Bali health authorities are warning about a sharp increase of dengue fever cases on the popular tourist island, with almost 40 deaths reported since the beginning of this year.
Mayors across Bali have been warned to take steps to eliminate nests of mosquitoes after several districts, including provinces that house the popular tourist hot spots of Kuta and Seminyak, have seen a spike in numbers of the mosquito-borne viral infection.
"The increase in those areas are quite sharp ... The one in Gianyar (near Ubud) especially, the incident is quite high," Wayan Pujana from the Bali Health Office told AAP on Wednesday.
Thirty-eight people have died as a result of dengue between January and April in Bali alone - a sharp increase from last year when the death toll stood at 29 for the whole 12-month period.
Meanwhile there have been 7,794 cases of dengue in first four months of this year, in comparison to 10,700 cases across last year in Bali.
Wayan pointed to several potential causes for the increase, including climate change that has made the timing of the wet and dry seasons unpredictable.
"If in the whole year there's rain with intermission of dry season, that's the most favourable condition for vector breeding."
Greater mobility of the population has also seen strains of the virus move across the country more quickly - particularly from densely populated Java - causing people to be reinfected.
The destruction of Bali's rice paddy fields in favour of housing could also play a role, he said.
But it's not all bad news. Denpasar which experienced the highest incidence of dengue fever on the island in 2013 and 2104 has seen decreasing infection numbers.
Through large-scale "fogging" and the elimination of mosquito nests by digging, burying and covering them the city has a "success story" to share.
Wayan said people need to be vigilant by frequently draining and covering water containers, such as in basins, plant pots and animal drinking bowls.
While Bali health officials cannot say if any foreigners have been infected, travel advice by the Department of Foreign Affairs and Trade warns that Australian Health authorities "have observed an increase in the number of dengue virus infections in returned travellers from Bali".
Dengue causes flu-like illness, and occasionally develops into a potentially lethal complication called severe dengue.
According to the World Health Organisation, global incidence of dengue has grown dramatically in recent decades with about half of the world's population now at risk.
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