Many travel related illnesses and diseases can be avoided by preventative care and having travel vaccinations.
Vaccination recommended prior to travelling are:
A watery diarrhoea illness, cholera is caused by infection of the intestine. The infection is often mild and without symptoms, but can be life-threatening.
Cholera is a public health concern in developing countries worldwide. This is especially true in Africa, South Asia and Latin America.
Risk to travellers
If food and water guidelines are followed the risk of contracting cholera while travelling in affected areas is thought to be less than 1 in 500,000. Cases in travellers from developed countries are rare.
There is no longer an official requirement for cholera vaccination for arriving travellers to any country. Vaccination for cholera is recommended for high-risk travellers. These would include aid or refugee camp workers or persons planning extended stays in rural areas who are in close contact with the local population. An added advantage of the cholera vaccine, is that it offers protection against a common diarrhoea-causing bacterium LT-ETEC (enterotoxigenic E Coli).
Vaccination: Oral inactivated
Schedule: 2 doses from 7 days to 6 weeks apart.
Children from 2 years to 6 years of age require 3 doses. The solution is mixed using the sachet and half the liquid is poured away (75ml) before the full vaccine dose is added.
Level of protection: Provides 60-70% protection against severe disease for 2 years.
Children 2 years to 6 years need a booster at 6 months, if at continued risk of infection. Adults and children over 6 years of age require a booster up to 2 years, if at continued risk. If doses are given later than the recommended timeframe, primary immunisation must be repeated.
Possible Side effects
Occasional nausea, abdominal cramps or diarrhoea.
This vaccine is recommended for long-term travellers and for those visiting countries experiencing floods.
Diphtheria is a potentially serious illness involving the upper respiratory tract. It is spread by coughing and sneezing or by direct contact with wounds or items used by infected persons. There are different infecting strains, some can cause severe illness affecting nerves and the heart.
Symptoms usually start with a mild fever, sore throat and problems swallowing. A general feeling of unwellness and a loss of appetite. After about 2 -3 days a firm, fleshy, grey and sticky coating develops in the throat; it will bleed if an attempt is made to remove it. If left untreated more serious problems occur. These include suffocation, heart & kidney damage and severe nerve damage.
Diphtheria is found in all regions of the globe. Early last century in Australia, more deaths were caused by diphtheria than any other infectious disease. Imported cases still occur, usually from less developed countries.
Risk to travellers
The risk to travellers is generally low. Australian children are vaccinated against diphtheria as part of the standard immunisation schedule. In adults, a booster to the childhood series is suggested every 10 years if at risk.
Vaccination: Adults: Diphtheria given in combination with Tetanus or Tetanus/Pertussis or Tetanus/ Pertussis/ Polio.
Children under 10 years: Diphtheria toxoid given in combination with Tetanus and others.
Schedule: Primary series is given from 6-8 weeks of age. 3 doses are administered at least 4 weeks apart, with boosters at 4 and 12 -17 years of age.
A single booster of tetanus/diphtheria-containing vaccine is given at 50 years of age. Boosters are administered every 10 years for travellers who are travelling to countries where health services are difficult to access. Every 5 years for those travellers that are partaking in adventurous activities such as mountaineering, bike riding, rock climbing or caving in areas remote from good medical care is suggested.
Level of protection: Over 95%
Possible Side effects
Pain, redness or swelling at injection site as well as fever, headache and malaise.
Acute allergic reactions occur in 1 per 1 million doses
In young babies, decreased appetite, fever and crying.
Hepatitis A is a viral disease transmitted via the faecal-oral route. Infection is usually passed through the eating or drinking of food and/or water contaminated by the faeces of an infected person. Other methods of disease transmission include contact with contaminated items. It is a common vaccine-preventable infection in travellers visiting developing countries. There is no specific treatment and the vast majority of those infected recover with bed rest. A person who has previously been infected then has life-long immunity. Taking the appropriate precautions will help minimise the risk. Vaccination is the most effective way of preventing the disease.
What are the Symptoms?
The incubation period for the hepatitis A virus is generally around 30 days. Symptoms include fever, loss of appetite, nausea and pain in the right upper abdomen. This is then followed by jaundice. The symptoms may range from mild to severe. Some individuals display none and children often do not display symptoms. Older people are prone to severe illness, although rarely is hepatitis A fatal. Hepatitis A is highly endemic throughout the developing world, but occurs in all countries.
Risk to travellers
Taking the appropriate precautions will help minimise the risk. Vaccination is the most effective way of preventing the disease. Travelling in developing countries the risk of infection is higher and may increase with duration of travel. The chance of infection is highest in those who live in or visit rural areas with poor sanitation.
HAV can be transmitted in several ways. It is most commonly associated with the eating of seafood, such as oysters or inadequately cooked shellfish. These shellfish almost invariably come from water that had been contaminated with sewage or have been stored in contaminated ice. Eating raw vegetables grown in soil fertilised with infected faeces is another cause of outbreaks, as is drinking untreated water.
How is hepatitis A treated?
Currently there is no cure for HAV and the only recommendation is bed rest. The infection can last anywhere from 1 to 3 weeks and is usually followed by complete recovery. Children generally show no symptoms but are still infectious. The elderly are usually more severely affected. Early in contamination, those infected will not show symptoms. The illness itself is not pleasant so prevention is the best possible cure.
Vaccination: Inactivated Hepatitis A vaccine is a safe, highly effective option.
How can I stay protected while travelling?
It is vital to ensure proper hygiene and the avoidance of sharing food or crockery. Always drink bottled water. This should always be the way when in a developing country, the best way to ensure you do not contract HAV on your next trip is through vaccination.
The inactivated hepatitis A vaccine is a safe, highly effective vaccination option.
Types of Hepatitis A vaccination:
Inactivated virus vaccine
Inactivated combination vaccine* with hepatitis B
Inactivated combination vaccine with typhoid
Inactivated vaccine: Single dose, followed by a booster at 6 to 12 months
Hepatitis A and B combined vaccine: Three doses at 0, 1 and 6 months
Hepatitis A and Typhoid combined vaccine: single dose, followed by Hepatitis A booster at 6-12 months.
Level of protection: The vaccine offers 99% protection after a full course. It is effective for 20 to 30 years. A single injection will protect for approximately one year. For long-term protection, a second dose is needed.
Possible Side effects
Infrequent and usually mild, the side effects that may occur include:
Redness, swelling, a hard lump or bruising around the injection site
Feeling unwell, headache, fever
Loss of appetite, nausea
If you would like more information on any of these vaccinations feel free to speak to one of our Doctors (03 8652 5441 or book online) or one of the Practice Nurses who would be more than happy to help!
Written by Vicki Ma (Accredited Practising Dietitian and Sports Dietitian) What you eat during pregnancy affects your developing baby.
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