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here for 1 page pdf ... see also consular advice
www.smartraveller.gov.au/zw-cgi/view/Advice/Indonesia & www.bali.indonesia.embassy.gov.au/
is probably the most popular overseas travel destination for Australians of all
ages. Studies have shown that illness occurs in between 15 - 55% of all
travellers with 11% requiring to see a doctor whilst away.
phrase “Travel broadens the mind and loosens the bowels.” is apt but it
should also be remembered that less common serious diseases do occur, which can
completely ruin ones holiday and even be life threatening. Remember
that ultimately your health is your responsibility.
coastal resorts such as Kutu and large hotels have a high standard of sanitation
and safe water supply but remember most people working in them and handling the
food do not.
episodes of diarrhoea are short-lived and require no particular treatment The
need to treat diarrhoea depends on either its severity or persistence.
Transmission is mostly via contaminated food or water.Vaccination with oral cholera vaccine (Dukoral) will reduce the incidence of one form of E Coli travellers diarrhoea (LT-ETEC) by 60% but this only accounts for 20% of traveller diarrhoea cases**. More recently Travelan® capsules containing antibodies that bind the ETEC bacteria has been shown to be more successful for these bacteria. www.Travelan.com.au The WHO have a good pamphlet copy
Choose food which is
freshly and thoroughly cooked and served stemming hot
Eat fruit or vegetables
that you can peel or cut open yourself, eg. banana, citrus fruits, papaya.
Dry foods and Breads are
Canned and bottled
drinks are safe.
Avoid milk, ice cream
and other milk products unless made with pasteurised (or boiled) milk.
Avoid sauces, mousses,
Avoid smorgasbord even
in 5 star restaurants (reheated foods & food sitting at room
Avoid prawns, oysters,
fish, unless thoroughly cooked.
Avoid uncooked leafy
vegetables, eg. in salads.
Ice is only as safe as
the water it is made from.
Because diarrhoea is so common
it is important to be aware of how to manage it if prevention fails.
travellers do not develop dehydrating diarrhoea; almost any beverage coupled
with a source of salt (eg., salted crackers) suffices for hydrating most ill
travellers Bottled or canned beverages, tea, broth, foods such as rice, bananas,
papaya (papaw), potatoes and dry biscuits are tolerated best.
(‘stoppers’). Since most diarrhoeal illnesses last only a few days, these drugs may
be very helpful in relieving diarrhoea and cramps. Do not use if high fever
or blood in motions. Do not use in children under 6, and be cautious in
children under 12. Adult
Dosage: loperamide (Imodium) -2 capsules (each 2 mg) followed by 1 cap
after each unformed stool. (maximum 8 caps per day.)
Diarrhoea with high fever, distressing symptoms or blood in motions; A
single dose of two tablets of any of the following drugs should be
response is not dramatic after 12 hours continue 1 tab twice a day for a
further 3 days. (Ciprofloxacin 500mg, norfloxacin 400mg, doxycycline 100mg,
without fever . A bowel parasite “giardiasis” is the commonest cause. The best
treatment is tinidasole (Fasigyn) - 4 x 500mg tablets (2g) in a single dose.
Prolonged diarrhoea with
fever .Seek medical help.
with diarrhoea are of special concern.
The younger the child, the more rapidly dehydration can occur. A child’s fluid
loss is best replaced with an oral rehydration solution (ORS) such as Gastrolyte. Adults travelling with young children should carry ORS sachets with them.
If ORS is not available, use one of the following:
Resort, Urban Areas
& Day trips Minimal risk and antimalarial
drugs not recommended. The use of insect repellents is recommended, as this will
also minimise the risk of other diseases from bites such as Dengue.
Inland Forested areas The benign vivax form of malaria exists and is sensitive to Chloroquine.
Dengue is a viral disease producing
Severe headache, bone & muscle pain, high fever and rash usually occur 4-6
days after an infected bite.
Rabies: Bali was Rabies up until August 2008
(illness is 100% fatal to humans) mostly acquired from dogs, cats & monkeys (even minor scratch, graze or lick). Incubation period 10 days to 10 years
Rabies risk management:
You should wash the wound immediately with soap and water and disinfect with iodine (betadine). Seek medical
attention if risk seems high. (unprovoked attack, irritable animal) and have post-exposure vaccine as soon as
possible (preferably within 48 hours). Otherwise at least seek medical advice on return. see Vic gov reference
Kit: Panadol, sunscreens, sunburn
cream, antihistamines, antiseptic (Betadine), antifungal (tinea and thrush),
diarrhoea medications (antibiotic, gastrolyte if taking children), bandages and
and Humidity: Plenty of drinks rich
in mineral salts (fruit and vegetable juices, clear soups and even a little
table salt) are recommended. Daily showering, loose cotton clothing and talcum
powder will reduce heat rash. Risk of severe sunburn needs consideration.
Shoewear: Shoes should be examined before use - as snakes tend to rest in them. ...
Leather goods made from inadequately treated skins may contain anthrax spores
causing life threatening skin sores.
Prevention: Traffic accidents are a
leading cause of accidents among travellers. Vehicles are often unroadworthy.
Unfamiliarity with roads, poor condition of roads and drunk drivers add to the
dangers. Kuta beach in Bali is considered a dangerous beach for swimming and on
average 6 tourists drown each year.
Insurance: Travel insurance should cover
not only medical & hospital expenses but also costs due to general
accidents, medical evacuation, loss of luggage & money, as well as delays
due to strikes.
Examination after travel: It is advisable (if not essential) to visit your
local doctor promptly if you
- suffer from a chronic disease, such as cardiovascular disease, diabetes
mellitus, chronic respiratory disease;
- experience illness in the weeks following their return home, particularly
if fever, persistent diarrhoea, vomiting, jaundice, urinary disorders, skin
disease or genital infection occurs;
- consider that you may have been exposed to a serious infectious disease while
- have spent more than 3 months in a developing country.
** page 203, Manual of Travel Medicine
Information mostly taken from: "International
Travel and Health" (WHO year book -
Australian Immunisation Handbook, 8th Edition - 9/2003 - Part1 - Part 2 & Part 3 (large pdf
Centre for Disease Control, USA - www.cdc.gov/travel Travel Health Seminar Oct 96, June 97,Feb 98, March 99, May 2000, August 2002 &
March 2005 - Victorian Medical Postgraduate Foundation.
Manual of Travel Medicine,
Melbourne, Oct 2004.
Updated 3rd edition 2011. Additional references & disclaimer.
August 24, 2014