Did you know that overseas travellers have up to a 50% chance of suffering from a travel related illness?

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

Australia is one of the safest countries in the world to travel around. You are unlikely to pick up a travel related disease while travelling here but that is not the case for many other regions in the world. High risk areas include many parts of Asia, Africa, and South America. As usual, prevention is generally better than the cure so we recommend discussing your travel plans with your doctor well in advance of your departure date. Your doctor can suggest preventative measures such as getting travel vaccinations, avoiding mosquitos, and reducing the risk of drinking contaminated water. Diseases which you can be vaccinated against include:

• 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.

Indonesia is a developing nation and as such does not have the same level of sanitation and health care standards which we come to expect in developed nations such as Australia. Many travel related diseases are prevalent in Indonesia, including Bali, and it is therefore recommend that travellers to Indonesia consult their doctor regarding travel vaccinations well before they travel.

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 is a severe diarrhoeal disease caused by a bacteria which is generally transmitted to humans by ingesting contaminated food or water. Contaminated shellfish can also be a source of infection. Cholera outbreaks usually occur due to poor sanitation in areas where there are a large number of people in close proximity, usually due to a natural disaster, war or civil unrest. Tourists are rarely at risk of contracting cholera, even in high risk countries. However, all travellers to high risk regions should take precautions when consuming food and water.

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.

Typhoid Fever is caused by a bacteria that is usually spread when the faeces or urine from an infected person contaminates food or water. It can also be spread by flying insects which have fed on contaminated faeces. When travelling in endemic areas, be especially careful when consuming:

• 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)

Unfortunately, not all mothers are able to breastfeed their babies, but when it is physically possible, mothers should try to breastfeed for at least 6 months. Experimental evidence suggests that, with few exceptions, human breast milk is the best source of nourishment for human infants. Experts still disagree about how long breastfeeding should continue to gain the most benefit and how much extra risk is involved in using breast milk substitutes. However, breastfeeding does benefit both mother and child physically and psychologically. Nutrients and antibodies are passed to the baby while hormones are released into the mother’s body. The bond between baby and mother can also be strengthened during breastfeeding.

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.