Travel Health Advice for Bali
UPDATE January 23, 2016: Doctors at Globe Medical have diagnosed Dengue fever in 2 people returning from Bali this week. One was away for just 4 days and the other 7. Neither case was typical although one had a rash subsequently.
So you are off to Bali? Are there any health concerns?
More than 250,000 Australians travel to Bali each year. Great weather, affordable accommodation, good food, plenty to do and very friendly people.
Booking a ticket over the internet and jumping on a plane for a few days break is becoming more common and pre-travel health advice often not considered. This commonly applies to places like Bali and Phuket.
While mosquito-borne diseases like Dengue and Malaria raise more concern other issues may be more common. Diarrhoea and respiratory tract illness may be less serious but their impact on the enjoyment of an overseas stay can be devastating.
Globe Medical would like to remind travellers that a visit to an experienced travel health professional prior to travel can be time well spent
Do I need to see a doctor before travelling?
The short answer is yes but you will not require a lot of injections to avoid exotic disease or a medical kit bigger than your normal carry-on bag. This is just not the case!
Travellers to Bali do get sick or injured – perhaps 30-40% in a 2 week stay - but very few end up in hospital or evacuated back to Australia. Many health issues are minor and may have been avoided by visiting an experienced health professional beforehand. Preparing travellers to Bali is not rocket science and if much of the visit is spent on diseases like cholera, typhoid and malaria then it is likely your time is being wasted.
The doctors at Globe Medical have been preparing travellers for many years. They view travel medicine from an “educative view” rather than a cookbook. Injections are only a minor aspect of your travel preparation. If you travel “well” and have a great time then you will “travel again”.
If you spend most of your time in a hotel room worrying about access to a loo then it is likely you will view your experience quite differently.
Do I need any vaccinations?
It is possible you are up to date with all your vaccinations and nothing extra is required apart from a reminder on the common health issues found in Bali.
The travel consultation provides the doctor/ nurse with an opportunity to review your routine vaccines:
|Tetanus/Diphtheria/Pertussis||All (Triple antigen recommended not just tetanus)|
|Measles/Mumps/Rubella||Born between 1966-1980, vaccine refusing families|
|HPV (Human Papilloma Virus)||Missed at school|
|Hepatitis B||Missed at school|
|Chickenpox||All (no past history of disease)|
|Influenza||Consider for all – exposure in travel more likely|
|Pneumococcal (Pneumovax)||Recommended over 65 years|
If this is your honeymoon then having a triple antigen with whooping cough is a great idea, particularly if starting a family is not far off!
If you have never had Chikenpox then now is the time to consider protection. You will never not be at risk (some-one with shingles can infect you eg an elderly relative)
The Hepatitis A vaccine is the main “specific vaccine” for Bali. You may have undertaken many trips in the past and never had an issue but in countries where Hepatitis A is a growing up disease exposure is always possible. The disease is mostly minor if contracted in childhood but can be severe as an adult. Australia’s recent outbreak of Hepatitis A (frozen berries from China) should remind us that it doesn’t matter whether you are travelling 5 star or as a backpacker you are always at risk. Typhoid vaccine may be offered to the more adventurous traveller. Rabies has been in the news in recent years but vaccination is rarely indicated. It might be considered for the long term traveller or someone working with animals.
Common health concerns
Bali belly, just like Delhi Belly, Cleopatra’s curse, Monezuma’s revenge and the Ho Chi Minhs is just traveller’s diarrhoea. This can be avoided by eating and drinking sensibly.
Care should be taken with water, ice, salads and shellfish (mussels, oysters and clams). Eating sensibly (cooked food) away from the resort or 5 star restaurant may go a long way to preventing an episode! Who would eat sandwiches in Bali? Take care with airport food and packed lunches. Stay with freshly cooked food from busy restaurants.
Hand hygiene a must (soap and water preferred but alcohol OK).
Have you ever sat around an evening fire and wondered why you are the only one being bitten by mosquitos? If yes, then you are a mosquito magnet. In places like Bali you have to be extra careful. Use appropriate repellents and cover up. You might receive 10 bites to the next persons 1! You are much more at risk for diseases like Dengue and Chikungunya. Both can cause significant joint issues much like our own Ross River. Biting mostly occurs around sunset or early morning. Prevention is possible if you are forewarned.
The mention of accidents would not surprise most Bali goers! Stand on the sidewalk and watch the overseas bike riders. It probably won’t surprise you to notice the flimsy clothing and footwear and the occasional non helmet. Injuries are common and many are serious.
Surfing injuries are also common, particularly in places like Uluwatu. Make sure you know how to look after a wound. Even minor ones can end up as abscesses requiring drainage. Primary management is important.
We know about the excesses of alcohol but sometimes we don’t appreciate that some alcohol may be toxic and very dangerous. Contaminated alcohol has been implicated in a number of deaths overseas. Methanol can also cause blindness. Be sure of what you are consuming and don’t accept drinks unless you are sure of the source.
Respiratory tract infections
How could this happen? Left the winter behind in Australia only to cop a nasty head cold in Bali. It really did impact on the enjoyment of the break! We see this commonly in the returned traveller and much can be done to reduce the risk.
- Minimise your contact with those unwell in the days leading up to your trip (sick people aren’t always considerate)
- Alcohol sanitisers are very effective against respiratory tract bugs (always have one in your pocket)
- Planes are pretty safe but think about the person who might have sat in your seat before you. Wipe down the table and the buttons with an alcohol wipe
- Clean your hands after visiting a public toilet (plane, airport)
Take home message.
Discuss your trip with a doctor who has an interest in travel medicine. It may mean the difference between money well spent or throwing your hard earned cash down a toilet!
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Image credit: Thomas Depenbusch, Flickr