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Staying Healthy in Bali

Many people mistakenly believe that because thry're travelling to Bali and staying in a good hotel or resort they don't need to consult a doctor before departure. The Travel Doctor has prepared a summary of some of the major health risks you may face while holidaying in Bali.

  • The major issues facing travellers to Bali are local hygiene, safe water and food, diseases transmitted by mosquitoes and accidents.
  • Check your basic immunisations such as Tetanus and Diphtheria are up-to-date.
  • Discuss with a Travel Doctor whether Hepatitus A and Typhoid immunisations are necessary.
  • In late 2008 animal and human rabies was reported on Bali and so travellers need to be vigilant to avoid close contact with animals.

Travelling With Children - Special Considerations

Bali is a wonderful family holiday destination. When travelling with children there are a number of travel health considerations that should be taken into account to assist you in having a safe and healthy family holiday.

  • Choose you destination carefully - being in an isolated area with a sick young child can be very stressful, particularly if communications in the area are poor.
  • The flight - Infants may need to breast feed or suck a bottle as the aeroplane takes off or lands. Swallowing helps their ears equalise and prevent ear pain. Older children may find it helpful to suck a lolly.
  • Eating and Drinking - Following the general eating and drinking safety rule of "boil it, cook it, peel it - or forget it" is particularly important. Children under 3 years of age tend to get diarrhoea which is more severe and lasts longer than in adults. As much as possible, watch what they eat and don't let children drink untreated water, even for teeth brushing. Carry "wet ones" or antiseptic hand wash so you can clean their hands regularly.
  • Hot and Cold Climates - Be careful to protext children from extremes of heat or cold. Beware of frostbite on tiny fingers and toes. Children cannot regulate their body temperature as well as adults. Offer fluids regularly as children dehydrate rapidly and their thirst sensation is unreliable.
  • Accidents - While travelling, you have less control over a child's environment. Drownings, poisonings, burns and falls are paricular hazards. Closely supervise children around animals - remember Australia and New Zealand are two of the few rabies free areas in the world.

Major Travel Health Issues and Considerations for Bali

Hepatitus A This is a viral disease of the liver which is transmitted through eating contaminated food or drinking contaminated water. it is the most common vaccine preventable disease that occurs in travellers to less developed areas of the world. It is strongly recommended for travel to Bali.
Hepatitys B This is a viral disease of the liver that is transmitted via blood, blood products or bodily fluids. It is vaccine preventable and now part of the childhood immunisation schedule. Many adults may have missed this important vaccine and travel is a good reason to get up-to-date.
Typhoid Typhoid Fever is caused by a bacteria found in contaminated food and water. It is endemic in the developing world and vaccination is recommended for travellers to areas where environmental sanitation and personal hygiene may be poor. The adventuous eater venturing "off the beaten track" should consider vaccination.
Tetanus, Whooping Cough and Diphtheria

Tetanus is caused by a toxin released by a common dust or soil bacteria which enters the body through a wound.

Diphtheria is a bacterial infection of the throat and occasionally the skin. It is found world wide and is transmitted from person-to-person by coughing and sneezing.

Whooping Cough (Pertussis) is a highly infectuous respiratory infection responsible for 300,000 deaths annually, mainly in children.

Because many adults no longer have immunity from childhood immunisation it is advised that travellers to less developed countries have a tetanus, dihtheria and pertussis booster.

Measles, Mumps & Rubella Childhood immunisation coverage in many developing countries is not good. As such, travellers under the age of 40 years should have their MMR immunisation completed. Those over the age of 40 years are most likely to have long term immunity from previuos exposure as a child.
Chickenpox This very comon infectious disease can now be prevented through immunisation. Many people miss the disease in childhood only to have a significant illness as an adult. If you do not have history of immunisation, a simple blood test can show whether you are at risk.
Influenza Individuals intending to travel out of an Australian winter might consider the current flu vaccine at the beginning of the season. exposure to illness in airports and commuter transport is common and exposure may ruin a much needed break.
Cholera Cholera is a severe, infectious diarrhoeal disease common in developing countries. It is associated with conditions of pverty and poor sanitation. It causes a sudden onset of extremely profuse, watery diarrhoea within one or two days after contact with the bacteria. Rapid dehydration can occur. Travellers who follow guidelines for eating and drinking safely will minimise the risk of contracting cholera. An oral vaccine is now available.
Malaria Malaria is transmitted by a night biting osquito. The risk of exposure is very low in Bali, particularly when the stay is restricted to the main tourist areas. Medications to reduce the risk of disease are not generally recommended but any illness which flu-like in nature after returning should still be checked for malaria.
Dengue Fever Dengue (pronounced Den-gee) Fever is a viral disease with flu like symptoms that is transmitted by mosquitoes. There is no vaccine for dengue fever and prevention is based upon insect avoidance via repellents, nets and insecticides.
Japanese Encephalitis (JE) JE is a mosquito borne viral disease prevalent in rural areas of Asis and Indonesia that can lead to serious brain infection in humans. Risk is usually greatest during the monsoon months. A vaccine is available and is particularly recommended for adults and children over 12 months of age who will be spending a month or more in rice growing areas of countries at risk (or who repeatedly visit such areas). Insect avoidance should be considered the primary means of defense.
Rabies Rabies is a deadly viral infection of the brain transmitted to humans. The diease itself is rare in travellers, but the risk increases with extended travel and the likelihood of animal contact. The best way to avoid rabies is to avoid all contact with animals. Dogs are the main carriers, however monkeys, bats, cats and other animals may also transmit the disease. Pre-exposure vaccination is recommended for extended travel and those who work with, or are likely to come in contact with animals. Regular tourists do not need to be pre-immunised routinely but must report any animal bites so post-exposure treatment can be administered.
Travellers' Diarrhoea Up to 40% of tourists may develop diarrhoea wihtin the first week of travel. A variety of germs can be responsible and a Traveller's Medical Kit containing appropriate therapy can rapidly improve the symptoms. It is also important to follow the rules of healthy eating and drinking to minimise risks.