Dengue, rabies and Bali belly: staying well

The things most likely to put you in a Bali hospital are small: a dog's tooth, a mosquito, a bad drink and a dodgy prawn.

The short version

Rabies is present throughout Indonesia, including Bali, and once symptoms start it's fatal. Talk to your GP about the pre-exposure vaccine before you move [1][2].
After any bite or scratch from a dog, cat or monkey: wash it for 15 minutes, then get to a clinic the same day [3].
Dengue is a year-round risk. Bali's health department recorded more than 10,000 cases in 2025 [5]. A vaccine, Qdenga, is now available in Australia [6][7].
Methanol in poor-quality alcohol, including arak, has killed and blinded people in Bali. Drink sealed, branded drinks from licensed venues [1].
Bali belly is common. Drink bottled or properly filtered water, and be choosy about ice and seafood [1].

How this differs from home

Australia is free of terrestrial rabies, so most of us grew up patting any dog that wagged at us. In Bali, that habit can kill you. Dengue exists in north Queensland, but most southern Australians have never had to think about it. And at home, a cocktail is a cocktail; in Bali, Smartraveller warns that a single shot of methanol-laced spirit can be fatal [1].

Indonesia also has no reciprocal health agreement with Australia, so every clinic visit, vaccine course and hospital stay comes out of your pocket or your insurer's [1]. Prevention is the cheap option.

Rabies: the one you can't gamble on

Bali's first rabies outbreak was in 2008. Since then the province has run mass dog vaccinations and awareness campaigns, aiming for at least 70% vaccination coverage, the level needed to stop transmission. Human cases have fallen a lot, but bites and suspected rabid animals still turn up across the island [3].

Smartraveller says rabies in Indonesia is mainly spread by dogs, cats and monkeys, though any mammal can carry it, and that treatment may be limited, with the vaccine not available everywhere. You may need to come home to Australia or go to another country for urgent treatment [1].

Should you get the jab before you move?

Australia's Immunisation Handbook says pre-exposure vaccination (PrEP) should be considered for people travelling to or living in places with rabies, after a risk assessment that weighs animal contact and access to emergency care. Parents should also consider it for younger children [2], who may not tell you about a scratch or a lick on broken skin.

For residents, the case is strong. Here's why it matters:

	Vaccinated before the bite	Never vaccinated
Vaccine doses after a bite or scratch	2 doses, days 0 and 3	4 doses, days 0, 3, 7 and 14
Rabies immunoglobulin (RIG)	Not needed	Needed for bites that break the skin
Pressure if RIG is hard to find	Low	High: you may have to fly out to get it

Figures for healthy adults, from the Australian Immunisation Handbook [2].

That RIG line is the real point. The Handbook notes that rabies immunoglobulin is difficult to obtain and expensive in many countries with rabies, and its safety can't always be guaranteed [2]. Pre-exposure vaccination takes RIG off the table.

The usual course is two or three visits over three to four weeks, so start it well before you fly [2]. It's not on the free national program for travellers, so ask your GP or a travel clinic for a quote.

What to do after a bite or scratch

Wash the wound with soap and running water for at least 15 minutes [3]. Then apply an antiseptic such as povidone-iodine if you have it [2].
Go to a clinic or hospital the same day, even if it's "just a nip" from a monkey at Uluwatu or the Sacred Monkey Forest [1][3].
Start the post-exposure vaccine course and ask whether you need RIG [3].
Ask for a written record: vaccine brand and batch, any RIG product and batch, and the dates. Your GP in Australia needs it to finish the course [2].
Report the animal to local authorities or the banjar so it can be watched [3].
Call your insurer if you're told to leave Bali for treatment [1].

Bites on the head or neck are the most urgent [2]. Don't wait to see whether the dog gets sick.

Living with dogs and monkeys

Don't feed or pat street dogs, including the friendly beach regulars.
At temples and monkey forests, keep food, sunnies and phones out of sight.
Teach kids to stand still and back off rather than run.
If you adopt a local rescue dog, keep its rabies vaccine current. Our pets guide covers the rules.

Dengue: the mosquito that bites by day

Dengue is spread by Aedes mosquitoes, which bite during the day, especially just after sunrise and before sunset [4]. Local media, quoting Bali's health department, reported 10,391 cases and 14 deaths on the island in 2025, down from 15,570 cases in 2024. Badung, home to Canggu, Seminyak and Kuta, had the most cases, followed by Gianyar, which includes Ubud [5].

Australian health authorities have reported dengue in travellers returning from Bali, as well as Japanese encephalitis [1]. Cases tend to rise in the wet season, but treat it as a year-round risk.

Symptoms and the ibuprofen trap

Symptoms usually appear 4 to 10 days after the bite: sudden fever, a headache behind the eyes, aching muscles and joints, nausea and sometimes a rash [4]. Warning signs of severe dengue, such as severe stomach pain, persistent vomiting or bleeding gums, can start 3 to 7 days in. That's a hospital trip, now [4].

Use paracetamol, not ibuprofen or aspirin, which can increase bleeding risk [4]. And if you've had dengue before, a second infection carries a higher risk of severe disease [4].

The vaccine

The TGA approved Qdenga on 2 June 2026, for people aged four and over [6]. It's two doses, at least 12 weeks apart [4]. It isn't on the PBS or the national program, so you pay privately, and it doesn't replace repellent [6]. There are medical exclusions, including pregnancy and some immune conditions, so it's a conversation with your GP [6].

Keeping mosquitoes out of the villa

Use repellent with DEET, picaridin or oil of lemon eucalyptus on exposed skin [4].
Tip out standing water weekly: pot plant saucers, offering trays, buckets, blocked gutters [4].
Screens, air conditioning or nets in bedrooms [4].
Ask your landlord about fogging if your banjar does it.

Methanol: the cocktail risk

Methanol can be added to, or accidentally created in, cheap or homemade alcohol. Smartraveller says drink poisoning has been reported in Bali and Lombok, and that the traditional rice spirit arak has caused deaths and serious illness [1].

Stick to branded, sealed drinks at reputable, licensed venues [1].
Be wary of bargain cocktails and "free" shots, and don't rely on labels [1].
Symptoms can look like drunkenness but are usually stronger: vision problems, confusion, severe headache, vomiting. Get to hospital fast and tell staff you suspect methanol [1].

Bali belly: water, ice and food

Smartraveller says waterborne, foodborne and parasitic diseases are widespread in Indonesia, with serious outbreaks [1]. Most Bali belly is a few miserable days, but some cases need a doctor.

Water: don't drink the tap. Use sealed bottled water, refill gallons from a known supplier, or a proper filter system. Brush your teeth with it too.
Ice: busy cafés and restaurants usually buy factory-made ice; ice of unknown origin at a roadside stall is more of a gamble.
Food: go for busy places with high turnover. Be careful with seafood, which can carry toxins [1].
Rehydrate: oral rehydration salts from any apotek. See a doctor for blood in your stool, high fever or if you can't keep fluids down.

Smartraveller recommends a doctor or travel clinic check-up and vaccines before you go [1]. Ask specifically about hepatitis A and typhoid, and make sure routine vaccines are up to date.

Your before-you-go list

Travel clinic appointment six to eight weeks before you move.
Rabies PrEP, and talk about Qdenga, hepatitis A and typhoid [2][6].
Keep vaccine records on your phone.
Pack repellent, ORS sachets and paracetamol.
Check your insurance covers vaccine-related care and evacuation [1].

Not sure which clinic in your area stocks rabies vaccine this month? Join Cooee Indonesia, our Facebook group for Australians in Indonesia, and ask the people who've just had their shots.

Dengue, rabies and Bali belly: staying healthy when you live on the island