Bali & Indonesia Vaccination Advice
There are no specific vaccine requirements for entry into Bali, however there are a number of factors to consider when deciding whether or not to take precautions and get vaccinated against diseases prevalent in Bali and surrounding South East Asian countries including Indonesia. Much will depend on your individual situation, which you should discuss one on one with the doctor. The advice given below is general advice only and should not be relied upon as a substitute for medical advice, but you can use it to start a conversation with the Travel Vaccination Clinic doctor about your trip to Bali.
You should speak to the doctor about the following:
- Whether your existing vaccinations from childhood including tetanus, measles mumps and rubella, and diphtheria are all up to date
- Whether you have been vaccinated against hepatitis and typhoid in the last few years
- Your general health and history of disease
- Exactly where you want to go and what you plan to do while in Bali
- The style of travel you intend on doing, e.g backpacking vs 5-star hotels, whether you will be doing adventure sports and mixing with the locals etc
- The length and purpose of your visit
You should advise the doctor of all of the above, including any risk taking activities or adventure activities you plan on doing while away.
Both Hepatitis A and Hepatitis B are vaccine preventable diseases and Hepatitis B is now part of the childhood vaccination schedule if you come from Australia originally. If you are unsure of whether you are vaccinated against either or both of these the doctor can make sure you are up to date.
Hepatitis A in particular is prevalent in countries in the developing world and strongly recommended for travel to Bali. The vaccine lasts a number of years once given.
Rabies, insect borne diseases, avian flu and typhoid in Bali
As of May 2013 there are some particular risks which have been highlighted on the Smart Traveller website and elsewhere for travellers to Bali; rabies, dengue fever, avian flu and typhoid and general hygiene are common concerns.
Rabies – avoid all contact with animals
Since 2008 cases of rabies in humans and animals in Bali have been reported. There is an active campaign to stop the spread of the virus on large billboards across the country. Touching dogs, cats, monkeys or other animals in any way is not recommended. Rabies is not only transmitted through dogs, though they are the most common carrier of the virus.
Nothing besides avoiding contact with animals and general good hygiene practice is recommended for short-term visitors, but for those on an extended stay or travelling to work with animals a pre-exposure vaccination can be given to you before you travel. Do speak to your doctor about the risk of rabies before returning to Australia as Australia and New Zealand are two of the few remaining rabies-free countries left in the world.
Pre-empting contact can also be important, as one recent large scale study found that most cases of rabies infected dog bites involved the animal approaching the traveler, rather than the patient approaching the animal. The common adage “I’ll just avoid any animal contact” does not always work in some countries where rabies is prevalent.
Mosquito borne illnesses – Dengue fever and Malaria
Bali is a hot, humid country very close to the equator and as such mosquitos and mosquito borne illnesses are prevalent in the area.
Denghue fever infection in febrile travelers varies from mild flu-like illness through to severe denghue hemorrhagic fever and hemorrhagic shock syndrome. Its prevalence has substanially increased and is most common in travellers returning from Asia, the Americas and Africa
Malaria is not generally prevalent in the tourist areas of Bali, but it can be present in mosquitos if bitten. In general it is not recommended to take preventative medication for malaria in the more developed parts of Bali, however if travelling to rural or remote village areas or if malaria is contracted medication may be taken to counteract the symptoms. Speak to the doctor about where you are going in Bali and discuss whether or not you should have malaria medication with you. If you have recently returned from a trip to Bali and have flu like symptoms you should see the doctor and get checked for malaria.
Malaria is a complex mosquito borne illness with various strands and drugs available. Different medications may not be able to be taken by people with depression or other illnesses either, so it is essential to have a proper conversation with the doctor about this before requesting medication.
Depending on whether you plan to spend a lot of time outdoors or in undeveloped areas at night, how long you stay and what season you plan to travel in the doctor may recommend a vaccination against Japanese Encephalitis Virus (JEV). This is another mosquito borne virus that is preventable through vaccination, but unless you are travelling through Bali/Indonesia for an extended period of more than one month the risk may be very low so you should consult the travel vaccination clinic about your planned activities and discuss prevention.
Avian influenza cases have been reported in Bali, and you should discuss your trip with the doctor and ask whether it is worth your while taking anti-viral medication with you. Long stay travellers and residents may be at increased risk over time and will need to take responsibility for their own safety in the event of an outbreak.
Typhoid is another common illness, which sees around 50-70 Australian travelers affected each year. Typhoid can be passed on through contaminated food or water and symptoms can take 10-14 days to appear. The vaccine can be given orally or by injection, and there is a combined hepatitis A and typhoid vaccine available. If you have not been vaccinated against typhoid you can request this vaccination before you go, and it is recommended for travelers to Bali.
General healthy travel advice for Bali
Aside from diseases that can be prevented through up to date immunization, the main risks associated with travel to Bali include drink spiking, man made or natural disasters and travellers’ diarrhea, cholera and other illnesses that can be prevented through good hygiene practices. An oral cholera vaccination is available and the doctor can assist you if you are interested in getting it.
As such, there are a few golden rules to follow when travelling around Bali to ensure your trip is a great one full of positive experiences. Read the general healthy travel advice page as well as the points below:
- Do not drink or clean teeth with untreated water (that hasn’t been boiled), and stick to bottled if possible.
- Never leave drinks unattended while out.
- Carry hand sanitizing gel or anti-bacterial wipes with you. Do not expect there to be soap and running water in public toilets or bathrooms.
- Follow safe eating and drinking practices, do not consume food that hasn’t been thoroughly cooked or vegetables that haven’t been peeled.
- Avoid overheating and use sun protection measures like a hat, shirt and sunscreen and stay well hydrated at all times.