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Travel Medical Advice for Indonesia

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Preparing for Your Trip to Indonesia

Before visiting Indonesia, you may need to get the following vaccinations and medications for vaccine-preventable diseases and other diseases you might be at risk for at your destination: (Note: Your doctor or health-care provider will determine what you will need, depending on factors such as your health and immunization history, areas of the country you will be visiting, and planned activities.)

To have the most benefit, see a health-care provider at least 4–6 weeks before your trip to allow time for your vaccines to take effect and to start taking medicine to prevent malaria, if you need it.

Even if you have less than 4 weeks before you leave, you should still see a health-care provider for needed vaccines, anti-malaria drugs and other medications and information about how to protect yourself from illness and injury while traveling.

CDC recommends that you see a health-care provider who specializes in Travel Medicine.  Find a travel medicine clinic near you. If you have a medical condition, you should also share your travel plans with any doctors you are currently seeing for other medical reasons.

If your travel plans will take you to more than one country during a single trip, be sure to let your health-care provider know so that you can receive the appropriate vaccinations and information for all of your destinations. Long-term travelers, such as those who plan to work or study abroad, may also need additional vaccinations as required by their employer or school.

Although yellow fever is not a disease risk in Indonesia, the government requires travelers arriving from countries where yellow fever is present to present proof of yellow fever vaccination. If you will be traveling to one of these countries where yellow fever is present before arriving in Indonesia, this requirement must be taken into consideration.

Be sure your routine vaccinations are up-to-date. Check the links below to see which vaccinations adults and children should get.

Routine vaccines, as they are often called, such as for influenza, chickenpox (or varicella), polio, measles/mumps/rubella (MMR), and diphtheria/pertussis/tetanus (DPT) are given at all stages of life; see the childhood and adolescent immunization schedule and routine adult immunization schedule.

Routine vaccines are recommended even if you do not travel. Although childhood diseases, such as measles, rarely occur in the United States, they are still common in many parts of the world. A traveler who is not vaccinated would be at risk for infection.

Vaccine-Preventable Diseases

Vaccine recommendations are based on the best available risk information. Please note that the level of risk for vaccine-preventable diseases can change at any time.

Vaccination or Disease Recommendations or Requirements for Vaccine-Preventable Diseases
Routine  Recommended if you are not up-to-date with routine shots such as, measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, poliovirus vaccine, etc.
 
Hepatitis A or immune globulin (IG) Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection (see map) where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors.
 
Hepatitis B  Recommended for all unvaccinated persons traveling to or working in countries with intermediate to high levels of endemic HBV transmission (see map), especially those who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident).
 
Typhoid  Recommended for all unvaccinated people traveling to or working in Southeast Asia, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water.

Rabies  Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking. Also recommended for travelers with significant occupational risks (such as veterinarians), for long-term travelers and expatriates living in areas with a significant risk of exposure, and for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. 

Japanese encephalitis  Recommended if you plan to visit rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis, see country-specific information.

Malaria

Areas of Indonesia with Malaria: Present in rural Sumatra, Sulawesi, Kalimantan (Borneo) and Nusa Tenggara Barat (includes island of Lombok)

All areas of eastern Indonesia (provinces of Papua Indonesia, Irian Jaya Barat, Nusa Tenggara Timur, Maluku, and Maluku Utara).

None in Jakarta, resort areas of Bali and the island of Java, except for the Menoreh Hills in central Java. None in urban areas in Sumatra, Kalimantan, Nusa Tenggara Barat and Sulawesi.

If you will be visiting an area of Indonesia with malaria, you will need to discuss with your doctor the best ways for you to avoid getting sick with malaria. Ways to prevent malaria include the following:

Taking a prescription antimalarial drug

Using insect repellent and wearing long pants and sleeves to prevent mosquito bites
Sleeping in air-conditioned or well-screened rooms or using bednets
All of the following antimalarial drugs are equal options for preventing malaria in Indonesia: Atovaquone/proguanil, doxycycline, or mefloquine. For information that can help you and your doctor decide which of these drugs would be best for you, please see Drugs to Prevent Malaria.

Note: Chloroquine is NOT an effective antimalarial drug in Indonesia and should not be taken to prevent malaria in this region.

To find out more information on malaria throughout the world, you can use the interactive CDC malaria map. You can search or browse countries, cities, and place names for more specific malaria risk information and the recommended prevention medicines for that area.

Malaria Contact for Health-Care Providers

For assistance with the diagnosis or management of suspected cases of malaria, call the CDC Malaria Hotline: 770-488-7788 (M-F, 9 am-5 pm, Eastern time). For emergency consultation after hours, call 770-488-7100 and ask to speak with a CDC Malaria Branch clinician.

A Special Note about Antimalarial Drugs

You should purchase your antimalarial drugs before travel. Drugs purchased overseas may not be manufactured according to United States standards and may not be effective. They also may be dangerous, contain counterfeit medications or contaminants, or be combinations of drugs that are not safe to use.

Halofantrine (marketed as Halfan) is widely used overseas to treat malaria. CDC recommends that you do NOT use halofantrine because of serious heart-related side effects, including deaths. You should avoid using antimalarial drugs that are not recommended unless you have been diagnosed with life-threatening malaria and no other options are immediately available.

For detailed information about these antimalarial drugs, see Information for the Public: Prescription Drugs for Malaria.

More Information About Malaria

Malaria is always a serious disease and may be a deadly illness. Humans get malaria from the bite of a mosquito infected with the parasite. Prevent this serious disease by seeing your health-care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites (see below).

Travelers to malaria risk-areas in Indonesia, including infants, children, and former residents of Indonesia, should take one of the antimalarial drugs listed above.

Symptoms

Malaria symptoms may include

fever
chills
sweats
headache
body aches
nausea and vomiting
fatigue
 
Malaria symptoms will occur at least 7 to 9 days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, you should see a doctor right away if you develop a fever during your trip.

Malaria may cause anemia and jaundice. Malaria infections with Plasmodium falciparum, if not promptly treated, may cause kidney failure, coma, and death. Despite using the protective measures outlined above, travelers may still develop malaria up to a year after returning from a malarious area. You should see a doctor immediately if you develop a fever anytime during the year following your return and tell the physician of your travel.

Other Diseases Found in Southeast Asia

Risk can vary between countries within this region and also within a country; the quality of in-country surveillance also varies.

The following are disease risks that might affect travelers; this is not a complete list of diseases that can be present. Environmental conditions may also change, and up to date information about risk by regions within a country may also not always be available.

Dengue, chikungunya, filariasis, Japanese encephalitis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites (see below) will help to prevent these diseases.

Highly pathogenic avian influenza (H5N1) continues to cause outbreaks in domestic and wild bird populations and has caused human cases in several countries in Southeast Asia. In 2006, the virus continued to spread in poultry populations in Indonesia.  Avoid all direct contact with birds, including domestic poultry (such as chickens and ducks) and wild birds, and avoid places such as poultry farms and bird markets where live birds are raised or kept.  For a current list of countries reporting outbreaks of H5N1 among poultry and/or wild birds, view updates from the World Organization for Animal Health (OIE), and for total numbers of confirmed human cases of H5N1 virus by country see the World Health Organization (WHO) Avian Influenza website.

Do not swim in fresh water (except in well-chlorinated swimming pools) to avoid infection with schistosomiasis. Leptospirosis, a bacterial infection often contracted through recreational water activities in contaminated water, such as kayaking, is common in tropical areas of Southeast Asia. (For more information, please see Swimming and Recreational Water Safety.) An outbreak was reported in Borneo among expedition travelers in 2000.

Measles transmission persists in the region, although vaccination coverage is improving in some countries in Southeast Asia.  Influenza infections can occur throughout the year in tropical areas.

Polio resurfaced in Indonesia in 2005.  Imported cases in neighboring countries have occasionally occurred.

For more information, see the Geographic Distribution of Potential Health Hazards to Travelers and Goals and Limitations in determining actual disease risks by destination.

After You Return Home

If you are not feeling well, you should see your doctor and mention that you have recently traveled. Also tell your doctor if you were bitten or scratched by an animal while traveling.

If you have visited a malaria-risk area, continue taking your antimalarial drug for 4 weeks (doxycycline or mefloquine) or seven days (atovaquone/proguanil) after leaving the risk area.

Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the physician your travel history.

Important Note: This document is not a complete medical guide for travelers to this region. Consult with your doctor for specific information related to your needs and your medical history; recommendations may differ for pregnant women, young children, and persons who have chronic medical conditions.

Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Security Website concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked. 


You can also check out the Travel Security Advice for Indonesia HERE......

The UK Foreign & Commonwealth Office also has information regarding travel to Indonesia HERE.....

There is also a Malaria Travel warning for Indonesia HERE......

Regards

The SW Team......