Planning a winter getaway? Check these tips first!

Overseas travel exposes you to wonderful new experiences, but it can also expose you to potentially serious health risks. Remember – your health is your responsibility – with a bit of preparation, you can prevent an illness that could ruin your holiday, or worse.

Before you leave, it is important to research every country you will visit, and to get advice that is tailored to your health needs. The risk of acquiring an infection and the appropriate preventative measures can be different for older travellers, children, pregnant women or those with underlying chronic diseases.
While you are away, there are some things you need to keep in mind to prevent illness, like preventing insect bites and being careful of what you eat.
When you return, keep an eye on your health. Some diseases may not become apparent until you have returned home and could spread to your loved ones.

Before you leave

1. Research your destination and planned activities

The risk of infectious disease differs greatly depending on where you intend to travel and what activities you plan to undertake while overseas. In particular consider:

• Will you be travelling to countries in which food or water quality might be of a lower standard? 
  Contaminated food and water can increase the risk of acquiring infections such as gastroenteritis, hepatitis A and some parasites.
• Will you be travelling to wilderness or rural areas where you are likely to be exposed to farm animals or wildlife?
  Animals in many parts of the world may carry rabies. Diseases carried by ticks and mosquitoes are a risk in wilderness areas of many parts of the world unless preventative measures are taken.
• Will you be spending a lot of time outdoors where you might be exposed to mosquitoes?
  Mosquitoes can carry serious diseases including Malaria, Dengue Fever and Yellow Fever.

Information on the health risks associated with many destinations can be found online at:

• Smartraveller www.smartraveller.gov.au
• World Health Organization www.who.int

We also suggest you get in touch with the foreign missions of all of the countries you intend to visit or transit through. They can give you specific information about particular health requirements in their countries (e.g. vaccines you may need or medicines you should bring with you). They can also provide you with other information about their country that you could find useful or important.

2. See a doctor well in advance before you leave – even if you are well

Your doctor can advise you on measures which can be taken to avoid infectious diseases to which you might be exposed while overseas. This might include measures to avoid consuming potentially contaminated water or food, medication to reduce the risk of acquiring infections or vaccination against serious disease.

Immunisation:

Many diseases which are a risk to travellers can be prevented by immunisation. You should talk to your doctor about any vaccines or boosters you may need. Some diseases that should be considered are:

• Hepatitis A
• Hepatitis B
• Influenza
• Japanese Encephalitis
• Meningococcal Meningitis
• Rabies
• Tuberculosis
• Tick-borne encephalitis
• Typhoid Fever
• Chickenpox
• Yellow Fever
• Cholera

Some countries still suffer high rates of infection from diseases that are rare in Australia due to our routine childhood vaccination. If you were born overseas, and you are returning to visit friends and family, you should still check with your doctor if you need any immunisations. Your immunity to some diseases may have changed or diminished with time.

Immunisations which are now routine in childhood in Australia should also be considered if travelling to areas where these diseases remain common. Depending on your age and previous medical history, you may not be protected against diseases such measles or polio. It is important to schedule a visit to your doctor at least 6-8 weeks before you travel to allow time to complete any vaccination schedule you undertake.

Important:

Yellow fever is a potentially fatal viral infection spread by mosquitoes. A vaccine for yellow fever is available from most registered travel clinics and some GPs.

Yellow fever is not found in Australia, but some countries require proof of vaccination against Yellow Fever before you are allowed to enter.

Some countries take a very hard line on yellow fever and may vaccinate you when you arrive, refuse you entry, or put you in a quarantine facility if you are not vaccinated against yellow fever.

If you are travelling to a Yellow Fever country you should contact the diplomatic missions of ALL of the countries you intend to visit to check their requirements for Yellow Fever vaccination and discuss these requirements with your doctor or a specialist travel clinic before you leave. The public health unit in your state or territory can assist you in locating your closest accredited vaccination centre.

If you are returning to Australia from a country where Yellow Fever occurs you may be asked to provide proof of vaccination. You can enter Australia without proof of vaccination but will be placed under Quarantine Surveillance which asks you not to travel to Northern Queensland and to present the Quarantine Surveillance form (the yellow form) to your doctor if you become unwell. 

While you are away

You can reduce the risk of developing an infectious disease when travelling by taking some simple preventative measures. Advice on the main health risks of travelling to particular countries can be found online at www.smartraveller.gov.au or by consulting a doctor experienced in travel medicine. 

Some common measures which will help reduce the risk of infectious disease in many parts of the world to which Australians travel are:

1. Protect yourself from insects

The bite of infected mosquitoes is a major way by which infectious diseases can be spread in many parts of the world. Potentially serious diseases which are spread by mosquitoes include:

• Yellow Fever, which occurs in South America, Central America and Africa. 
• Malaria, which occurs in Africa, Asia and South America and can be particularly severe in people without previous exposure to the disease.
• Dengue Fever, which occurs in most urban centres in the tropics. Serious outbreaks have occurred in Queensland when ill travellers have returned and infected local mosquitoes.

The most reliable way to make sure you don’t catch a mosquito-borne disease is to wear a mosquito repellent containing DEET or Picaridin which will help avoid being bitten by a mosquito. There are other measures you can take to avoid being bitten, including:

• Wearing light coloured, long-sleeved clothes when you’re outdoors
• Avoiding wearing perfume or cologne (some of these can attract mosquitoes)
• Preventing mosquitoes entering your accommodation
• Using a mosquito net at night-time (if mosquitoes are likely to be present)

Mosquito-borne diseases don’t occur in all countries, but it is advisable to talk to your doctor about what vaccinations or medications you might need to take.

2. Be aware of the risk of rabies

Rabies is a virus which can potentially infect any warm-blooded animal and is found in most countries outside of Australia and New Zealand. It is spread through bites or scratches from infected animals. The greatest risk is posed by the types of animals people interact with commonly, such as dogs, but also includes monkeys, bats and rodents. Domestic or zoo animals in many parts of the world are vaccinated against rabies.

Travellers should be very careful around wild or feral animals, especially dogs, in all nations outside Australia and New Zealand. Avoid handling or feeding wild or unvaccinated animals as they might bite or scratch. Animals carrying rabies often do not behave differently or look unwell.

Infections with rabies are very rare but the disease is almost always fatal. If you are bitten or scratched by an animal while overseas it is important to seek medical attention as soon as possible. If a bite or scratch is considered sufficiently high-risk it is usual to provide vaccination and immunoglobulin to provide immunity against infection.

3. Think about what you eat and drink

Food-borne illness is a major cause of disease overseas and includes ‘traveller’s diarrhoea’ as well as more serious diseases such as Hepatitis A or Cholera. 

The sources of food-borne illness are not always obvious. A glass of soft drink might be safe but the ice in the glass could be made with contaminated water. 

High risk foods include:

• Unpasteurised dairy products
• Ice
• Raw or minimally cooked meat or seafood
• Reheated food
• Salads
• Food which has been left exposed to flies
• Food prepared in premises with poor hygiene

Your doctor can provide advice on antibiotics which can be carried if you are at high risk of developing food or water borne infections.

When you return

If you become unwell in the two weeks after your return to Australia see your doctor.

It takes time after you are exposed to an infectious disease for you to become unwell (the incubation period).

For this reason, for the two weeks after you get back from overseas, you should pay close attention to your health.

If you get any of the following symptoms, see your doctor as soon as possible.

• Fever
• Unexplained skin rashes or lesions
• Persistent vomiting
• Persistent diarrhoea
• Unusual bleeding from the eyes, ears, nose, mouth or anus
• Swollen glands in your armpits or neck
• Persistent coughing or difficulty breathing

This list is not exhaustive and if you are feeling unwell after being overseas you should see your doctor. It is important to tell your doctor that you’ve been overseas, where you went and what activities you undertook.

Most diseases acquired by travellers are not serious, but it is important to detect a serious infectious disease early. This allows infectious diseases to be treated as soon as possible and you to take immediate steps to avoid transmitting this disease to others.

(Source: Department of Health & Aging)

More Information

For more information on immunisation, including the childhood immunisation scedule, types of vaccines, preconception screening, as well as some useful videos, see Immunisation.