Autumn 2017 Travel Health Update
- Many people are deciding to travel to more “exotic” or “off the beaten track” destinations and as a result, put themselves at risk of contracting serious diseases and illnesses. Many of these diseases can be prevented by ensuring each individual traveller is protected through vaccination prior to travel. Furthermore, travellers should consider and implement preventative measures in relation to clean sanitation; mosquito protection; hand washing/hygiene; filtered/bottled water for consumption; “sun smart” prevention techniques; reducing risk, injury and even death by restricting participation in “high risk” and “dangerous” activities. Following such advice can reduce the risk of contracting vaccine preventable diseases, decrease serious accidents and ensure that travel is safe, comfortable, relaxing, enjoyable and problem-free.
- It is advised to make an appointment with your GP at least 6 weeks prior to departing to determine if any travel vaccinations are necessary and to collect scripts for travel medicines and anti-malarial medication if it is needed. Our Practice Nurses – Tanya, Susan, Karen and Danni are available to immunise all travel patients after consultation with your GP.
- Remember to visit the official Government website – smartraveller.gov.au . This website offers great travel tips and current health alerts for Australian and International travel. This website allows you to register your trip, allows you to subscribe for travel updates and advice and gives you information on taking out travel insurance for your impending trip.
- Listed below are countries with current health alerts for travellers. If you are planning a trip over the next few months, please take the time to read up on any disease outbreaks pertinent to the destinations you are visiting. These “Travel Health Alerts” have been resourced from the following reputable Travel Health and Medical Advice for travellers websites -:
Travelvax Newsletter – 16/2/17 and 23/2/17
Department of Health and Human Services Victoria – Health Advisory Updates 8/2/17 and 15/2/17
World Health Organisation – Disease Outbreak News – 24/2/17
DENGUE FEVER – OUTBREAKS IN -: AUSTRALIA (Cairns, Innisfail), NEW CALENDONIA (Noumea), VANUATU, AMERICAN SAMOA, INDIA, VIETNAM, HONDURAS
There have been increasing numbers of Dengue Fever cases reported in the countries listed above. Dengue remains a risk for travellers to most tropical destinations, regardless of where you stay or for how long. It is transmitted via mosquitoes. There is no vaccine or preventative medication. Apply an insect repellent containing an effective active ingredient, such as DEET, (ie: Bushman’s, RID Tropical) Picaridin, IR3535, or oil of lemon eucalyptus, to exposed skin at all times when outdoors, In addition, cover up with long-sleeved tops, long pants, and shoes and socks around dawn and dusk, as well as other times when the mosquitoes are most active. Ensure accommodation is mosquito-proof.
ROSS RIVER FEVER – OUTBREAKS IN -: VICTORIA (Geelong, Torquay, Lorne), N.S.W. (Riverina, Hunter – New England, Georges River)
Health Authorities in Victoria and New South Wales are concerned about the sharp rise in cases of Ross River Fever as well as other mosquito-borne virus such as Barmah Forest Virus and Murray Valley Encephalitis. The Ross River Virus (RRV) has been detected in mosquitoes in Southern Metropolitan Melbourne with concern that numbers of human infection could rise in early Autumn. Some of the patients who have been tested positive for RRV have not travelled to the endemic areas of regional Victoria but have contracted the illness via infected mosquitoes in Melbourne. Not all mosquitoes carry diseases but specific types of the insects can carry a range of diseases that can cause serious illness. RRV symptoms include joint pain and inflammation, fatigue, rash and muscle aches. Similar to Dengue Fever, there is no vaccine for RRV or other mosquito-borne virus. The best protection is to avoid being bitten by mosquitoes by using repellent containing Picaridin or DEET.
CHOLERA – OUTBREAKS IN -: MOZAMBIQUE, SOMALIA
Cholera continues to cause problems on the East Coast of Central and Southern Africa following recent tropical storms. Cholera is generally a low risk for most short-stay travellers and vaccination is normally recommended for longer stays in endemic regions – particularly if an outbreak is occurring. Cholera is usually spread in contaminated water. Travellers should adhere to strict personal hygiene guidelines including vigilant hand-washing/anti-bacterial hand rub use and choose only safe food and beverages. For example – drink bottled water, do not eat salads from a salad bar, choose fruits that you can peel yourself, do not have ice in your drinks, use bottled water to clean teeth etc. There is an oral vaccine available – DUKORAL for protection against Cholera and E Coli/ETEC infection (travellers diarrhoea). Please talk to your Doctor or Practice Nurse to determine if this vaccine is appropriate for you.
MEASLES – OUTBREAKS IN -: WESTERN CAPE OF SOUTH AFRICA, MYANMAR, SPAIN
The above countries and regions have reported rising numbers of Measles cases in recent months. Vaccination programs are currently being implemented to protect local populations from the spread of this highly contagious virus. Measles is a virus which can result in severe illness and even death. Regardless of your destination, Australian travellers should check their vaccination status and anyone who has not had Measles or has not received two documented doses of a Measles-containing vaccine during their life-time should consider a booster. If you are unsure of your vaccination status, please check with your Doctor or Practice Nurse. A blood test can be performed to confirm your antibody level of protection.
HAND, FOOT AND MOUTH DISEASE (HFMD) – OUTBREAKS IN -: VIETNAM. THAILAND
Travellers with small children should be aware of the increase in Hand, Foot and Mouth Disease (HFMD) in Vietnam and Thailand – especially in the Under 5 years age group. With the surge of hot weather, both countries are experiencing record levels of this viral disease, which affects mainly children. It is spread by direct contact with infected persons or with virus-contaminated surfaces. The disease mainly occurs in children and good hygiene practices will greatly reduce the risk of infection. Use of antibacterial wipes and alcohol hand rub will reduce the risk of transmission of the virus. There is no vaccine or preventative medication.
CHICKEN POX- OUTBREAKS IN -: VIETNAM
The World Health Organisation (WHO) has reported an increase in the number of cases of Chicken Pox (Varicella) in Vietnam with more adults than children affected. The Chicken Pox season usually runs from January to March each year in these countries. Chicken Pox is a highly contagious, vaccine-preventable disease caused by the Varicella- Zoster virus. It is mainly passed from person to person by coughing or sneezing. It is generally mild in children but can be severe in patients with low immunity, infants and adults. Please discuss with your Doctor or our Practice Nurses your risk and whether or not you have immunity to Chicken Pox. Adults require two Chicken Pox vaccines a minimum of 4 weeks apart if they are not immune to the disease.
CHIKUNGUNYA – OUTBREAKS IN -: THE PHILIPPINES, INDIA AND SOUTH AMERICA
A number of people have now been treated for Chikungunya fever in The Philippines, India and South America (Peru, Columbia, Venezuela). The symptoms of Chikungunya Fever are similar to Dengue Fever and both are transmitted by the same mosquitoes – the day-time feeding Aedes Aegypti and Aedes Albopictus. Acute joint pain with a rash is typical of Chikungunya and while fatal cases are rare, painful joints may persist for weeks or months after the acute phase has ended. There is no vaccine or prevention medication, so using an effective, tropical-strength repellent to avoid insect bites is the best form of protection. Ensure the repellent contains “DEET “.
YELLOW FEVER – OUTBREAKS IN -: BRAZIL
There is currently an outbreak of Yellow Fever Disease in six states of Brazil, South America. From December 2016 to 22nd February 2017 there have been a total of 1,336 confirmed cases of Yellow Fever infection. Travellers planning to visit areas at risk of Yellow Fever should receive the Yellow Fever Vaccine (Stamaril) at least 10 days prior to travel. As this vaccine is a “live” vaccine, your GP must check that you are able to have the vaccine based on allergies, immune status and other medications you may be taking that may interfere with the vaccine. A Yellow Fever Vaccination Record Book will be issued to you upon administration of the Yellow Fever Vaccine which you will need to keep with your passport whilst travelling.
Misconceptions re travel to well known destinations
We have observed that many patients regard destinations such as Fiji, Bali or Thailand, as places where travel vaccinations or advice should not be required.
On the contrary: please consider the current flu vaccine before you travel (now available). A check on your last tetanus vaccination, do you have Hep A & Hep B immunity. Do you require a Typhoid vaccination or would Oral Cholera be advised. This is also a good time to review your current vaccination status generally.
Discuss with your doctors the pros and cons of sensible eating & drinking in these locations and be aware of the need to prevent or avoid insect or animal bites (mosquitoes, monkeys, dogs etc. frequent these destinations).
MENINGOCOCCAL W – OUTBREAKS IN VICTORIA
Since 2014, there has been an increase in the number of notifications in Victoria of Invasive Meningococcal Disease (IMD) due to Serogroup W. All age groups have been affected with the most susceptible groups being -: older adults over 55 years, adolescents/young adults, young children/infants less than 5 years, travellers and people with pre-existing medical conditions. The most common symptoms of Meningococcal W infection are severe sepsis (bacteraemia), septic arthritis, epiglottitis and in some cases – Pneumonia. The Quadrivalent Meningococcal Conjugate vaccines (Menveo/Menactra) are recommended for occupational exposures, travel, certain medical conditions and those wishing to protect themselves and family members from Meningococcal Disease. The Victorian Government is introducing a one year free school-based vaccination program for Meningococcal W for 15 – 19 year olds to commence in Term 2 – 2017.
There are other Meningococcal strains also present in the community such as Serotype C and Serotype B. Meningococcal C cases have declined significantly since 2003 with the introduction of the Meningococcal C Vaccine. Currently on the National Immunisation Program, Meningoccocal C Vaccine (MenCCV) is provided and recommended for children at 12 months of age and for individuals up to 19 years for “catch up”. Furthermore, Serogroup B has been the most common cause of IMD in Victoria in recent years. Meningococcal B vaccine (MenBV) known as “Bexsero” is available on private script and is recommended for infants, young children, adolescents, young adults and individuals with specific medical conditions. Supply has been limited in recent months. Please ask your GP for a private script and source the vaccine from your local Pharmacy. Our Practice Nurses can administer the vaccine once Bexsero has been sourced.