News

10-01-2018

Overseas travel brings great experiences, but has some significant health risks, simple steps such as researching destinations and seeing your GP or Travel Dr for health advice before your trip and getting comprehensive travel insurance are important to reduce the risk of an unexpected illness or complication. Current issues for travellers are:

1. Measles

Measles remains endemic in many countries around the world, with currently large outbreaks in Europe, Italy, Romania and Germany being the worst affected countries. The MMR vaccine is available to all adults who have not had their two doses and children from nine months of age .

2. Insect Bourne Diseases

Many serious infections transmitted by insect bites are currently increasing worldwide, some have no treatment or vaccine and bite avoidance is the mainstay for prevention. A repellent containing up to 50 percent N,N-diethylmetatoluamide ( DEET) should be used on exposed skin, together with light cover-up clothing. If sunscreen is needed, using the DEET repellent reduces the SPF rating of the sunscreen and should not be used in products combining both sunscreen and insect repellent for the same reason.  The mosquitoes transmitting disease are unlikely to be found at altitudes above 2000 metres.

3. Yellow Fever

Since December 2016, a Yellow Fever outbreak has been ongoing in Brazil, the risk areas have expanded to include Rio de Janiro and parts of Sao Paulo states. Yellow fever is transmitted by mosquitoes and insect bite avoidance measures are strongly advised for day and night and the vaccination recommended for those travelling to Brazil and other areas of known risk for the disease. One dose of the yellow fever vaccine provides life long protection against the disease.

4. Dengue

Dengue infection is caused by mosquitoes which predominantly feed between dawn and dusk in urban and semi-urban areas. Symptoms include high fever, muscle and joint pains, headache, nausea and rash. Most cases are acquired in Asia, Western Pacific, the Americas, Africa, Eastern Mediterranean and the Caribbean.  The number of cases reported world-wide is growing dramatically according to the WHO. There is no vaccine or treatment available and travellers are advised to follow strict insect bite avoidance to reduce their risk of infection

5. Zika

Zika virus infection is transmitted by mosquitoes who mainly fed between dawn and dusk and a small number of cases have been reported as sexually transmitted and transmission from mother to fetus via the placenta. When symptoms do occur they are generally mild and short-lived such as fever, headache, red sore eyes and conjunctivitis, joint and muscle aches and a rash. There is now scientific consensus that zika virus is a cause of congenital Zika syndrome ( microcephaly and other congenital abnormalities) and Guillain-Barre syndrome. It is found in parts of Africa, Asia, the Pacific Islands, Central and South America and is likely to spread to new areas in the future. 

The WHO and the US CDC and the European CDC developed a revised ZIKV country classification scheme, published in March 2017. There continues to be differences in travel advice worldwide as public health authorities and policy makers in different countries have used the new WHO categories differently to determine their recommendations.    Those who are pregnant or planning a pregnancy are recommended to delay or change their travel plans to areas designated as moderate or high risk until after pregnancy ,

Male travellers who have pregnant partners are advise to use condoms or other barrier methods to reduce the risk of transmission during travel and for the duration of the pregnancy even if asymptomatic. Those who are planning a pregnancy are advised to use barrier methods for six months after return from the Zika risk area.

Female travellers are advised to avoid pregnancy during travel and for 8 weeks after the last possible ZIKV exposure. If you are pregnant and have travelled to a ZIKV high or moderate risk area while pregnant, you should seek advice from your GP on your return, even if you had not been unwell to discuss further evaluation

Anyone who is planning a pregnancy can be offered advice by their GP about the possibility of testing to help exclude zika virus infection if there are concerns about the consequences of delaying pregnancy for the recommended time periods.

Risk ratings for countries are reviewed on a regular basis and available at who.int for zika virus country classification table or  travelhealthpro.org.uk or smartraveller.gov.au

6. Malaria

Malaria is also a mosquito-bourne disease caused by a parasite. Those affected develop fever, chills and flu-like symptoms. If left untreated severe complications can develop including death. In 2016 it is estimated that 216 million cases of malaria occurred and 445,00 deaths as a result of the infection.   The WHO released their World Malaria report in late November 2017. Malaria incidence had been decreasing between 2010 and 2016, but showed no decrease since then, particularly in the Americas, SouthEast Asia, Africa and Western pacific areas. There are country and location specific guidelines and individual travellers are advised to see their GP or Travel Dr  for advice tailored to the individual taking into account the type of accommodation planned, season, style of travel and health conditions. The malaria Information by country is available at cdc.gov website, Malaria Maps

Some countries including those with malaria risk sell drugs that are counterfeit or substandard as prophylaxis. Antimalarials should be purchased before travelling overseas.

7. Cruising

The interest in cruising is increasing at a rapid rate internationally and destinations are also including more adventure activities such as sampling local specialities or rock climbing. It is common for travellers to not arrange a health check before leaving, but as the variety of experiences increase,  Tetanus boosters, MMR boosters and Hepatitis A vaccination is strongly recommended for travellers and a physical check-up for fitness if more activities are planned.

Medicare benefits are only payable to cruise passengers travelling between two Australian ports with no stops outside Australia, and only if the services are provided by an accredited Medicare provider ( the Cruise operator can tell you whether a medicare-accredited doctor will be available)

Noro virus is a common cause of severe diarrhoea and vomiting, and is estimated to cause 90% of gastroenteritis outbreaks on cruise ships and is common in the general in the community.. It is a highly contagious virus from contaminated food, surfaces or infected person. The recommendations to reduce risk include strict attention to hand washing particularly before touching food and after using the bathroom. 

8. Other Infectious Diseases:

The level of HIV/AIDS infection and other sexually transmitted diseases continues to increase world-wide including risk associated with tattoos, piercings, volunteering in a health care facility as well as unprotected sex.

New infectious diseases appear and spread rapidly. The smartraveller website provides up to date travel advice for your destination before departure

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