Last Friday, the Australian Department of Foreign Affairs and Trade sent out a tweet reminding travellers to talk to their doctor about vaccinations for Japanese Encephalitis before visiting Bali –

There has been some reporting about an increase in cases in part of Bali, as well as other regions of Indonesia. The Indonesian authorities have firmly pushed back against this, calling it fake news.

While Japanese Encephalitis is a very serious disease and should not be taken lightly, Travel Health Pro states that ‘travellers on shorter trips (typically less than a month), or trips that take place outside the peak transmission season and those who restrict their visits to urban areas are usually considered to be at very low risk.’

What is Japanese Encephalitis?

Japanese Encephalitis is spread by mosquitoes, and the virus has a host reservoir of pigs and wading birds. When bitten by a carrier mosquito, most people have a mild reaction or no symptoms at all. A small number of people will develop encephalitis – swelling of the brain – and this is fatal in around one in four cases. Symptoms include a ‘sudden onset of headache, high fever, disorientation, coma, tremors and convulsions.’

Bigger risks to your health

Japanese Encephalitis is very serious. However, the risks of infection are comparatively low and there are other health issues that pose more of a threat.

Road traffic accidents

One of the biggest dangers facing travellers to Southeast Asia and Bali in particular are road traffic accidents.

  • When you get a taxi, if the car does not look safe, do not get in. If the driver is going too fast, ask them to slow down. If you feel unsafe, ask them to stop and get out. Trust your gut and do not feel awkward about this.
  • If there is a seat belt available, make sure you wear it.
  • If you have not ridden a moped before, do not do it on your trip!
  • If you are an experienced biker and you want to hire a moped or motorbike on your trip, make sure your travel insurance covers you. We regularly share articles of people who have been injured (or worse) and their friends and family have to crowd sources funds to cover huge medical bills.
  • Always wear a helmet.
  • Be aware that the roads may be in poor conditions in places and this will get worse in poor weather. Other drivers may not behave the way you are used to – keep a look out for erratic and dangerous manoeuvres so you can avoid!
Dengue fever

During the rainy season, which runs roughly from October to April, there is a risk of dengue fever in Bali and elsewhere in Indonesia and Southeast Asia. There is no vaccination – this is one of the many reasons why you want to avoid getting bitten by mosquitoes. The symptoms of dengue can include ‘high fever, muscle and joint pains, headache, nausea, vomiting and rash.’

Rabies

Wild animals, pets, and semi-wild animals can all carry rabies. Those cute beach dogs and the street dogs that look longingly at your plate while you eat – they are potential hosts.

Rabies lives in animals’ saliva and can be spread through a bite or a scratch. Symptoms do not show up immediately – it normally takes two to three months for the disease to take hold, though this varies. If you think you have been exposed to the disease, act quickly.

From Travel Health Pro

If you are bitten or scratched by an animal, or if an animal licks open skin, you must immediately flush the wound/area under a running tap for several minutes, then thoroughly wash with soap/detergent and water to remove saliva. Apply a disinfectant like a 70% alcohol or iodine solution, and cover the wound covered with a simple dressing. If you have an animal saliva exposure (usually by spitting) to your mucous membranes such as eyes, nose or mouth, wash thoroughly with clean water as soon as possible. 

Get urgent medical help, even if the wound or incident seems very trivial. Prompt post-exposure treatment is needed, even if you have already had a full pre-exposure vaccine course, as further vaccine doses are necessary.

If you did not have or did not complete a rabies vaccine course before travel, you may need treatment with a blood product called rabies immunoglobulin, as well as a full vaccine course after a potential exposure. In some parts of the world, both rabies immunoglobulin and vaccines may be unavailable. However, getting rabies vaccine (a different product to immunoglobulin) is critical in post exposure treatment and should be started as soon as possible, whether or not immunoglobulin is available. You may need an emergency flight back to the UK or a nearby country for appropriate treatment and vaccines.

Ask for a written record of any post exposure treatment you receive overseas. If you do not feel comfortable with the advice you have received at the time of your consultation overseas, you should contact your medical insurance company.

Please click through for more information and guidance on rabies.

Advice

If you are headed to anywhere in Southeast Asia, talk to your doctor before you travel. Make your appointment for as soon as possible, because some vaccinations require multiple doses that are spread out over a series of visits.

Do not forget to check you are up to date on your MMR vaccination and strongly consider getting this year’s flu shot – both of these can save lives. International airports are a great place to pick up new and funky diseases.

Other travel issues + advice

Wherever you are headed in Southeast Asia, there are a couple of other potential travel risks you should read up on before you go.

Terrorism

There are several militant groups active in Southeast Asia, as well as (relatively rare) links to the conflicts in Afghanistan and the Middle East. Terrorists have carried out attacks across the region in recent years and there are travel advisories in place.

Natural disasters

The proximity to the Ring of Fire means earthquakes, tsunamis, and volcanic eruptions are all much more common in Southeast Asia than elsewhere in the world. Work out what threats might impact on your trip and then make a plan for what you would do if that were to happen. Know what the warning sirens will sound like.

Official travel advice

Here are some links to travel advice on visiting Indonesia from the following governments to help you with your research –

Please note that the travel advice varies – it is worth reading them all and reaching your own conclusion.

 

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