Bali Health & Hazzards

How to arrive and stay healthy in Bali

Most Common Health Hazards on Bali

Bali is much more developed than most regions in Indonesia and the main tourism areas match international standards when it comes to hygiene. If you plan to travel to other areas in Indonesia or venture out for a longer period into the more remote areas of Bali, then a more careful approach is recommended. Because vaccines need to be taken before arriving at your holiday destination you need to plan your vaccine strategy 4-8 weeks before scheduled departure.

Malaria, Dengue, Hepatitis A etc on Bali

Recommended Vaccination and Vaccines for your trip to Bali
Tetanus Diphteria Standard, last immunization should not be older than 10 years Vaccination strongly recommended
Measles-mumps-rubella (MMR) Standard also in “first world countries” Vaccination recommended
Typhoid Typhoid fever is linked to a salmonella species known as Salmonella typhi. Common symptoms are fever muscle aches, nausea, abdominal pain and problems with the stool (diarrhea or constipation). The salmonella is transmitted by contaminated food or water. People can transmit the disease without knowing that they have it. So a cook in a restaurant can have no symptoms but because he is handling your food can still transmit typhoid. If you stay only a short while on Bali and eat and drink mainly in the hotels and resorts then a vaccination is usually not recommended by most doctors. Vaccination recommended. Strongly recommended if you stay longer and wish to eat street food and travel to more remote areas.
Hepatitis A Hepatitis A vaccine is highly recommended for travelers to developing countries which includes of course Indonesia and Bali. Hepatitis A is a viral infection of the liver. It’s after diarrhea simply the most common travel related disease globally. Like typhoid-fever it is also transmitted by contaminated water and food. It might also be acquired by direct contact with infected people. If farmers or food stall owners are infected and handle their food, then their products could also be contaminated. Symptoms are usually fever, nausea, vomiting and pain in your abdomen. Sometimes Hepatitis A can result in a more sever liver damage but in most cases there are no complications. Vaccination strongly recommended
Other medical conditions and diseases
Rabies Recent outbreaks of rabies in 2008 and 2010 raised concerns among travelers to Bali. A rabies vaccination is still not a must if you come to Bali but considering the fact that dogs (and monkeys) who could interact with tourists can have rabies, and that Bali’s dog population is estimated at 500.000, a vaccination is not a bad thing before coming here. Avoid the street dogs, don’t get too near to them. When you raise your hand as if you would throw a stone, they usually run away. Watch your children not to get too close to them. Bali vaccinates every year tens of thousands of dogs and by now government estimates that around 50% of the dogs have been vaccinated. Which leaves another 50%. Bali got some bad press of culling street dogs after the outbreak in 2010. Vaccination slightly recommended
Malaria The general risk to catch malaria in Bali is very small. In the main resorts area the risk is close to zero. If you plan to visit rural areas for a longer period, or do a lot of mountain trekking, etc then you could consider malaria prophylaxis. No vaccination is available for malaria! The best protection is still not to get bitten by mosquitoes and make use of mosquito nets, wear long sleeves, long trousers etc when you take a jungle hike for example. Low risk, vaccine not available, prophylaxis not necessary
Dengue Fever Beside traffic accidents – the most imminent health hazard to Balinese and visitors is most likely Dengue fever. There is no vaccine against it, therefore the best way to prevent Dengue is like with Malaria not to get bitten by mosquitoes. Dengue fever is a flu-like illness and not uncommon in Bali. Like Malaria, Dengue is transmitted by mosquitoes although a different type. The Aedes Mosquito responsible for Dengue bites primarily in daytime but also during nighttime. They can be found mainly in densely populated areas like the capital Denpasar. The disease is observed all year-round. It can be very painful, and can in some cases be fatal. Main symptoms are beside fever, aching joints and muscles, vomiting, severe headaches, nausea. Usually it takes a few days for the symptoms to subside and there won’t be complications. If one gets his first Dengue infection as an adult, most likely one would not experience big complications. For patients who have had a Dengue infection before the age of 15 and get a second one as adults, the risk for complications is higher. High risk, no vaccine available, general mosquito bite precautions.
Diarrhea (Bali Belly) In Bali Montezuma’s revenge is called the Bali Belly. Globally the number one travel related disease due to contaminated water and food, mainly because of hygiene reasons. Diarrhea can strike you in Italy, Egypt, Mexico…all over the world when traveling. It’s a good thing to bring some of the general anti-diarrheal drugs along – just in case. Although diarrhea is in most cases not dangerous and only keeps you suffering for a day or two, one should be aware that the condition can become dangerous. If symptoms persist for more than 3 days (72h) then go to a doctor. Also, if you experience within 8 hours three more loose stools, vomiting, strong cramps, blood in the stool and fever then you might need antibiotics. Medium risk, don’t drink water from tab, careful with street food
HIV Bali has a lot of prostitution. Some studies suggest that HIV is widespread among the prostitutes (up to 30%!). There are several other sexual transmitted diseases (STD) that are not uncommon among working girls (and boys) which will be difficult to explain back home. Be cautious and conscious.
Yellow Fever Vaccination not required generally for Bali Only required for travelers arriving from yellow-fever infected countries (Africa, Americas)