Disease and treatment in Bali

Before you visit Bali be sure to check up with your local GP, on the vaccination requirements. Taking a look at the CDC website, you’d need multiple vaccinations for Bali, but in reality you don’t really need many.

Here is a look at the possible diseases you can contract in Bali and how to recognize them.

•Hepatitis:
There are several types, but all leave the patient with a yellowing of the skin and eyes. This is combined with extreme tiredness, diarrhea and fever. This is a common disease in this part of the world and the effects may last several months. The 2 main kinds of Hepatitis are A & B.

Hepatitis A is generally transmitted by viruses in food, water and human saliva. Hepatitis B is transmitted by viruses in human sexual interaction, contaminated blood or syringes. Vaccines offer a degree of protection and the treatment for hepatitis includes avoiding alcohol.

•Typhoid:
Typhoid is one of the common vaccinations for Asia. The disease is transmitted by contaminated food or water. Symptoms are intense fever, headaches, abdominal pains, diarrhea and red spots on the body. Very similar symptoms to a type of malaria, with the exact same cycle of fever / chills.

•Cholera:
Transmitted by contaminated food and water. Symptoms include cramps, low energy, runny diarrhea and vomiting. This disease can quickly leave you dehydrated. In its most severe forms, cholera is one of the most rapidly fatal illnesses known: A healthy person may become hypotensive within an hour of the onset of symptoms and may die within 2-3 hours if no treatment is provided.Vaccinations are not that effective against Cholera.

•Tetanus:
Transmitted through contact via open wounds. The tetanus booster shot is a very common one to get for long tern travelers, just in case of an accident. Generalized tetanus is the most common type of tetanus, representing about 80% of cases. The generalized form usually presents with a descending pattern. The first sign is trismus or lockjaw, followed by stiffness of the neck, difficulty in swallowing, and rigidity of pectoral and calf muscles. Other symptoms include elevated temperature, sweating, elevated blood pressure, and episodic rapid heart rate. Spasms may occur frequently and last for several minutes. Spasms continue for 3–4 weeks and complete recovery may take months

•Japanese encephalitis:
Transmitted by virus carried by mosquitoes. Most common in rural areas and carried by birds and other animals. Causes swelling of the brain which can be fatal. Japanese encephalitis has an incubation period of 5 to 15 days and the vast majority of infections are asymptomatic: only 1 in 250 infections develop into encephalitis. Severe rigors mark the onset of this disease in humans. Fever, headache and malaise are other non-specific symptoms of this disease which may last for a period of between 1 and 6 days. Signs which develop during the acute encephalitic stage include neck rigidity, cachexia, hemiparesis, convulsions and a raised body temperature between 38 and 41 degrees Celsius. Mental retardation developed from this disease usually leads to coma. Mortality of this disease varies but is generally much higher in children.

•Rabies:
Very common disease in Asia, spread through the saliva of dogs, cats and monkeys, which pierce your skin. It is possible to get pre-departure shots for rabies, most people don’t bother. If you suspect the animal that bit you might have rabies consult a doctor for a series of shots. Any mammal may become infected with the rabies virus and develop symptoms, including humans. Most animals can be infected by the virus and can transmit the disease to humans. Infected bats, monkeys, raccoons, foxes, chickens, cattle, wolves, dogs or cats provide the greatest risk to humans. After a typical human infection by bite, the virus directly or indirectly enters the peripheral nervous system. It then travels along the nerves towards the central nervous system. During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. Once the virus reaches the brain, it rapidly causes encephalitis and symptoms appear.

•Malaria:
Caused by a parasite in the saliva of mosquitoes. Can be fatal. Symptoms are fever /shivering, headaches. Cycles of the symptoms come and go with periods of feeling fine. Each time the symptoms get worse, until the brain overheats. Malaria medication is available to take while on your trip and after you return home. Discuss the effectiveness of the various options with your doctor.

Among other ways of preventing malaria are:

• covering up with long pants and long sleeves at dawn / dusk.
• burning a mosquito coil to rid your room of mosquitoes before sleeping.
• using insect repellent at dawn / dusk
• sleeping under a mosquito net
• sleep with a strong fan on you
• avoiding black clothes
• sleep in an AC room and keep the doors and windows shut during the day

•Dengue fever:
Transmitted by a virus carried by mosquitoes. This mosquito tends to attack during the day and is slightly larger than the malaria carrying variety. In Bali this mosquito likes to hide inside the petals of a certain yellow flower. Symptoms include headaches, fever, joint and muscle pain. The classic dengue fever lasts about six to seven days, with a smaller peak of fever at the trailing end of the fever (the so-called “biphasic pattern”).The only cure is rest and hydration. There are no drugs that will cure dengue but it is manageable.

The climate in Bali is one that is a natural breeding ground for germs. Add to that some of the local methods of washing and cooking and its no wonder people gets sick occasionally. The local method of washing one’s rear after going to the bathroom involves scooping water out of a mandi (brick reservoir of still water) and splashing over oneself with a plastic scoop. A trip to an airport bathroom, will reveal a floor covered in water, which has rebounded of someone else. Same thing for the toilet seat and people’s private bathrooms. A small house used by many people, will have micro-particles floating around on the bathroom floor.

Showering is a variation of the same, with scoops of water being tipped over the participant, ending up all over the bathroom. Fortunately for most visitors a shared bathroom will never be necessary during a trip to Bali and most restaurants have western standards.

If you have any reason to think you are unwell during your visit to Bali, get checked out at a reputable clinic.