Dr G M (Mike) Galvin BSc MB BS DTM&H FACEM

Dr Mike Galvin graduated from the University of WA with degrees in Science and Medicine. Following a residency in Perth he served in Australian Defence Forces as a Medical Officer. During his time with the ADF he served in most Australian states, Papua New Guinea, Malaysia, United Kingdom and USA.

While in the USA he underwent advanced training in aerospace medicine and later attended the University of Liverpool where he obtained the Diploma of Tropical Medicine.

On leaving the permanent military forces he joined Fremantle Hospital as a Consultant in Emergency Medicine and remained there for 10 years. Since then he has worked in East Timor and in the maritime industry based out of Singapore.

Dr Galvin is also actively involved in the international movement of patients and has travelled to a great many countries as diverse as Latvia, Bangladesh and the Philippines as well as providing a regular service from Indonesia.

Dr Galvin has a continuing interest in all aspects of infectious disease; tropical medicine and the aeromedical transfer of patients.

There are a number of ways that you can significantly reduce these risks and visiting a Travel Doctor is a good place to start. The doctor can discuss with you which vaccinations are required or recommended for the area you are travelling to.

However, not all diseases are vaccine preventable and vaccination does not always provide 100% protection. Consequently, precautions need to be taken at all times when travelling. These may include:

• mosquito precautions
• having a suitable first aid kit
• carrying appropriate medications to treat diarrhoea

There is a range of travel related products available at the East Perth Medical Centre to help protect you from travel related illnesses.

Any questions that you have can be discussed with your Doctor during your consultation. You can then relax in the knowledge that you have fully prepared yourself for your trip.

Enjoy your travels!

East Perth Medical Centre
Ph: (08) 9221 4242

Traveller’s Pocket Medical Guide

Travel Clinics Australia is about to release the 7th edition of the popular Traveller’s Pocket Medical Guide. This handy booklet, which includes an internationally recognised vaccination record, has helped thousands of travellers protect their health over the last decade. Each new edition is thoroughly reviewed and updated to include new vaccines, medications and travel health advice. Succinct information on common travel health issues such as gastro (traveller’s diarrhoea) and malaria prevention and management are packed into this travel resource.

Jet lag, travelling with children and other special risk groups, medication guides, first aid and a comparison of disease and vaccines are some of the topics covered in the passport sized booklet.

Every new traveller is given a free copy of the pocket guide with their first travel consultation. The booklet is popular with GPs all over Australia. Many companies also use it as an OH&S resource for staff. Pocket Guides can be purchased at clinics.

Looking After Your Ears

It is well known that sucking lollies, yawning and swallowing help equalize air pressure or ‘unblock ears’ when a plane descends. Yet, sometimes these measures are not enough to prevent distressing ear pain or barotitis, particularly in the young traveller.

It is estimated that up to 25% of children and 5% of adults will develop barotitis while flying, with many at risk of developing injury (temporary and permanent) to their ears. In addition to discussing other options, your Travel Clinic doctor may recommend a product called ‘Earplanes’ to help avoid barotitis.

Earplanes® are a special silicone and ceramic ear plug that helps regulate changes in airline cabin pressure. They are suited to people with a history of ear problems such as blocked eustachian tubes, which are more prevalent with winter colds, as well as for those with allergies and sinus infections. Earplanes® come in adult and children’s sizes and retail for around $22 a pair. They can be purchased from TCA clinics and through our website.

Travel Clinics Australia recommends all travellers with ear problems or a history of ear problems see one of our doctors prior to flying.

Bushwalking and Camping

Typhus is a disease caused by fleas, lice, mites or ticks. There are different types of typhus, found overseas and in Australia. Epidemic typhus, spread by body lice, was responsible for killing thousands of people during the world wars. It is mainly found in parts of Africa, South America and Europe.

Tick typhus, spread by ticks, is associated with dogs, cattle and wild animals. It is found in Mediterranean countries and Africa. Scrub typhus, spread by mites, occurs in Southeast Asia and PNG, and rarely, in some parts of northern Australia. Typhus causing insects usually attach to passing humans and transmit an infection by a bite. Travelling campers, bushwalkers and those staying in the affected areas are most at risk. Symptoms include fever, rigors (uncontrollable shaking), headache and a rash. Some people require hospitalisation. Fortunately, typhus is easily treated by antibiotics.

Japanese Encephalitis Vaccine Shortage

Due to a world wide shortage of the Japanese Encephalitis vaccine, many Australian travellers are unable to access the injection prior to going overseas. Japanese Encephalitis, a relatively rare disease spread by mosquitoes, is seen in only a few parts of Asia and Papua New Guinea.

We recommend you speak to your Travel Clinic doctor prior to travelling to a country endemic with Japanese Encephalitis.

Pre-Travel Assessment Form

To help your doctor assess your needs and your medical situation, we suggest you download and complete the Pre-Travel Assessment Form before your appointment.

Download the Form (Word Document)

Instructions

The completed Pre-Travel Assessment form may be emailed or faxed to the East Perth Medical Centre.

1. Emailing your document:

Click on the form link and enter your patient details onto the Pre-Travel Assessment form. Save the document onto your computer and send an email with the form attached to:

2. Faxing your document:

Click on the form link and print the Pre-Travel Assessment form. Complete the form and fax to:

Fax: (09) 9221 3916

Please contact us if you have and questions on how to complete the form.

Symptoms of Dengue Fever

Typical symptoms of dengue fever include:

• fever
• headache
• sore muscles
• nausea
• vomiting
• rash

Treatment for Dengue Fever

The main treatment for dengue fever is to encourage the intake of food and especially fluids. This may be supplemented with intravenous fluids if necessary.

Dengue Fever Vaccine

There is no clinically proven vaccine available for the prevention of dengue fever. It is therefore important that travellers to high risk areas take precautions to prevent infection.

Prevention of Dengue Fever

As there is no vaccine available to prevent dengue fever, people in high risk areas are advised to protect themselves against infection by avoiding mosquito bites. Mosquitos carrying dengue fever typically bite during the day, especially at dawn and dusk. Avoid getting bitten by wearing clothing which protects the skin and by using insect repellents on exposed skin. It is also recommended to remove all potential breeding sites for mosquitos such as still water found in containers, pots, and old tyres.

High Risk Destinations

Dengue fever can be found in any tropical or subtropical area and is most prevalent during the warm and humid seasons. Mosquitos infected with the dengue fever virus can be found in both rural and urban areas including major cities. The highest risk is for travellers visiting South East Asia and Central and South America. In Australia, the risk is mainly confined to northern Queensland including Cairns and Townsville as well as the Torres Strait Islands.

Travel Vaccinations for Indonesia and Bali

Travel vaccination requirements and recommendations are subject to change but we currently suggest the following vaccines for travellers to the region.

Recommended for all travellers to Indonesia:

• Hepatitis A vaccine
• Typhoid fever vaccine
• Flu vaccination (for people over 50 or people with a compromised immune system)

For travellers staying for longer periods or for frequent visitors:

• Hepatitis A vaccine
• Hepatitis B vaccine
• Typhoid vaccine
• Japenese Encephalitis vaccine (especially for visitors to Bali, Kalimantan, Nusa Tenggara, Sulawesi, Mollucas, Irian Jaya, and Lombok)
• Rabies vaccine (rabies can be transmitted by monkey bites as well as from other infected animals)

Other Diseases

Malaria is of high risk in rural areas but the main cities and tourist areas, such as Bali, and generally risk free.

Diarrhoea is very common throughout the country, including with visitors staying in high end accommodation.

Other diseases to be aware of include:

• Avian Influenza (bird flu)
• Dengue Fever
• Tuberculosis
• Herpes B (can be transmitted by monkey bites)

Cholera can be life threatening if left untreated or in very severe cases but with treatment, the death rate is less than 1%.

Symptoms of Cholera

The main symptom of cholera is diarrhoea but other stomach related symptoms are often also present. Most of the symptoms are a result of severe dehydration caused by fluid loss due to the diarrhoea. Possible symptoms include:

• diarrhoea
• stomach cramps
• muscle cramps
• vomiting
• fever

Treatment for Cholera

The typical treatment for cholera involves aggressive rehydration to restore lost body fluids as well as treatment to replace electrolytes. The treatment usually consists of an intravenous injection of a salt/sugar solution.

Cholera Vaccine

The cholera vaccine is given in two doses and generally provides protection for 3 years. The cholera vaccine is not 100% effective so travellers should take care at all times when consuming food and water in high risk areas.

High Risk Destinations

Vaccination against cholera is recommended for travellers to certain high risk countries and regions where there is an immediate risk of cholera. Although any traveller to these regions may require the cholera vaccine, it is mainly administered to health care and emergency relief workers. Cholera is present in many countries such as:

• Afghanistan
• Angola
• Cameroon
• Central African Republic
• Chad
• Congo
• Côte d’Ivoire
• Equatorial Guinea
• Ethiopia
• Ghana
• Guinea-Bissau
• Iraq
• Liberia
• Madagascar
• Malawi
• Mauritania
• Mozambique
• Nigeria
• Senegal
• Sierra Leone
• Somalia
• South Africa
• Sudan
• Swaziland
• Tanzania
• Togo
• Uganda
• Zambia
• Zimbabwe

Travel vaccination advice is subject to change so please consult your doctor well before you plan to travel.

• Hepatitis A
• Hepatitis B
• Cholera
• Japanese Encephalitis
• Rabies
• Typhoid Fever
• Yellow Fever

Hepatitis A can easily be spread through personal contact, eating contaminated raw seafood or drinking contaminated water, so you may consider getting vaccinated against it no matter where you are headed.

Japanese encephalitis may be a risk for travellers to:

• Bali
• Bangladesh
• Cambodia
• China
• India
• Indonesia
• Malaysia
• Myanmar
• Nepal
• Pakistan
• Papua New Guinea
• Thailand
• Timor
• Torres Strait islands
• Vietnam

Vaccination against cholera is recommended for emergency relief and health care workers travelling to Afghanistan, Iraq, and Africa.

Travellers heading to developing countries in Asia (especially India), Africa (north and west), and Central and South America (especially Peru) may wish to get vaccinated for Typhoid Fever.

Vaccination against Yellow Fever may be necessary for travellers to certain regions in Africa, South America, Central America, and the Caribbean.

Other diseases to be aware of when travelling are:

• Dengue Fever
• Malaria
• Meningococcal Meningitis
• Other strains of hepatitis
• HIV/AIDS

If you require a vaccine or would like further information, contact us for an appointment. We are registered with Travel Clinics Australia to provide travel vaccinations and can help you with all your vaccination needs.

• raw fruit
• raw vegetables
• milk
• other dairy products
• seafood
• water

Symptoms of Typhoid Fever

Some people present no or very mild symptoms so it is important to see your doctor immediately if you suspect you may have Typhoid Fever. There is a wide range of possible symptoms which may or may not include the following:

• sustained fever
• severe headache
• constipation
• chills
• sore throat
• nausea
• abdominal pain
• skin rash
• loss of appetite
• diarrhoea
• enlarged liver

Treatment for Typhoid Fever

Antibiotics are used to treat Typhoid and prompt treatment reduces the fatality rate to around 1%. However, left untreated, the fatality rate is around 10% to 30%.

Typhoid Fever Vaccination

Prevention is the best cure so it is advised to avoid consuming potentially contaminated food and water in high risk, unsanitary areas. In such high risk areas, you may wish to only consume bottled water, even when cooking and when brushing teeth.

If you will be travelling to a country where the disease is endemic, you may wish to get vaccinated against Typhoid Fever. This can be achieved by a simple injection, giving you immunity for 3 years. It is important to note that the vaccine doesn’t give 100% immunity so good hygiene is essential while travelling.

High Risk Destinations

Typhoid Fever is rarely found in developed countries. High risk areas include any endemic regions where environmental hygiene is poor and drinking water is unsafe. This includes certain regions of:

• Asia (especially India)
• Africa (north and west)
• South America (especially Peru)

Benefits of Breastfeeding

• Breast milk is highly nutritious.
• The baby has a lower risk of sudden infant death syndrome.
• The baby has a lower risk of many other diseases.
• Suckling encourages the development of teeth and speech.
• Breast milk contains amino acids required for brain and nerve development.
• Breastfeeding helps mothers return to their pre pregnancy weight.
• Breastfeeding mothers have less risk of breast, ovarian, and endometrial cancer.

Protection from Diseases

A baby which has been breastfed is at lower risk of contracting the following health problems and diseases:

• Allergies
• Asthma
• Bacterial meningitis
• Breast cancer
• Celiac disease
• Crohn’s disease
• Diabetes
• Eczema
• Hodgkin’s lymphoma
• Multiple sclerosis
• Obesity
• Respiratory infections
• Rheumatoid arthritis
• Urinary tract infection

New Scientist writes about the benefits of older mothers breastfeeding:

Women who delay pregnancy past their mid-twenties may reduce their risk of breast cancer later in life by breastfeeding their children, a new study suggests.

Previous research has shown that women who have their first child in their thirties have an increased risk of breast cancer, regardless of how many children they go on to have. But the new study found this link only among older mums who did not breastfeed.

So breastfeeding is especially important for older mothers.