Travelers tend to worry about contracting infectious diseases when in the tropics, but infections are a rare cause of serious illness or death in travelers.
Pre-existing medical conditions, such as heart disease, and accidental injury (especially traffic accidents) account for most life-threatening problems. Becoming ill in some way is relatively common, however; ailments you may suffer include gastro, overexposure to the sun and other typical traveler woes.
It’s important to note certain precautions you should take on Bali, especially in regard to rabies, mosquito bites and the tropical sun. The advice we provide is a general guide only and does not replace the advice of a doctor trained in travel medicine.
Before you go to Bali, make sure all medications are packed in their original, clearly labelled containers. A signed and dated letter from your physician describing your medical conditions and medications (including generic names) is also a good idea. If you are carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity. If you have a heart condition, ensure you bring a copy of an electrocardiogram taken just prior to travelling.
If you take any regular medication bring double your needs in case of loss or theft. You can buy many medications over the counter without a doctor’s prescription, but it can be difficult to find some of the newer drugs, particularly the latest antidepressant drugs, blood-pressure medications and contraceptive pills.
When you travel to Bali specialized travel-medicine clinics are your best source of information; they stock all available vaccines and will be able to give specific recommendations for you and your trip.
Your doctor may also recommend vaccines against the following: tetanus (single booster), hepatitis A, typhoid, and rabies. The only vaccine required by international regulations is yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone (primarily some parts of Africa and South America) within the six days prior to entering Southeast Asia.
In Bali there some diseases that often occur when you are travelling in Bali. Here we help you to get to know the disease better one by one.
- Dengue Fever
This mosquito-borne disease is a major problem on Bali. As there is no vaccine available it can only be prevented by avoiding mosquito bites. The mosquito that carries dengue bites day and night, so use insect avoidance measures at all times. Symptoms include high fever, severe headache and body ache (dengue was previously known as ‘break bone fever’). Some people develop a rash and experience diarrhea. It’s vital to see a doctor to be diagnosed and monitored. Travelers are advised to prevent mosquito bites by taking these steps:
- Use a DEET-containing insect repellent on exposed skin. Wash this off at night, as long as you are sleeping under a mosquito net. Natural repellents such as citronella can be effective, but must be applied more frequently than products containing DEET
- Sleep under a mosquito net impregnated with permethrin
- Choose accommodation with screens and fans (if not air-conditioned)
- Impregnate clothing with permethrin in high-risk areas
- Wear long sleeves and trousers in light colours.
- Use mosquito coils
- Spray your room with insect repellent before going out for your evening meal.
If you are going to an area where there is a malaria problem, consult with a clinic about the various prescription drugs you can use to reduce the odds that you’ll get it.
- Hepatitis A
A problem throughout the region, this food- and waterborne virus infects the liver, causing jaundice (yellow skin and eyes), nausea and lethargy. There’s no specific treatment for hepatitis A; you just need to allow time for the liver to heal. All travelers to Southeast Asia should be vaccinated against hepatitis A.
Rabies is a disease spread by the bite or lick of an infected animal, most commonly a dog or monkey. Once you are exposed, it is uniformly fatal if you don’t get the vaccine very promptly.
Bali has had a major outbreak dating to 2008 and people continue to die each year. To minimize your risk, consider getting the rabies vaccine, which consists of three injections. A booster after one year will then provide 10 years’ protection. This may be worth considering given Bali’s rabies outbreak. The vaccines are often unavailable on Bali, so get them before you go.
Also, be careful to avoid animal bites. Especially watch children closely. Having the pre travel vaccination means the post bite treatment is greatly simplified. If you are bitten or scratched, gently wash the wound with soap and water, and apply an iodine-based antiseptic. It is a good idea to also consult a doctor.
Those not vaccinated will need to receive rabies immunoglobulin as soon as possible. Clean the wound immediately and do not delay seeking medical attention. Note that Bali is known to run out of rabies immunoglobulin, so be prepared to go to Singapore immediately for medical treatment.
- Hepatitis B
The only sexually transmitted disease that can be prevented by vaccination, hepatitis B is spread by body fluids.
- Bird Flu
Otherwise known as avian influenza, the H5N1 virus remains a risk to be aware of when travelling in Southeast Asia. It has claimed more than 100 victims in Indonesia; most cases have been in Java.
The risk of contracting malaria is greatest in rural areas of Indonesia. Generally, malaria is not a concern on Bali or in the main touristic areas of Lombok. Consider precautions if you are going into remote areas or on side trips beyond Bali. Two strategies should be combined to prevent malaria: mosquito avoidance and antimalarial medications. Most people who catch malaria are taking inadequate or no antimalarial medication.
This serious bacterial infection is spread via food and water. Its symptoms are a high and slowly progressive fever, headache and possibly a dry cough and stomach pain. It is diagnosed by blood tests and treated with antibiotics. Vaccinations are 80% effective and should be given one month before travelling to an infected area.
HIV is a major problem in many Asian countries, and Bali has one of the highest rates of HIV infection in Indonesia. The main risk for most travelers is sexual contact with locals, prostitutes and other travelers. The risk of sexual transmission of HIV can be dramatically reduced by the use of a condom (condom). These are available from supermarkets, street stalls and drugstores in tourist areas, and from the pharmacy store in almost any town. Don’t buy a cheap brand.
Diarrhea (aka Bali belly) is by far the most common problem affecting travelers – between 30% and 50% of people will suffer from it within two weeks of starting their trip. In over 80% of cases, diarrhea is caused by bacteria (there are numerous potential culprits) and therefore responds promptly to treatment with antibiotics.
Diarrhea is defined as the passage of more than three watery bowel actions within 24 hours, plus at least one other symptom such as fever, cramps, nausea, vomiting or feeling generally unwell. The treatment for diarrhea which is Loperamide is just a ‘stopper’ and doesn’t get to the cause of the problem. However, it can be helpful, for example, if you have to go on a long bus ride.
Don’t take Loperamide if you have a fever or blood in your stools. Seek medical attention quickly if you do not respond to an appropriate antibiotic. You can always stay well hydrated; rehydration solutions such as Gastrolyte are the best for this. Also, antibiotics such as Norfloxacin, Ciprofloxacin or Azithromycin will kill the bacteria quickly.
Giardia lamblia is a parasite that is relatively common in travelers. Symptoms include nausea, bloating, excess gas, fatigue and intermittent diarrhea. The parasite will eventually go away if left untreated but this can take months. The treatment of choice is Tinidazole, with Metronidazole being a second-line option.
Besides of the pathological disease, you can also get sick by the environmental hazard disease meanwhile you are travelling in Bali. Some of these diseases are:
Even on a cloudy day, sunburn can occur rapidly, especially near the equator. Don’t end up like the dopey tourists you see roasted pink on Kuta Beach. Instead: Use a strong sunscreen (at least SPF 30), reapply sunscreen after a swim, wear a wide-brimmed hat and sunglasses, and avoid baking in the sun during the hottest part of the day (10am to 2pm).
Divers and surfers should seek specialized advice before they travel to ensure their medical kit contains treatment for coral cuts and tropical ear infections, as well as the standard problems. Divers should ensure their insurance covers them for decompression illness – get specialized dive insurance if necessary. Divers should note that there is a decompression chamber in Sanur, which is a fast-boat ride from Nusa Lembongan. Getting here from north Bali can take three to four hours.
Bali is hot and humid throughout the year. It takes most people at least two weeks to adapt to the hot climate. Swelling of the feet and ankles is common, as are muscle cramps caused by excessive sweating. Prevent these by avoiding dehydration and excessive activity in the heat. Be careful to avoid the following conditions:
- Heat exhaustion Symptoms include weakness, headache, irritability, nausea or vomiting, sweaty skin, a fast, weak pulse and a normal or slightly elevated body temperature. Treatment involves getting out of the heat and/or sun, fanning the victim and applying cool wet cloths to the skin, laying the victim flat with their legs raised, and rehydrating with water containing one-quarter of a teaspoon of salt per liter. Recovery is usually rapid and it is common to feel weak for some days afterwards.
- Heatstroke A serious medical emergency. Symptoms come on suddenly and include weakness, nausea, a hot dry body with a body temperature of over 41°C, dizziness, confusion, loss of coordination, fits and eventually collapse and loss of consciousness. Seek urgent medical help and commence cooling by getting the person out of the heat, removing their clothes, fanning them and applying cool wet clothes or ice to their body, especially to hot spots such as the groin and armpits.
- Prickly heat A common skin rash in the tropics, caused by sweat being trapped under the skin. The result is an itchy rash of tiny lumps. Treat by moving out of the heat into an air-conditioned area for a few hours and by having cool showers.
- Skin Problems
Fungal rashes There are two common fungal rashes that affect travelers. The first occurs in moist areas that get less air such as the groin, armpits and between the toes. It starts as a red patch that slowly spreads and is usually itchy.
Treatment involves keeping the skin dry, avoiding chafing and using an antifungal cream such as Clotrimazole or Lamisil. Tinea versicolor is also common – this fungus causes small, light-colored patches, most commonly on the back, chest and shoulders. Consult a doctor. Cuts & scratches: These can easily get infected in tropical climates so take meticulous care of any cuts and scratches. Immediately wash all wounds in clean water and apply antiseptic. If you develop signs of infection, see a doctor. Divers and surfers should be careful with coral cuts because they become easily infected.
- During your time in Indonesia, you may make some unwanted friends. The first one, bedbugs These don’t carry disease but their bites are very itchy. They live in the cracks of furniture and walls and then migrate to the bed at night to feed on you as you sleep. You can treat the itch with an antihistamine. Second, jellyfish Most are not dangerous, just irritating.
Stings can be extremely painful but rarely fatal. First aid for jellyfish stings involves pouring vinegar onto the affected area to neutralize the poison. Do not rub sand or water onto the stings. Take painkillers, and anyone who feels ill in any way after being stung should seek medical advice.
The last one, ticks contracted after walking in rural areas, ticks are commonly found behind the ears, on the belly and in armpits. If you have had a tick bite and experience symptoms such as a rash at the site of the bite or elsewhere, fever or muscle aches, you should see a doctor.
Those are some information about disease in Bali. Be careful always when you go to the public places especially in rural area. In ubud and Kuta, in case you need the medical treatment while you are traveling in Bali you can contact Unicare for comprehensive medical therapy and treatment.
Have fun while you are in Bali and always stay safe.