Some 44% of the 2600 West Australians who returned from overseas trips with infectious diseases last year had been to Bali, according to WA Health Department figures.
And, almost 4% of all infectious diseases tracked in WA last year were contracted in Bali, with dengue fever (270 cases) the most common, closely followed by gastroenteritis or Bali Belly (500 cases) caused by salmonella or campylobacter bacteria.
Other serious diseases ‘imported’ by travellers returning from Bali last year included Legionnaires' disease, measles, typhus, typhoid fever, hepatitis A, and HIV, WA Health’s medical epidemiologist Gary Dowse announced last week.


Healthy co-operation needed
Rabies remains endemic in Bali. The deadly disease has claimed the lives of at least 150 Balinese in the past three years.
More than 140 West Australians have needed precautionary rabies vaccinations after being bitten or scratched by monkeys, dogs, or other animals while on holiday.
Dr Richard Choong, vice president of the Australian Medical Association (WA), believes the Australian Government needs to act now to ensure our national health is not compromised.
“Almost 400,000 West Australians currently travel to Bali each year and this is growing dramatically," he said in a statement.
“The Federal Government needs to work with Balinese officials to improve health and hygiene standards in Bali.
“We need to look at sharing our skills and knowledge with the Indonesian Government, especially public health officials in Bali, to help reduce the incidences of blood-borne diseases, sexually transmitted diseases, rabies, whooping cough, measles, gastroenteritis, dengue and typhus.”

Imported diseases threaten nation’s health
Dr Choong said the diseases, illnesses and viruses being brought back by travellers have the potential to pose a huge health threat.
“We have seen hundreds of patients after they return from Bali for a range of issues relating to their holiday,” he said.
“These figures are only the tip of the iceberg … these are just the reported cases.
“These patients need treatment for diseases we do not have in Australia, such as rabies, or ones we have worked hard as a nation to eradicate, such as typhus.”

Better outcomes for Aussies and Balinese
There are reasons we have such tight quarantine laws and stringent health and hygiene regulations within Australia, Dr Choong said.
“We do not want these diseases to become endemic in Australia.
We know the potential cost to life, our national food production, and general national wellbeing.
“By working with the Balinese Government to lift standards we create a healthier and safer holiday destination for Australians, which also will provide better outcomes for the Balinese.”

Travellers must be wary – and prepared
Travellers also need to be wary of Bali's limits for providing health care and be responsible for their actions.
While there are no legally required vaccinations, Travelvax recommends that travellers consult with a travel health specialist or their own GP to investigate:
- updating routine and childhood vaccinations 
- vaccine-preventable travel health risks
- food and water-borne illnesses, including Traveller’s diarrhoea (Bali Belly)
- blood and body fluid-borne infections
- the risk of mosquito-borne diseases, such as malaria, dengue fever, Chikungunya fever
- first aid treatment for animal bites
Not only are Aussies travelling more than ever, but we are ditching the familiar for the exotic.
The number of overseas trips Aussies are taking each year has more than doubled in the last decade. We took nearly 8 million overseas journeys in the 12 months to last November, compared with 3.5 million in the year to November 2001, according to a study by Sydney’s Daily Telegraph newspaper.
In addition, Australian Bureau of Statistics data reveals we are travelling increasingly to destinations like Cambodia (up 372%), China (240%) and Brazil (196%), and less to traditional destinations like the UK, Europe and Canada, which hold fewer health risks for travellers.