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Travel health advice

Travelling is an exciting and rewarding experience. Maintaining health and avoiding injury, illness or disease are important pre travel goals to maximise your holiday, business or exchange experience.

Deakin Medical Centres provides comprehensive pre and post travel-related services including, vaccination assessment, medications review, risk assessment, safe behaviours advice (for example, insect bite avoidance) and provision of education resources such as handouts and a travel brief.

The following general travel health information and advice is designed to provide basic information but does not replace the need for an individualised and, or group travel health consultation or education session with a travel health professional.

Did you know?

  • Around 3 million Australians travel overseas each year (work, study or leisure).
  • Daily hospitalisation costs in South East Asia regularly exceed $800.
  • A stay in a general ward in Noumea's main hospital costs a minimum of $1500 per day.
  • Around 16 to 19% of travellers lose one day or more of their trip to illness.
  • By far one of the greatest risks to overseas travellers is death or injury from motor vehicle or pedestrian related accidents.
  • It is important to seek travel health advice at least two to three weeks pre departure.
  • Travel health requirements are individualised and influenced by factors such as:
    • age
    • medical and surgical history
    • allergies
    • past vaccination history
    • itinerary and destinations
    • length of time and time of year away
    • standard of accommodation
    • type of activities that will be undertaken
    • type of trip (work, exchange, leisure).

Travel vaccinations (immunisation)

NOTE: this vaccine information is a guide only and should not be used in place of medical consultation.

Some counties require specific vaccinations to be given before entry or exit to that country (for example, yellow fever) however in the majority of cases vaccination is an important health measure to minimise contracting certain vaccine preventable diseases. It is important to remember that:

  • few vaccines are 100% effective in preventing a disease
  • some vaccines require a period of time to become effective (for example one to two months)
  • some diseases and infections cannot be vaccinated against including SARS, bird flu and dengue fever
  • disease outbreaks can occur at any time
  • vaccination does not replace the need to behave safely including avoidance of contaminated food and water and insect bites
  • check out the Department of Foreign Affairs and Trade 'Smart traveller' for basic vaccine and travel health advice.

All travellers should be in date for and/or have completed the standard childhood vaccination schedule according to the travellers age and medical history including:

  • tetanus, diphtheria and pertussis
  • polio
  • measles, mumps and rubella
  • hepatitis B
  • meningococcal C
  • chickenpox (if no previous disease).

For other vaccinations that may be recommended please visit Department of Foreign Affairs and Trade 'Smart traveller'

All vaccines have the potential to cause side effects however in most instances they are minor and short term. Please discuss vaccine contra-indications and potential side effects with your travel health provider.

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Medical and dental check

Before travelling overseas (particularly for exchange and long term travel) it is important to be in optimal physical and mental health to ensure maximum enjoyment. Therefore it is recommended to undertake a health check or medical examination, well before departure especially if you have any chronic or current medical conditions (for example depression, asthma or skin conditions).

Ensure you carry a letter or documentation from your doctor outlining any medical or surgical conditions you have and usual treatments including medications and allergies.

A pre-departure dental check is also highly recommended, in particular if you have not had one in the last six months. You may also consider carrying an emergency dental kit. Discuss this with your dentist or travel health provider.

Travel insurance

Travel insurance is critical for all travellers to cover issues including theft, loss, medical treatment and evacuation. Medical and hospital costs in many countries are significant for example:

  • the return of a deceased person's remains from Europe can cost in excess of $10,000
  • the cost of medical evacuations from the United States regularly range from $75,000 to $95,000 and sometimes up to $300,000 (DFAT 2007).

Shop around for policies and ask for guidance from your travel agent. This is one insurance policy you need to fully understand to ensure you know exactly what you are covered and not covered for. Some policies may exclude high-risk activities including scuba diving, bungy jumping and transportation where you have not used safety equipment such as riding a motorbike without a helmet.

First aid kit and equipment

A first aid kit is a must for all travellers. Kit contents vary depending on time away, destination and isolation to reliable medical care. Recommended items include:

  • bandages (roller and triangular), plain gauze squares and a variety of sterile, non stick dressings
  • normal saline sachets or ampoules for wound cleaning
  • antiseptic solution
  • resuscitation mask
  • alcohol swabs
  • pocket torch
  • disposable gloves
  • plastic bags
  • thermometer (digital)
  • tweezers, scissors, band aids, tape
  • water purification equipment
  • eye drops (for wind, dust or antibiotic), ear drops (antibiotic or to dry the ear canal)
  • paracetamol, aspirin or other
  • anti-diarrhoea medication (for example Lomotil or Imodium)
  • re-hydrating solution (for example Gastrolyte) anti-vomiting medication (for example Stemetil or Maxalon) anti-fungal preparation for thrush / tinea motion sickness medication
  • oral or topical antihistamine medication for bites / stings / hay fever / allergies)
  • cold / flu tablets and / or nasal spray and lozenges
  • antibiotics (discuss with your healthcare provider)
  • anti-malarial tablets (discuss with your healthcare provider)
  • any medication normally taken (for example the oral contraceptive pill)
  • 30+ sunscreen / lip balm repellent (should contain at least 30% of the active ingredient DEET)
  • permethrin treated clothes and mosquito netneedle / syringe / suture material kit. Recommended when travelling in developing countries and remote areas. A pack is available which includes a letter signed by a doctor indicating items are for personal emergency useemergency dental kit vaccination certificate.

A variety of pre-packed first aid kits are available from some travel health providers and are often a more cost effective way than buying first aid kit items separately. Discuss your first aid kit, medications and equipment requirements with Deakin Medical Centre staff or your travel health provider.

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Travelling with medication

Sending or carrying Pharmaceutical Benefits Scheme (PBS) medications overseas that are not for personal use is illegal. Some time ago a female traveller was jailed in Greece for carrying headache medication containing codeine.

Before travelling contact the embassy of the country(s) you are visiting to check your medication is legal there. You can obtain further information by calling the Health Insurance Commission's (HIC) ' Overseas drug diversion line' on 1800 500 147. Always carry medication in its original container clearly labelled with your name and carry written instructions and a letter of authorisation from your doctor for any medications you are taking overseas.

Try at all times to keep your first aid kit and medications in a cool and dry place, and when flying ensure you carry any required medication with you in your hand luggage. If your luggage goes missing you will at least have some medication available.

Australian prescriptions cannot be filled overseas. Take enough medication with you for the whole of your trip and avoid purchasing medication overseas. It is estimated that up to one third of medication sold overseas is either fake or sub standard. You may not know what you are buying! In addition many drug names are different in other countries.

'Gastro' prevention

Probably the greatest risk to overseas travellers is contracting a disease or infection from contaminated food or water. Although usually minor, traveller's diarrhoea affects approximately 50% of travellers. Many diseases and organisms can be transmitted by contaminated food or water including; typhoid, cholera, hepatitis A and E and e-coli..

Minimise your risk:

  • 'boil it, peel it, cook it or forget it' - the safest food to eat is food that has been recently and well cooked - just cooked and steaming hot!
  • bottled or canned drinks (including for teeth cleaning) where possible. Always check that the seal on the bottle is intact. Tea or coffee is usually OK, however ensure milk is canned and avoid unpasteurised milk or milk products
  • avoid raw foods including fruit you haven't peeled yourself, salads and seafood
  • avoid ice
  • only eat fruit you peel yourself
  • avoid undercooked or food left to sit for long time periods (for example on display)
  • always wash your hands before handling food and before / after meals
  • generally meat, rice, noodles and vegetables that are freshly and thoroughly cooked are the safest
  • check with other travellers for safe, reputable places to eat.

There are a number of strategies and products available if fresh or safe bottled drinking water is not available. Discuss these with your travel health provider.

Despite prevention strategies (as above) studies indicate traveller's diarrhoea is still a common occurrence for all travellers regardless of their trip length and safe food / water practices, therefore it is important to discuss and have written information on how to manage travellers diarrhoea should it occur.

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Insect avoidance

Insect bites including mosquitoes don't just hurt or cause infection but can transmit diseases including malaria, dengue fever, yellow fever, typhus, Chagas disease, Japanese encephalitis and Lyme disease!

Minimise your risk by:

  • covering up - wear clothing that covers your arms and legs day and night
  • knowing when the insects bite - for example malaria mosquitoes bite general at night so dusk to dawn poses the greatest risk, whilst dengue fever mosquitoes bite during the day
  • wearing light coloured clothing
  • avoiding wearing strong perfumes, scents or after-shaves
  • using an effective insect repellent containing at least 30% DEET. Effectiveness ranges from one to several hours depending on concentration, and is affected by sweating, swimming, rain or wiping the skin. Be sure to reapply as directed
  • sleeping in air-conditioned, screened or under a permethrin impregnated mosquito net. Ensure you tuck the net well in under the mattress!
  • using mosquito coils and knock down sprays which may be of some benefit
  • learning about the local 'bugs' - including tsetse flies in Africa and ticks / leeches found in many parts of the world.

Please note: no conclusive research has found vitamin B to be beneficial in decreasing the amount of mosquito bites you receive.

Rabies first aid

Avoid deliberate contact with animals. If bitten or scratched and there is a risk of rabies treat the area immediately with (preferably) warm soapy water OR normal saline, bottled or boiled water and apply an antiseptic. Seek medical aid immediately. Treat other bites and stings as per normal first aid practices.

Malaria

Malaria is an illness caused by a parasite transmitted by the bite of a female anopheline mosquito during dusk to dawn hours. There are four species of malaria-causing parasites: one is rapidly fatal, while others can cause recurrent episodes over years.

There are different types of anti-malaria medication available. The need to prescribe and the type of anti-malaria medication recommended is based on a number of factors including, country or part of a country or countries visited, time of year or season, length of stay, type or standard of accommodation, rural or urban travel, age / medical condition of the traveller and proximity to medical treatment.

Important note: No tablet is 100% effective is preventing malaria! You need to avoid mosquito bites, take malaria tablets as prescribed and seek medical treatment immediately if you develop a temperature over 38 degrees celsius during or after a visit to a malaria area

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Checklists

Pre departure

  • travel health consultation
  • medical/health and dental check
  • register your travel plans with the Department of Foreign Affairs and Trade
  • vaccine history checked and vaccines up-to-date
  • first aid kit
  • health and travel insurance
  • know embassy and consulate addresses
  • read up and know local laws and customs including road safety.

While away

  • practice insect bite avoidance
  • don't pat animals including dogs and monkeys
  • eat and drink safely
  • follow all road safety laws and rules and use equipment such as seatbelts and helmets
  • know and follow local laws and customs - including dress standard and photography laws
  • take anti-malarial pills if advised to do so
  • practice safer sex - sexually transmitted infections (STIs) are a risk in any country! Carry condoms from Australia
  • avoid excess alcohol and drug use - know each countries drug laws
  • practice stranger and acquaintance danger
  • know and avoid the local bugs. There are some nasty parasites you can pick up through the skin, either by bathing in fresh water (schistosomiasis) or by walking around with bare feet (hookworm). It is a good general rule to not walk bare foot even on a beach, to protect yourself against burrowing parasite and cuts.

Adequate and thorough planning and sensible behaviour while you're away will ensure maximum safety and enjoyment and minimal problems. So bon voyage and enjoy safe, happy travels!

Further information and advice

Please note: Whilst care has been taken to ensure that external web sites are credible sources of information, no responsibility can be taken for their content. Web-based health information does not replace the need to see an appropriate health care professional.

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6th June 2011