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Bali’s escalating cases of acute encephalitis syndrome underscore the pressing need for Japanese encephalitis (JE) vaccination. This precaution is crucial for travellers planning a month or more in endemic areas during the JE virus transmission season, encompassing both urban and rural zones. Notably, the risk is deemed negligible for short visits to urban areas.

While JE vaccination isn’t routinely recommended for those spending less than a month in endemic regions, the potential for acquiring JE within this timeframe warrants consideration. Particularly, travellers should contemplate vaccination if their visit aligns with the wet season, involves ongoing travel to at-risk areas, includes extensive outdoor activities, or entails stays in accommodations lacking air-conditioning, screens, or bed nets.

The local scenario in Bali, with up to 92% of children exhibiting antibodies against the virus and the presence of infected international travellers, emphasizes the need for proactive measures. The vaccination program initiated by the Indonesian government aligns with global recommendations to safeguard both locals and international visitors. In the intricate web of factors contributing to JE transmission, vaccination emerges as a critical tool, especially for travellers engaging in activities that heighten the risk of exposure.

As Bali navigates the complex interplay of sociocultural practices, ecological factors, and disease transmission, JE vaccination becomes a linchpin in public health efforts. By adhering to recommended guidelines, travellers can fortify their defences against this potentially severe illness, ensuring a safer and more secure exploration of the enchanting landscapes Bali has to offer.


Australian Immunisation Handbook, https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/japanese-encephalitis#recommendations , Last accessed 16.11.2023.

Kardena IM, Adi AAAM, Astawa NM, O’Dea M, Laurence M, Sahibzada S, Bruce M. Japanese encephalitis in Bali, Indonesia: ecological and socio-cultural perspectives. Int J Vet Sci Med. 2021 Sep 16;9(1):31-43. doi: 10.1080/23144599.2021.1975879. PMID: 34589543; PMCID: PMC8451599.

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