85 South St, Beaconsfield WA 6162

May 18, 2018

Meningitis C Vaccination Program in Fiji

We are very proud of our involvement with the UNICEF Champion for Children’s program, through our own Vax4Vax initiative. The 2018 outbreak of m

May 4, 2018

FIFA World Cup – Russia 2018

Heading to Russia in June / July to watch the Socceroos? Here’s a few tips. Security will be tight. Sources warn of possible anti-western sentim

April 24, 2018

World Immunisation Week

This week is World Immunisation Week. A celebration very close to our hearts. Why? Because vaccinations save two to three million lives each and every

April 19, 2018

Machu Picchu

‘Absolutely breathtaking’ is how one of our intrepid travel doctors describes this famous landmark. ‘Unlike what many people do, I d

Meningitis C Vaccination Program in Fiji

We are very proud of our involvement with the UNICEF Champion for Children’s program, through our own Vax4Vax initiative. The 2018 outbreak of meningococcal C in Fiji is one example of UNICEF’s rapid response to children in need. UNICEF, WHO and the Fiji government recently launched a vaccination program aimed at providing immunisations to over 350,000 children and adolescents, after the country’s health department confirmed 34 cases up to the end of March. Travellers to Fiji should discuss this and other risks with a travel medicine specialist, as vaccination may be recommended.

Always relevant, the increase in meningococcal cases in Australia in the past few years has seen the ACWY vaccine offered free by the WA Health Department to age groups 1-4 years and 15-19 year olds and our clinic has plenty on hand for those who haven’t had theirs as yet. Individuals in other high risk groups are also encouraged to seek advice about the need for vaccination.

FIFA World Cup – Russia 2018

Heading to Russia in June / July to watch the Socceroos? Here’s a few tips.
Security will be tight. Sources warn of possible anti-western sentiment due to recent world events. Be alert in public places and keep away from protests. Carry all documents at all times including your Fan ID and passport. Make copies and make sure your passport is in good condition and has an expiry of at least 6 months after your return date. Register your travel plans with DFAT, good advice for any overseas travel.

Severe penalties apply for possession or consumption of illicit substances, including ‘soft’ drugs. Medicines containing ‘narcotics’ (many commonly prescribed painkillers) or ‘psychoactive substances’ require a doctor’s letter (with Russian translation) listing the name, dose and reason.

What are the health risks attending the World Cup in Russia?

Like all travel to destinations where large numbers of people converge, respiratory illnesses (colds and flus) and gastrointestinal upsets are the most likely, although the latter is reduced if staying in high end accommodation. Diseases rarely encountered in Australia, such as rabies, tick-borne encephalitis and tuberculosis occur in Russia but are unlikely to be a problem for the average World Cup traveller staying in good accommodation in cities .

What about vaccines? We recommend all travellers attending large international gatherings have the latest flu shot (which has just become available) and make sure they are up to date with the measles vaccine (2 shots in a lifetime) or have natural immunity. A tetanus booster might not be a bad idea if due, and you may want to consider hepatitis A vaccination depending on future travel plans.
Need medical help ? Contact your travel insurance before calling an ambulance or attending a clinic/hospital otherwise your insurance might not cover you. Payment is usually required up front before treatment.

Finally, don’t drink too much vodka and keep a close eye on your friends if they do !

Dr Raphael Beilin

Machu Picchu

‘Absolutely breathtaking’ is how one of our intrepid travel doctors describes this famous landmark.

‘Unlike what many people do, I didn’t do the four day hike into Machu Picchu as I was doing the Santa Cruz trek from Huaraz in the north of Peru later in the trip. Instead, from Cuzco I headed into the Sacred Valley, visiting the Pisac markets, the ruins and town of Ollantaytambo, the salt ponds of Maras and the Inca Ruins of Moray. I then stayed in the town of Aguas Calientes, allowing myself a full day to explore Machu Picchu. Machu Picchu is one of the most unique and amazing views I have ever seen and certainly lives up to its reputation – extensive ruins surrounded by mountains. It is a sight and experience I will never forget. Among other things I would definitely recommend using some tropical strength insect repellent to avoid getting bitten by the midges, and either taking Diamox or allowing time to acclimatise to the altitude’. Dr Boey-Leng Loy

The best time to visit Machu Picchu is May/June. It’s a long way to go and such a beautiful place, that minimising the risk of illness should be a high priority.

Altitude sickness is one of the most important things to consider, given that it lies high up in the Andes at 2430m. There are also a number of other concerns which are worth preparing for, including the fact that although its too high for mosquitoes (and the myriad of illness they transmit),  sand-flies and midges can still be a nuisance. Food and water safety is very important with hepatitis A and typhoid vaccination usually recommended and you may want to take a self-treatment kit in the event that you fall victim to a simple but highly inconvenient bout of gastro (travellers diarrhoea).

Travellers to Peru may be required to present a Yellow Fever vaccination certificate for onwards travel and re-entry into Australia and whilst there is no malaria in Machu Picchu, it does become relevant if you add on a trip to the Amazon for example. Simply put, we definitely wouldn’t recommend travelling to Peru without having had an appointment with one of our experienced travel doctors. Dr David Rutherford

Do I need vaccinations on a cruise?

With more cruise ships than ever leaving from Fremantle Port, increasing numbers of West Australians find themselves able to sail to exotic locations without even having to get on a plane. Risk from disease on a cruise ship is generally considered to be low but does vary depending on itinerary (Africa v New Zealand for example).

In most instances cruises involve single day stopovers at a number of ports. The recommendation for vaccination is itinerary and activity based, on cumulative risk. On a 2 week cruise stopping 5 times at ‘higher risk’ destinations for example, the risk is therefore spread over 5 days not 14. Any developing country should be considered higher risk from a health perspective and some developing  countries (ie India) ‘high risk’.

Where stopovers occur in a developing country, hepatitis A vaccination is often recommended. A viral disease of the liver, hepatitis A is transmitted through contaminated food and water and even if you stick to 5 star organised tours whilst on land, you may still find yourself at risk.

Respiratory infections can sometimes spread quickly on cruise ships. Older passengers or those with pre-existing respiratory, cardiac or metabolic conditions are advised to be vaccinated with the current flu vaccine. Many people who fall into this group should also be considering the pneumonia vaccine.

A proof of Yellow Fever vaccination certificate may be required on some cruises that visit part of the African or South American continents. Cruise companies and travel agents should advise you on the need for a Yellow Fever vaccination but don’t always, and its a complicated issue, so it’s best to double check.

As always this is broad advice and other vaccinations may be recommended depending on specific itinerary and an individual’s personal medical circumstance, so it’s worth a consultation to ensure you are covered – and don’t forget you should never leave Australia without ensuring you are immune to measles and your tetanus vaccine is up to date (even if going to Europe).

 

For more information about staying healthy on a cruise (not all diseases are vaccine preventable), read our Cruising the High Seas information guide.

Vaccination Timeline- how far in advance do you need to vaccinate before travel?

We often get calls from people wanting to know how far in advance of their trip they should be getting vaccines. In general we recommend making an appointment 4- 6 weeks before departure. This gives us plenty of time to prepare you for your trip (vaccination against hepatitis B or rabies for example requires more than one shot),  and is close enough for us to advise you of any current disease outbreaks that might be relevant to your itinerary. Also a small percentage of people having vaccines will experience some mild side effects (often 3-7 days afterwards) and no-one wants to be feeling out of sorts whilst on holiday.

Coming in well ahead  of time is particularly important for anyone who is immunosuppressed, with a complicated medical history, who was unvaccinated as a child or who plans to be away for an extended period of time. There is often lots to talk about and more than one visit may be required.

Leaving sooner than 4 weeks from now? It’s not too late, so still make an appointment.  Be aware however that coming for an appointment with only a few days until departure  may mean we can’t cover you for all the things you may be at risk of. The Yellow Fever certificate  for example, isn’t valid until 10 days after vaccination.  Don’t forget that a travel consultation is also much more than just vaccination. Even if you have no vaccines you need to know how to minimise your risk of disease and may for example need altitude sickness or malaria tablets. You may also choose to take a prescription self treatment kit with you, for prompt and reliable treatment of gastro and other ailments. There is always plenty to discuss!

Doxycycline vs Atovaquone – Proguanil

Doxycycline vs MalaroneTM

(aka PromozioTM or Atovaquone – Proguanil)

Which Malaria prevention medication should I take? This is a common question we get asked a lot.

If you have been advised to take malaria prevention medication for your next trip it’s possible you have been given the option of doxycycline or atovaquone- proguanil (more commonly known as the brand names Malarone or Promozio). Here are the main differences you need to consider:

Malarone is great for short term exposure, you take it 1-2 days before you are at risk (not always at the start of your trip) and then one per day whilst at risk plus for 7 days afterwards. It is well tolerated and side effects are uncommon but may include nausea and headaches. There is a paediatric tablet suitable for children. It is however usually quite a bit more expensive than Doxycycline, which you need to consider if going on longer trips to a malaria area.

Doxycycline (known by many brand names) is also taken 1-2 days before risk, one per day whilst at risk but then for 4 weeks afterwards. Side effects can include increased sun sensitivity (more prone to sunburn) and some gastric symptoms, which can be avoided by taking with food at breakfast time and specifically not just before lying down. In women it can increase likelihood of yeast infection. Doxycycline is not suitable for children under 8 years of age. Relatively cheap to purchase, it can also prevent other infections that you may be at increased risk of, depending on your itinerary and for this reason alone is sometimes recommended over Malarone.

It is important to remember however, that no malaria medication is 100% effective and should be used with mosquito avoidance measures to significantly decrease your overall risk.

If you are planning to travel to a Malaria risk country, seek tailored travel health advice from our travel doctors in Fremantle. 

Book an appointment easily online.

Yellow Fever Outbreak in Brazil Continues

An ongoing Yellow Fever outbreak in Brazil (since July 2017) has resulted in  545 confirmed yellow fever cases and 164 deaths. Recently this has also resulted in Yellow Fever cases being reported in the Netherlands, Argentina and France, all in unvaccinated travellers returning from Brazil to their country of origin.

This provides a great segue into one of the many issues surrounding Yellow Fever, the reasons to vaccinate against it and why you need to have an appointment with a Yellow Fever approved provider to discuss your itinerary.  The Aedes aegypti mosquito, responsible for the transmission of Yellow Fever, is not found in France and the Netherlands. For these particular travellers there was a risk of disease (very real and potentially fatal) but no requirement by either France or the Netherland governments for them to provide proof of vaccination on re-entry. Simply because there is no risk of them passing it on to anyone else.

In countries where Aedes aegypti is active the risk is that a traveller returning with Yellow Fever is bitten by an aedes mosquito who then goes on to bite subsequent people who become infected, who may then also be bitten….. And so an outbreak occurs. As a general rule these countries have a Yellow Fever vaccination requirement to prevent the introduction of the disease – and yes  Australia has the aedes mosquito too, which is why we are required to show proof of vaccination if returning from a designated country of risk.

 

Merry Xmas from the Staff

The staff at Travel Health Plus are looking forward to the holiday period. Many of us are heading overseas to visit family and friends or to enjoy a much anticipated holiday. We would like to wish everyone a very safe and fun filled Xmas and  New Year. We look forward to seeing you in the clinic or somewhere in the world in 2018.

Whooping Cough in New Zealand / Diphtheria in the Americas

We often forget why  our routine childhood immunisation schedule came into being, but be assured it was in response to significant numbers of cases being reported – having a huge burden of disease on not only those individuals affected but also the health system as a whole. Some of those diseases whilst occurring rarely  have not disappeared entirely, but do remain vaccine preventable and highlight the need to keep your immunisations up to date.

In recent weeks in New Zealand for example significant numbers of cases of Whooping Cough (pertussis) have been reported; more than 260 cases over a 4 week period from mid October. Often it is adults who lack immunity, not having had a booster since childhood.

Similarly a number of countries in South and Central America are reporting increased numbers of diphtheria, Venezuela in particular intensifying its national vaccination program. Rare but highly contagious and potentially life-threatening, diphtheria was once the most common infectious cause of death in Australia.

All adults are recommended to check their vaccination status for baseline vaccines, particularly prior to travelling to developing countries where vaccination rates may be significantly lower than at home, resulting in greater risk. A triple antigen vaccine, providing immunity against diphtheria, tetanus and whooping cough is readily available.