Daily Bulletin


The Conversation

  • Written by Irani Thevarajan, Honorary Fellow Nossal Institute for Global Health and Infectious Diseases Physician, University of Melbourne

So your well-earned holiday is finally here. But before you pack your swim gear, magazines and camera, take a moment to think about your health.

Experiencing an illness in a foreign destination can be very challenging. Obviously it will reduce the quality of your trip, but it can also leave travellers with unexpected costs and exposed to a foreign medical system. On occasion, serious complications can follow.

More than nine million Australians travel internationally per year, with most trips undertaken by people between the ages of 25 and 55. The top ten most popular destinations for Australians are New Zealand, Indonesia, the USA, UK, Thailand, China, Singapore, Japan, Fiji and India.

A range of new health problems can be encountered during travel, and existing health problems can be exacerbated. Staying healthy is all about being informed, prepared and sensible.

The leading causes of infection-related illness during travel are travellers’ diarrhoea, respiratory infections and infections transmitted by mosquitoes.

Minimise your chances of experiencing these by following a simple ABCDE.

A: Allow time to prepare

Around popular holiday periods, it pays to allow plenty of time to book an appointment at a travel clinic, or a local medical clinic that offers travel vaccinations.

Some vaccinations have two or three doses and may need four weeks for the course to be completed. Examples include vaccines for Japanese encephalitis and rabies.

If travelling as a family, several visits may be required for preparing children for travel certain destinations.

image Indonesia is a popular holiday destination for Australians. rueful/flickr, CC BY

Keep in mind that your travel medicine practitioner may need detailed information about your exact itinerary, your past childhood vaccinations, your medical history and medications. If you have all this information readily available, you can get the most out of your travel consultation.

If you have an existing medical condition, get checked out to make sure it’s being managed as expected. For example, blood pressure medications may need to be adjusted if your blood pressure is either too high or too low.

Yellow fever immunisations and other live vaccines – those that contain active components – should be avoided if you are on medications that reduce your immunity, such as steroids like prednisolone. You may need alterations to immunosuppressive medications some weeks before you travel, or an official letter exempting you from a vaccine that is necessary for entry into certain countries (as is the case with yellow fever vaccine).

B: Behaviour - think about it

Holiday makers often seek to get out of their comfort zones. But it’s worth avoiding the temptation to completely let your hair down: behaviours you would never entertain in the home setting should be avoided in a foreign setting as well. You may also need to alter some of your daily living behaviours.

Traveller’s diarrhoea can largely be avoided by using bottled water in any setting that you consume water, including staying hydrated, brushing your teeth, washing fruit and salads, and making ice blocks and other drinks.

Eat food from venues that appear to adhere to good food hygiene standards – although this can be difficult to judge. Avoid hawker food or street food where items may have been left for long periods at temperatures where bacteria can multiply. When uncertain of hygiene standards, selecting packaged food is the safest choice.

Respiratory infections are common in travellers. If you find yourself in a crowded setting where someone appears unwell and is coughing, create a distance to reduce the risk of being infected. Alcohol-based hand gels are useful to maintain hand hygiene and may protect you from infection due to common colds and other viruses that linger on surfaces.

Smart packing is also important. You should travel with sunscreen and clothes that protect you from sun exposure, and repellent that has an active component to repel insects if travelling to an area where mosquitoes can transmit infections such as dengue, Zika and malaria.

image Dengue is a virus transmitted by mosquitoes. echbirmingham/flickr, CC BY

Avoid acquiring a sexually transmitted infection by using barrier protection (condoms) for sexual intercourse.

C: Check safety, and have a check up

Review travel warnings at a reputable website, such as SmartTraveller.

A general check up is advised to ensure your health is stable. Health conditions such as inflammatory bowel disease, diabetes or a lowered immune system may put you at greater risk of travellers’ diarrhoea. Cancer or recent operations can increase risk of developing a blood clot.

Check ups are also a good opportunity to ensure that your vaccinations are up-to-date (see below).

D: Drugs (medications) and vaccines are vital

Medications that can reduce the time or severity of travellers’ diarrhoea are recommended for almost any destination, but particularly when travelling to developing countries where food hygiene standards can be variable. Examples include antibiotics such as azithromycin that treat bacterial causes of diarrhoea, and drugs such as tinidazole to treat parasitic causes of diarrhoea.

Medications such as doxycycline or malarone that protect against being infected with malaria are recommended in some regions within Africa, Asia, South America and the Pacific.

Zika virus infection generally causes a mild illness or no symptoms at all. Pregnant female travellers are advised to avoid travel to a Zika endemic area. Couples planning a pregnancy in the near future should seek advice from a health professional if travelling to a Zika endemic country.

image Sunburn can easily be prevented with appropriate clothing, hats and sunscreen. nicksie2008/flickr, CC BY

If you’re travelling to destinations that are above 2500 metres (such Cusco in Peru), talk to your doctor about medications that help prevent or manage altitude sickness.

The normal schedule of vaccinations provided to Australians may not cover you for illnesses found in your holiday destination. Extra vaccinations are necessary for certain destinations.

For example, yellow fever is transmitted by mosquitoes and can cause anything from mild fevers to a severe illness involving multiple organs. Vaccination against yellow fever is required for entry into countries with known yellow fever transmission, and for returning back to Australia if visiting an area of known transmission.

Australians may consider vaccinations against the following diseases before travel to popular holiday destinations:

  • Hepatitis A
  • Hepatitis B
  • Influenza
  • Japanese encephalitis
  • Meningococcal disease
  • Rabies
  • Tuberculosis
  • Typhoid
  • Varicella (Chickenpox)
  • Yellow fever
  • Cholera
  • Measles
  • Polio
  • Tetanus

A full list of countries and recommended vaccinations has been compiled by the USA’s Centers for Disease Control and Prevention.

Even if you’re previously been vaccinated for some of these conditions, as time passes you may require boosters to strengthen your immunity.

E: Enjoy your trip!

image Relax, you’ve earned a break. from www.shutterstock.com

Authors: Irani Thevarajan, Honorary Fellow Nossal Institute for Global Health and Infectious Diseases Physician, University of Melbourne

Read more http://theconversation.com/prepare-for-a-healthy-holiday-with-this-a-to-e-guide-69552

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