Surge of Dengue Virus Infection and Chikungunya Fever in Bali in 2010: The Burden of Mosquito-Borne Infectious Diseases in a Tourist Destination

Abstract

Labor flow and travelers are important factors contributing to the spread of Dengue virus infection and chikungunya fever. Bali Province of Indonesia, a popular resort and tourist destination, has these factors and suffers from mosquito-borne infectious diseases. Using area study approach, a series of fieldwork was conducted in Bali to obtain up-to-date primary disease data, to learn more about public health measures, and to interview health officers, hotel personnel, and other resource persons. The national data including information on two other provinces were obtained for comparison. The health ministry reported 5,810 and 11,697 cases of dengue hemorrhagic fever in Bali in 2009 and 2010, respectively. Moreover, two densely populated tourist areas and one district have shown a particularly high incidence and sharp increases in 2010. Cases of chikungunya fever reported in Bali more than doubled in 2010 from the previous year. Our findings suggest that Bali can benefit from a significant reduction in vector populations and dissemination of disease preventive knowledge among both local residents and foreign visitors. This will require a concerted and trans-border approach, which may prove difficult in the province.

Mosquitoes established in Lhasa city, Tibet, China

“…Tourist aircraft or trains may carry mosquitoes to urban Lhasa and subsequently threaten the health and lives of local citizens. It was reported that labor flow and travelers are significant factors contributing to the spread of dengue virus infection and chikungunya fever [62]. …”

The Bilateral Relationship Between Tourism and Dengue Occurrence: Evidence From Aruba

“…(Suaya et al, 2007). Yoshikawa and Kusriastuti (2013) showed that the average cost related with one case of dengue in Malaysia would be US$445 of the government health care budget being spent on the disease. In Thailand, it was estimated in 2005 at US$573 for non-fatal hospitalization of dengue infection.…”

“…Tourist destinations can be either positively or negatively influenced by climate variability that induces climate anomalies that influence a tourist's comfort, safety, and the products that attract tourists or deter tourists, such as infectious diseases (Scott, Lemieux, & Malone, 2011). A downturn in tourism demand, during epidemics, can cause a negative effect on the local economy (Yoshikawa & Kusriastuti, 2013). Vector-borne diseases such as dengue and malaria can induce epidemics, which could influence tourism demand.…”

An interdisciplinary study: disseminating information on dengue prevention and control in the world-famous travel destination, Bali, Indonesia

“…Dengue virus (DENV) infection is the most rapidly spreading mosquito-borne infectious disease in the world today. The disease is endemic in many popular travel destinations in tropical and subtropical countries (Wilder-Smith and Schwartz 2012), including Hawaii, the USA (Effler et al 2005;Johnston 2016) and Bali, Indonesia (Yoshikawa and Kusriastuti 2013). The influence of cruise tourism on the incidence of DENV infection in Aruba, in the Caribbean, has also been noted (Oduber et al 2014).…”

“…The social burden of diseases can be heavy if a large portion of the community or a labour force misses work. Key family members may become unable to provide care for children and the elderly (Ng and Hapuarachchi 2010;Yoshikawa and Kusriastuti 2013).…”