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Bali - malaria pills?

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Old Jan 10th, 2012, 08:16 PM
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Bali - malaria pills?

We are going to Bali for the first time in May and are completely up on all our immunization - Hep A, B, Typhoid, MMR, Tetanus and others that are not required for Bali but we keep them up to date because of other travel. However, I am not getting a clear information on Malaria. Are the pills needed? I would rather not take them because they make me feel nauseated, but I would also rather take the pills than get sick from the bites. For some reason mosquitoes really love me. Also, some sites are mentioning that a Rabies shot is needed, but it seems a little far fetched to me. Any thoughts?
Many thanks!
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Old Jan 10th, 2012, 10:03 PM
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There is some malaria in Bali but it's not so widespread that you need to take malaria pills. (Dengue is also a problem, but there's no preventative.) The best approach is long sleeves and long pants in the evening and in mosquito-y places plus repellent.

Recently rabies has been an issue in Bali, mostly for the Balinese. I wouldn't go to the extreme of getting vacinated, but I would be vigilant. Avoid stray dogs and don't get close to monkeys. In the unlikely event that you are bitten, you would most likely have to leave Bali to get treatment.

In my opinion, medical evacuation insurance is a good idea in Indonesia and many other Asian countries. Quite honestly the biggest risk to personal safety is getting hit by a motorcycle!
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Old Jan 11th, 2012, 01:03 AM
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Wasn't a problem for me when I was there in April. I never got bitten when I was in Bali...then again, I wasn't out very late at night, especially when it rained. Like marmot says, just be vigilant and use mosquito repellant and take your standard precaution for mosquito bites.

And really, just don't touch the monkeys and avoid stray animals--I've heard that time and time again about Asia and many still-developing places. Once encountered a stray dog in Tahiti--most frightening experience ever, and it wasn't even rabid!
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Old Jan 11th, 2012, 06:59 AM
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Bali had previously eradicated malaria, but there has been an increase in the last few years. It is still considered a low risk area for malaria, though if you go to Lombok, it is considered malarial risk. Do everything you can to prevent bites.

There is rabies in Bali. If you get bitten by a dog or a monkey, you need to get to Singapore or Bangkok ASAP for preventative treatment. You'll need a shot of human immune globulin, which is not available on Bali as well as the rabies series. If you have the pre-exposre series, you would not need the immune globulin, only another series of the rabies vaccine.

If you are engaging in activities that are higher risk for attracting dogs, such as bicycling, you might want to consider the rabies pre-exposure vaccine.

I always carry med evac insurance. We buy it by the year and its very inexpensive.
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Old Jan 11th, 2012, 10:25 AM
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In my opinion,you do not need to take malaria medication or get a rabies shot in advance of going to Bali. As others have said, you should always carry medical insurance that covers you for any contingencies but in many years of living full-time in Indonesia I have never taken any malaria pills or a rabies shot. I did recently get tetanus and hep and other innoculations though. (And I travel quite a bit around areas with a lot more mosquitos than Bali) Dengue is slighly higher risk, that is carried by the black and white striped mosquito that bites during the day. But assuming you will be staying in tourist accomodation and doing "normal" tourist activities, even walking in rice fields, or driving araound the island, you should be fine. There are some things you can do to lessen your exposure to mosquitos. Balinese bathe at least twice a day, and part of the beauty of that, is that mosquitos are attracted to smell. I don't use any perfumes and use a bit of mosquito repellent most days.

As for rabies, it's true that Bali used to be rabies-free (or at least very rare) and when it sprang upon Bali the government was caught unawares and did not do enough to fight it. Sadly, many people died who didn't even know what rabies was, and were living in villages where they didn't have access to health care. anyway, it's a long long story... But the government and some other organizations have carried out very extensive educational, vaccine and even culling operations that have greatly reduced exposure.

It's
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Old Jan 11th, 2012, 06:10 PM
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What you say makes perfect sense. We will be doing the typical touristy stuff so taking simple precautions like long sleeves, etc. in the evening as well as using insect repellent should be sufficient. And as much as we would probably want to pet/feed a stray dog or a cat, we will not do it. BTW, do you use insect repellant with deet? Thank you so much!
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Old Jan 11th, 2012, 06:17 PM
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Also, great point about a possible need to evacuate - I will definitely check into the med evac insurance. We did it for a trip to Africa and although we did not need it, it provided a piece of mind. Thanks for the reminder!
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Old Jan 11th, 2012, 06:23 PM
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I use a deet-containing repellant with 20-30% deet. The very best is a micro-encapsulated type by Sawyers, as it provides excellent protection without you absorbing the deet through your skin. Sawyers also makes a picardin repellant which works well.
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Old Jan 12th, 2012, 02:18 AM
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I am going to bali next week! 18/1/12 & was advised that rabies vacine which consists of 3 jabs is NOT required by the government, either is malaria. I have been there 3 times & never had a problem. The deet repellient is a must for survival! I just washed it off before sleep every night! I am now looking for a driver as my last one has now a huge van & only wants a family or group & I am travelling solo! if anyone has suggestions of a reasonable driver please let me know!
thanxamill, nancy
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Old Jan 12th, 2012, 05:46 AM
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rose, this discussion is not about what is required by the Indonesian government to visit Bali, it is about what precautions are wise. Totally different issues.

There is a recent post on drivers in Bali as well as many older posts. Use the search function above, or just pull up all the Indonesia posts via the drop down menu and scan them for the recent post on drivers.
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Old Jan 12th, 2012, 08:40 PM
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Thanks again for all the great comments (including the repellent brand name) - much appreciated!
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