In the last few days travel medicine has been in the news twice. Firstly a Sydney Morning herald article discussed how few people speak to their doctor prior to going overseas, then at the weekend there was a report in The Age about a young Australian who died in a motorcycle accident in Vietnam.
I feel it is important to know and plan for the health risks you may face when travelling. That’s why we advise people to come to the doctor 6 to 8 weeks before going overseas.
Please remember that the advice in this post is general. If you are going overseas, I strongly advise you to speak to your GP a couple of months prior to your trip.
Don’t ask “what vaccines do I need?” ask “How do I stay healthy on holiday?”
It’s natural that focus often falls to vaccinations, as catching in Australia the illnesses we vaccinate against for travel is almost unheard of. But there’s lots more to it than jabs alone.
Decisions about what vaccinations to get depend on not only the destination, but also the trip: (Will it be remote? Will there be close contact with animals? Are you going on an adventure working in a refugee camp, or is it a resort holiday? Both of those could be in the same country, but would have very different infectious disease risks associated with them) and the person concerned (How old are you? Have you had a full course of childhood vaccinations?) That said, for most destinations other than Europe and USA, there a some vaccines we advise everyone to get, and there are some vaccinations that are mandatory for some destinations (if you don’t get them you could end up being put into quarantine when you try to get back into Australia).
After the vaccinations, the next topic for discussion tends to be malaria, or more accurately, mosquito borne illness. The best way to avoid getting these illnesses is to avoid getting bitten as much as possible. This means covering up with long sleeves and long pants whenever out and about where mosquitoes fly, and using plenty of repellant. In some parts of some countries, the number of mossies is such that we recommend taking medication to minimise the chance of getting malaria. There are 2 types of medication: The type that works on the malaria parasite as soon as it gets into your system, and the type that works on the parasite later in its life-cycle. This is why we advise people to take some of the medication for 4 weeks after leaving the malaria area – these medications don’t kill the malaria bug until a stage in its life-cycle that can be as much as 4 weeks after being bitten.
My comment about trying not to get bitten, whilst obviously not possible to achieve completely, is important for other reasons too. Firstly, bites are uncomfortable and, if you are unlucky, can get infected and interfere with enjoyment of your holiday, and secondly there are more mosquito-borne illnesses than malaria. One that deserves a special mention is Dengue fever. Dengue is a virus, for which there is no vaccine at present, that is spread by mosquitoes. It is currently quite prevalent in South East Asia, and also found in many other parts of the world. It gives fever, headache, rash and severe fatigue and can linger for a long time. Less commonly it can cause internal bleeding and severe illness. This year, having never seen Dengue before, I’ve seen 3 cases.
So now, after talking about vaccine preventable illness and mosquito spread illness, we get onto the stuff that is much more common.
Traveller’s diarrhoea. It’s common and it is not very nice, but it can be treated. You can try to avoid it by eating well cooked food from hygienic places and drinking bottled water, but it is still very common. We often prescribe antibiotics that can be taken overseas and used if you’re unlucky enough to get it, and these tend to work well.
Then there’s the common stuff which sounds simple, but makes up most of the health issues I see that people have got overseas. Sunburn and insect bites are common. Using sunblock is as important as it is over here, and it can be a good idea to have some over-the-counter medications with you to help with these type of ailments. Sexually transmitted diseases are out there too, and no assessment of risks in travelling should ignore them.
I’ll often speak to kids about taking care around animals, as a bite from a not-so-friendly dog or monkey can result in the need for unpleasant injections to avoid the possibility of contracting rabies, an uncommon but universally fatal virus spread through animal bites.
Having said all that, the commonest cause of severe illness and death overseas is pre-existing illness, such as having a heart attack, and the commonest in young people is traffic accidents. This leads to my final 2 points I make when discussing staying healthy on holiday:
1 – PLEASE don’t get on a scooter.
2 – MAKE SURE YOU HAVE TRAVEL INSURANCE.
Sorry to shout.
There is more information available on this Australian Government website. I will link to this site on the main links section of the blog also, as I think it’s really useful.
And on that note, I bid you adieu. I’m off on my holidays! Hurrah!