats have been implicated in the transmission of rabies (2, 3, 8).
Indonesia has many varieties of insectivorous and frugivorous bats. In Bogor, A
thousands of huge frugivorous bats, Pteropus vampyrus, migrate from the famous Bogor
  ,j•·,‘~ ? . .
  .
it  , 1* ( IE .  
mg. 2-Tnis FRUGIVOROUS BAT (PTERoi>us VAMPYRUS) HELD BY DR. CHARLES TITKEMEYER _
HAS A w1Ncs1>AN or 56 1Nci-[Es AND A BODY LENGTH or is INCHES. THOUSANDS or
THESE FLYING EoxEs LIVE IN THE BOGOR BoTAN1eAL GARDENS NEAR PRESIDENT
soEieARNo·s PALACE. _
Botanical Gardens to neighboring fruit farms every evening. Although these flying mam-
mals ean be readily killed by various routes of exposure to rabies, our present opinion
is that they play little or no part in rabies transmission. Numerous cold—blooded species
have also been used to investigate the biological properties of the rabies virus. Among
them have been snakes, land turtles, lizards, and alligators. Incomplete tests confirm
the opinions of other authors that large dosages of rabies virus do not kill these reptiles,
that rabies virus does not live long in their brains, and that they are not important in
rabies control.
Diagnostic Tests. Diagnostic tests for the identification of rabies must be improved.
At the present time. the agar preeipitin test and the complement—fixation test show great
promise when used in conjunction with thc identification of negri bodies in the brain (l).
-$..

 \
* The complement-fixation test is a laboratory procedure and is not so readily adaptable
to field conditions as is the agar precipitin test. The latter test, because of its sim-
_ plicity, should be used more widely by men in the field where only a simple laboratory
` is available. The biological test with white mice is the most conclusive diagnostic test,
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Fig. 3-DR. RACI-[MAT NABIB REMOVINC THE BRAIN FROM AN ALLIGATOR
(VARANUS SALVATOR) WITH A STRYCHER AUTOPSY SAW TO STUDY
THE PROPERTIES OF RABIES VIRUS IN REPTILES. DR. NABIB SPENT
A YEAR,STU'DY1NG POULTRY PATHOLOCY AT TI-[E CALIFORNIA
AGRICULTURAL EXPERIMENT STATION, DAVIS, UNDER THE PAR-
TICIPANT PROGRAM.
especially in cats where negri—like bodies in the normal brain may confuse the issue
(18). However, this test takes a minimum of 5 days for completion, and if a quick
diagnosis is essential, the agar precipitin and the complement-fixation tests are more
advantageous.
Recommended Measures for Rabies Control. 1. A compulsory vaccination and
licensing program for all dogs 3 1/2 months of age or older should be initiated.
2. The judicious elimination of unlicensed dogs should be practiced. The present
program for the control of stray dogs in Indonesia is neither effective nor judicious.
When a rabies scare occurs, poisoned meat is indiscriminately distributed throughout
the area. This results in the destruction of vaccinated dogs and of expensive, well-
cared for dogs as well as strays. As soon as the rabies scare is over, stray dogs are
again allowed to roam the streets. Thus, the problem is never solved. A dogcatcher
should be appointed as a member of the town's health team and should have the complete
-9-

 cooperation of law enforcement agencies. All unlicensed dogs should be impounded for · °
a few days. If they are claimed by the owner, they should be released only after a
rabies vaccination. If they are not claimed in that period, they should be either humanely `
destroyed or turned over to a medical or veterinary school for teaching and research pur-
poses.
3. All warm—blooded animals brought into the country should be quarantined for
30 days.
4. Research on rabies should be encouraged, especially in the preparation of bet-
ter vaccines and in the improvement of diagnostic techniques.
5. Extension work in educating the public to the dangers of rabies should be in- A
creased.
ANTHRAX
Importance in Public Health
Anthrax is primarily a disease of animals, but in Indonesia it is frequently ob-
served in man. The causative organism, Bacillus anthracis, is an aerobic sporulating
species. Spores, which are formed in abundance when the organism is growing in the
presence of oxygen, remain viable in the soil for many years. Thus soil that is seeded
by improper carcass disposal is a potential reservoir of infection.
Customs Which Contribute to Its Dissemination. Many habits and customs contribute ·
to its dissemination. People, incidentally, eat the meat from anthrax—infected animals
which have been illegaly slaughtered. This is very dangerous and may result in the
rapidly fulminating septic form or the less-dangerous gastro-enteric form of the dis-
ease. Indonesians frequently eat "sate," small pieces of meat skewered on a bamboo
stick and grilled over a charcoal burner. The meat farthest from the center of the fire C
remains relatively rare. The consumption of this poorly cooked meat if it is from an ·
animal that was infected with anthrax may cause a serious outbreak. In the Krawang
regency of West Java, 246 cases of human anthrax were attributed to the consumption
of "sate" in 1955 alone (6). The eating of raw, unwashed cucumbers also is a source
of infection if the cucumbers were harvested from fields where the ground had been `
seeded by improper carcass disposal. In 1916-17 such a severe outbreak occurred from
this cause that all the cucumbers from one contaminated area were condemned and des-
troyed (6).
Environmental Contributory Factors. Because of a shortage of trucks, meat is
frequently carried on the bare shoulders of porters. Skins of animals are often used
as linings for wearing apparel such as bamboo hats. In any case where meat or skin
from an anthrax-infected animal comes in contact with the broken human skin, anthrax
lesions of the carbuncle type occur (6). Insufficient numbers of trained personnel
make adequate antemortem and postmortem inspection impossible in remote areas;
-lO..

 therefore the enforcement of existing regulations governing the condemnation and dis-
posal of diseased carcasses is reduced. Inadequate communication between scientists
and the general public leads to a misunderstanding of the dangers of this disease and to
` an apathetic attitude toward control measures. The shortage of meat encourages people
to consume uninspected meat, and sometimes, illegally slaughtered meat animals.
, These are the factors which must be considered in any program for eradicating anthrax.
J ointly Conducted Research on Anthrax
Recommendations. Our primary work in this field has been directed toward pre-
vention rather than treatment. We have encouraged and aided the government program
` for mass vaccination of meat- and milk—producing animals against hemorrhagic septi-
cemia and anthrax. Whenever an outbreak is reported, vaccination of all animals in the
. surrounding area is compulsory. We have instigated a reporting service for com-
municable diseases. We have suggested that the existing official regulation concerning
the disposal of an anthrax—infected animal (all carcasses must be burned or covered with
lime and buried at least 2 meters deep) is not sufficient. We have recommended that
such carcasses be destroyed by trained personnel using a mobile incinerator, that not
_ only the carcass be burned but that the soil containing any discharge from the body
openings also be burned, that the stable be chemically sterilized, and that the owner
be given instructions concerning the danger to himself, his family, and his livestock.
We continually warn our veterinary students to inspect anthrax in any case where an
animal dies suddenly, is edemic (swine and wild animals), and bleeds from natural body
openings. We have impressed upon them the necessity for incineration of the carcass
whenever there is a possibility of this communicable disease. We have recommended
. the Ascoli test for detecting anthrax on skins and other animal products used for wearing
apparel.
Work in Progress. In spite of our vigilance in detecting and preventing anthrax,
the condition is still prevalent. During the past few months, the Djakarta Zoological
_ Garden has lost several valuable animals by unknowingly feeding them anthrax—infected
meat. A tiger and a panther died within a few hours of each other and were sent to our
necropsy laboratory for diagnosis. They showed the extensive edema in the ventral
neck region so characteristic of anthrax in swine and wild animals. History revealed
that they had been fed meat from a young ruminant which had died suddenly. A
valuable orangutang died the following day with similar symptoms.
Dr. Mohammed Mansjoer of our faculty has made an extensive study of anthrax in
man and animals in Indonesia (6). He has outlined the areas where this condition is pre-
valent and hopes to introduce a program for human vaccination in these anthrax—infected
areas. Much work remains to be done in anthrax control in Indonesia. As more trained
personnel are made available, we hope to reduce the seeding of the soil with viable spores,
the consumption of uninspected meat, and the exposure of the human body to infected ani-
mal products. We can now do little more than "hold the line" until the many factors
which contribute toward the spread of this disease are partially eliminated.
-11-

 · \
FOOD POISONING AND FOOD INTOXICATING AGENTS
Importance in Public Health
Many factors contribute to food poisoning in Indonesia. The most important one _
is the antiquated method of food handling. Because of the inadequacy of Indonesian
transportation facilities, much of the food is transported in baskets supported by a pole
which is carried on the shoulder of a porter, on bicycles, or in open vehicles. The
food item, whether it is meat, pastry, or vegetable, is often exposed to the weather,
flies, and dirt and filth of the highway. Much of the food is retailed in an open market
without benefit of refrigeration, screens, or protective covering. The retailer is satis-
fied that he is being sanitary if he occasionally chases the flies from his product. Food
inspection is poorly enforced or non-existent. Thus food which may have been entirely
wholesome at its point of origin is often contaminated through its long exposure to
tropical weather conditions, dust, flies, and the hands of prospective customers.
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BY CUSTOMERS. THIS sor is vicoizousiv PUNCHING THE MEAT TO
TEST IT Fon TENDERNIZSS. ·
Many other unsanitary practices contribute to possible food poisoning. In the poorer
districts, streams serve as public bathrooms. It is not unusual to see individuals brush-
ing their teeth, laundering clothes, urinating. dcfccaiing, bathing themselves, or even
washing a water buffalo all in thc same area of one stream. The extreme density of the
-].2..

 population and the lack of an adequate sewerage system make conditions ideal for the
dissemination of food poisoning agents.
Jointly Conducted Research on Food Poisoning
Food Poisoning in the Krawang Regency. Most cases of food poisoning and food in-
toxication are handled by the Ministry of Health. There is a very critical delimitation
. of authority for each particular ministry in Indonesia, thereby, limiting the number of
groups which may participate in solving a public health problem. Since the College of
Veterinary Medicine is under the Ministry of Education, it is infrequently consulted on
A public health matters even though the food in question is of animal origin, and the sus-
pected etiological agent is that of a common animal disease. If animal deaths occur
_ simultaneously with or prior to a food poisoning outbreak, the veterinary college may be
" consulted. Such a coincidence occurred in an outbreak of food poisoning i