Preventive health advice for Australian travellers to Bali

Five hundred travellers to Bali were surveyed with a predeparture questionnaire to assess the source and nature of health advice for international travel that is provided to Australian tourists. Eighty-seven per cent of travellers received some health advice for travel from either their family doctor, travel agent or both. Eighty-nine per cent of travellers were advised to be immunized against typhoid and 75% of travellers were advised to receive a cholera vaccination; the proportion of travellers who underwent such therapy was the same irrespective of the standard of their accommodation in Bali or their likely risk of exposure to these infections. A gamma-globulin injection was recommended to 18% of travellers and tetanus vaccine was recommended to 35% of travellers. General antimalarial measures were discussed with 59% of travellers, and 88% of travellers were advised to take antimalarial medications. Combined prophylaxis with chloroquine and a sulpha drug (usually dapsone--pyrimethamine [Maloprim]) was recommended most frequently (39% of travellers), with chloroquine alone (27% of travellers) or a sulpha drug alone (14% of travellers) also being prescribed commonly. A history of drug allergy was sought in 46% of the travellers who were advised to take antimalarial agents, and 41% of travellers were informed of possible side-effects of the antimalarial drugs. This survey showed that health advice about predeparture immunizations and antimalarial prophylaxis frequently differs from current recommendations of the Commonwealth Department of Community Services and Health and the World Health Organization.