Does anyone have a view on the current malaria situation in Bali? We're heading out there in November, and I'm struggling to get consistent advice from my doctor or the various websites devoted to malaria hotspots. I'd rather not take the pills if I can avoid it, but I'd much rather not get malaria!

On a related note: is Japanese encephalitis something anyone actually worries about? The vaccine's available in the UK but only via a pretty circuitous route, and I gather it presents minor hazards all of its own. Very grateful for any advice on either issue!

Sean

I find the US travel med website to be more up to date that the British one. Take a look at www.cdc.gov/travel

Do use mosquito repellant, but the risk of malaria is quite low in Bali. Typically no anti-malarial is recommended. Unless you have special health issues, it would be unlikely that yourdoctor would recommend anti-malarials. If you are headed to Lomok, there has been a recent outbreak of malaria there.

As far as JE is concerned, the usual advice is to get the vaccine only if you will be spending one month or more in rural farming areas.

Although the CDC deems Bali a low risk malaria area, interestingly enough, I personally know 2 people who got malaria in Bali 3 years ago and last year respecitively...and they did not stay anywhere but in the south. Still, we did not take antimalarials in Bali on either of our two trips...one reason is we cannot get either Doxy or Malarone in Japan where we live.

We have all had the Japanese Encephalitis vaccine...it is still a common disease in Asia, and kids in Japan are routinely vaccinated for it. I had read that JE was very common in Bali so we all got the vaccine.

Dengue Fever is also a risk. No vaccine.

At least 3 illnesses transmitted by mosquitos...use repellent all the time. We found Balinese mosquitos numerous and hungry.

I would strongly recommend Hepatitis A vaccine. Before going to Bali, we each had 2 off the 3 required doses of this one, which gave us partial immunity. We all got Hep A in Bali, or one of us got it and shared...anyway, my husband learned he had it from his company physical blood test. We knew we were sick, but thought it was just a stomach thing. There is no treatment other than rest really, but the doctor told us that we were lucky to have had the shots even if the series was incomplete, as without the partial immunity we would all have been very ill.

Kim, it's good to remember that low risk is not the same as no risk. I was aware of an outbreak several years go on Bali, but there was a concerted mosquito eradication campaign and the incidence dropped back to being very low. But obviously, there is still some.

And of course, you are quite right about the Hep A vaccine. I think one should have it even if you're staying home!

Yes, I know low risk is not no risk, which is why I mentioned my friends' experience...I think it is very easy to be complacent if the risk is "low," although we should be quite diligent in fact.

My imunoligist said Bali is fine but urged a spray with at leasy 50% DEET on both exposed areas and a little on clothes. She suggested 2 times a day. She said that even 50% DEET is NOT harmful for 4-5 days if not overused. In fact for Borneo she wanted us to use 90% DEET but only for the 2 and 1/2 days we were there.But because of Borneo we took anti-malaria pills before, during and 3 days after we returned to the US.