NEDLANDS: 2/141 Stirling Highway

BOOK NEDLANDS

FREMANTLE: 85 South St, Beaconsfield

BOOK FREMANTLE BOOK NOW

NEDLANDS: 2/141 Stirling Highway

BOOK NEDLANDS

FREMANTLE: 85 South St, Beaconsfield

BOOK FREMANTLE BOOK NOW

Travel Health Blog

January 9, 2020

Measles – the plane truth

Measles – the plane truth By Dr Aidan Perse The main risks associated with overseas travel to any destination are food and water borne, mosquito, an

December 10, 2019

XMAS OPENING HOURS 2019

At this stage in December we like to remind our patients that both our Beaconsfield and Nedlands clinics close at lunch time on Xmas Eve. Our main cli

December 10, 2019

Meet The Team – Dr Jenny-Ann McLellan reflects on travelling with children

Experiencing new places is always wonderful and it’s great to expose your children to different cultures and environments. Travelling as a famil

December 6, 2019

HIV in travellers

Whilst the overall rates of HIV in Australia have fallen, statistics recently released by the government indicate rates are increasing in heterosexual

measles vaccination

Measles – the plane truth

Measles – the plane truth
By Dr Aidan Perse

The main risks associated with overseas travel to any destination are food and water borne, mosquito, and airborne diseases. In most instances the risk is greatest in developing countries, but not always.  With measles outbreaks being reported in many countries including Israel, Thailand, Japan, Vietnam, Ukraine, the Philippines and New Zealand, in 2019 the CDC  issued a global measles outbreak notice.

Measles( from the Latin meser, relating to miserable) was described by Persian physician Rhazes in the 10th century. He distinguished it from smallpox and believed it to be the worse of the two. The virus was isolated in 1954, and the first vaccine developed in 1963.

As a result of mass immunisation programs, many doctors have never seen a case of measles, and have even less experience with its complications. Typical symptoms include a cough, conjunctivitis and a rash starting from the head and spreading to the torso and extremities. There is often a high fever that disappears quickly with the onset of the rash. Incubation is up to two weeks, with people being infectious from two to four days before the rash to four days after.
Complications include middle ear infections, diarrhoea and pneumonia with encephalitis one in every 2000 cases (sometimes years later). There is also emerging evidence the immune system is suppressed for up to 5 years after infection. Death occurs in 0.1-0.3% of cases and is higher in children under five and people who are immunocompromised. The death rate in developing countries is up to 15%, mainly from diarrhoea and pneumonia.

Two doses of the combined measles/mumps/rubella vaccine is 99% effective. However, measles is probably the most contagious of diseases, remaining infectious in the air for up to two hours, and very effective at finding those not immune. Over 90% of non-immune contacts will catch it.

Whilst two doses of the vaccine now form part of the childhood immunisation schedule, this has not always been the case and people born between 1966 and 1982 may only have had one vaccine and should get another. Most people born before 1966 will have natural immunity.

WHO declared Australia measles free in 2014. All subsequent outbreaks here have been traced back to someone returning with it from overseas, making immunity in travellers vital. Whilst given at 12 and 18 months on the current childhood schedule, the first dose can be given as young as six months and early immunisation is often considered for those children whose overseas travel puts them at particular high risk.

Are you immune?

 

travelling over christmas

XMAS OPENING HOURS 2019

At this stage in December we like to remind our patients that both our Beaconsfield and Nedlands clinics close at lunch time on Xmas Eve.

Our main clinic in Beaconsfield resumes normal trading hours on Thursday January 2nd, and as in previous years we have a single morning session on New Years Eve Tuesday December 31st, for anyone mid vaccine schedule (by appointment only).

Our Nedlands clinic doesn’t reopen until Tuesday January 7th.

Please keep this in mind if you need to return for a follow up appointment prior to departure or have medications/kits to collect before January 2nd. Whilst we are closed you can still make appointments through our website but emails and social media messaging won’t be monitored.

Like you our staff are looking forward to a well earned break and travel to distant shores. We’d like to wish you  a safe and happy holiday season.

Travel Health Plus

Children who are carefree after being vaccinated

Meet The Team – Dr Jenny-Ann McLellan reflects on travelling with children

Experiencing new places is always wonderful and it’s great to expose your children to different cultures and environments. Travelling as a family can be challenging but with a bit of preparation and forethought you can reduce the stress for everyone to ensure a special holiday is enjoyed by all.

A simple tip is not to try and pack too much into a single day. Perhaps plan something for the morning and then ‘play’ for the afternoon. A swimming pool, play area or beach near where you are staying is always good, as is an icecream stop.  If its a busy holiday, factor in frequent specific rest days so that small children don’t get increasingly tired.

Pack carefully and limit your luggage, to make movement through airports and into buses, cars and taxis as smooth as possible.  Remember that with small children you may also end up carrying them, as well as their cute backpack  filled with  toys. Carry paracetamol and zofran (the latter is good for nausea)  in your carry on luggage – so it’s readily accessible mid-flight or on arrival.

Consider going on holiday with another family or pick family friendly accommodation so there are other children to play with. We have travelled to many places with our children but the most successful and enjoyable were skiing in Japan, doing a safari in Botswana and surfing/snorkelling in the Maldives, all with other families.

You can also find lots of websites (Smart traveller has some great tips) and blogs dedicated to travelling with children.

Dr Jenny-Ann McLellan

travel Mexico

HIV in travellers

Whilst the overall rates of HIV in Australia have fallen, statistics recently released by the government indicate rates are increasing in heterosexual men. This largely seems to be as a result of them having unprotected sex in countries where there are high rates of HIV.

To coincide with World AIDS day the health department has launched a campaign to raise awareness amongst those travellers who are at the greatest risk. We can’t stress enough the importance of using condoms regardless of which country you are in  (HIV isn’t the only thing out there) and speak to your GP about getting tested upon return (and regularly if you are at continued risk). For some,  preventative medications may be appropriate and don’t forget to take your own condoms with you to ensure they are of good quality.

https://www.mediastatements.wa.gov.au/Pages/McGowan/2019/12/Going-somewhere-Dont-bring-HIV-home-from-your-holiday.aspx

https://www.abc.net.au/news/2019-12-01/hiv-diagnosis-rates-in-wa-more-straight-man-than-gay/11752598

Philippines – Polio outbreak

Smartraveller has sent notification that the Philippine Department of Health has reported a polio outbreak. As well as other destination specific vaccines, travellers to the Philippines should ensure they have had the full primary course of polio immunisations (part of the childhood schedule) plus an additional booster dose for adults.

Saudi Arabia travel health advice and vaccinations

Hajj & Umrah Health Requirements

Australians heading to Saudi Arabia for the Hajj & Umrah pilgrimages need to ensure that they are vaccinated prior to departure, to meet the requirements of the Saudi government. These requirements can change from year to year and are aimed at disease prevention, not just in Saudi Arabia but also within countries pilgrims will be returning to. With massive numbers of people coming together from all over the world, the potential for disease spread is great and all travellers are advised to ensure their routine vaccinations are up to date and should consider Hepatitis A and B and typhoid vaccines. There are also Saudi vaccine requirements in order to attend.

In 2019 the requirements for those travelling directly from Australia to Saudi Arabia are:

  • Proof of vaccination against Meningococcal ACWY within the last 3-5 years (depending on which type of vaccine was last given), and no less than 10 days prior to arrival

Of note:

  • Yellow Fever vaccination – this is not required if travelling directly from Australia to Saudi Arabia
  • Yellow Fever vaccination – an international certificate is required if arriving from one of the  Yellow Fever risk countries in Africa or South America (discuss with your doctor if you have a complex itinerary and are not taking a direct flight)
  • Polio vaccination – proof of vaccination required if coming from a country where polio remains a risk (Australia is not one of them)
  • Influenza vaccination is recommended by the Saudi Health authorities for everyone

 

Travel health advice and vaccinations for Sri Lanka

Travel Safety and Security

Safety and security is something that should always be in the back of every travellers mind, especially when travelling to countries that have a reputation of being unsafe. I regularly travel with my children to these types of places and have a few rules that I employ that reduce the risks but still leave us being able to fully explore.

Below are some of  the tips that I recently used to plan a trip to South Africa:

Research Do your research on the safety concerns of your destination. The Smart Traveller website is a good place to start https://smartraveller.gov.au/resources/Pages/travel-advice-explained.aspx. Each country is designated an Advice Level, with lots of great safety tips that are destination specific. You can also register your trip which you should do  regardless of the destination (ie earthquakes in New Zealand /  a Tsunami in Japan).

Travel Insurance Don’t leave home without it!! Take out insurance with a reputable insurer, and read the PDS (especially if you have a pre-existing condition, are travelling to altitude or plan on snow skiing).

On Arrival Depending on your destination, you have often been travelling for a long time and are jet-lagged and exhausted. In higher-risk, unfamiliar countries I like to organise an airport transfer rather than trying to negotiate transport or taxis on arrival. I tend to stay at a nearby hotel for the first night to have a good sleep, and start my trip feeling refreshed.

Transport It is often safer to organise a local driver or use a tour company. Road rules are often different or appear non-existent! If you chose to hire a vehicle, make sure you have the appropriate license – especially on motorbikes. Your insurance will often be void if you don’t hold a motorbike license– in the case of an accident you will be left high and dry in an often sub-standard hospital. The RAC does International Drivers Licenses for about $30.

Local Laws These can often be very different to home, especially in relation to drugs, women rights and cultural expectation. Research before you arrive and behave accordingly. Know where the nearest Australian Embassy/Consulate is.

Crime Crime is often opportunistic, so reduce your risk by being sensible. Use money cards, rather than carry a lot of cash. Use a money belt or cross-shoulder bag. Be wary at isolated ATMs. Know what parts of town are high risk and avoid, or use a local guide. Avoid wandering around in isolated areas at night especially. Don’t leave your valuable belongings lying around in sight. Once again SmartTraveller can often pin-point destination specific problems.

Every traveller has a different level of risk they are willing take, and every destination has a different safely and security profile. Being informed and sensible is the key to a safe and enjoyable holiday.

Travel Safe!

Nadia (clinic nurse)

Travel Health and advice France

Sporting Events – World Cup France and Rugby World Cup Japan

2019 will see two major sporting events being played out on the world stage, the FIFA Women’s World Cup in France and the Rugby World Cup in Japan.

Heading to France to see the world’s best women compete for ultimate football glory? Here’s some information to know.

France has been one of the world’s leading tourist destination in terms of foreign visitors since the 1990s. The country’s appeal lies in it’s rich history, outstanding gastronomy and deep artistic heritage. The FIFA Women’s World Cup 2019 runs from 7 June to 7 July 2019 and kicks off with the opening game with the host nation France competing against South Korea on 7 June in Paris. The month long event will see 52 matches play to determine the ultimate winner with the final match being played at Parc Olympique, in Lyon.

This year’s FIFA Women’s World Cup 2019 consists of teams from:

  • Argentina
  • Australia
  • Brazil
  • Cameroon
  • Canada
  • Chile
  • China PR
  • England
  • France
  • Germany
  • Italy
  • Jamaica
  • Japan
  • South Korea
  • The Netherlands
  • New Zealand
  • Nigeria
  • Norway
  • Scotland
  • South Africa
  • Spain
  • Sweden
  • Thailand
  • USA

As needed with all travel, the following safety and health precautions should be considered prior and during travel to France.

Smart Traveller official advice on France is to exercise a high degree of caution due to the high threat of terrorist attack. There have been several major terrorist attacks in France. Since 2015, over 200 people have been killed and hundreds injured. Major sporting events can attract much higher levels of security due to the increase of large groups of spectators for games.  Demonstrations linked to the Yellow Vest movement may continue across France for some time, including in tourist areas. Protests mostly happen on Saturdays. Avoid all demonstrations as they may turn violent and disrupt traffic in some regions. Monitor local media and follow the advice of local authorities.

Health risks in France are broadly similar to those in Australia. There is currently a measles outbreak across the world so make sure your measles vaccinations are up to date prior to travel and consider the flu vaccine.

 

Rugby World Cup 2019 Japan

The 9thRugby World Cup is set to kick off in Tokyo Japan on Friday 20 September following the opening ceremony, when the host nation plays team Russia. A total of 48 matches will be played across the tournament which runs from 20 September through to Saturday 2 November. 2019 will see the tournament being held for the first time in Asia.

Japan is a stunning combination of ancient traditions, modern life and breath-taking nature and with the Rugby World Cup taking place around the country, spectators are set for an experience like no other.

This year’s Rugby World Cup features teams from:

  • Argentina
  • Australia
  • Canada
  • England
  • Fiji
  • France
  • Georgia
  • Ireland
  • Italy
  • Japan
  • Namibia
  • New Zealand
  • Russia
  • Samoa
  • Scotland
  • South Africa
  • Tonga
  • Uruguay
  • USA
  • Wales

As needed with all travel, the following safety and health precautions should be considered prior and during travel to Japan. Smart Traveller official advice on Japan is to exercise a normal degree of caution. Japan experiences earthquakes, tsunamis, typhoons and volcanic activity from time to time. The Japan Meteorological Agency provides up-to-date information in English on these issues as they arise.

The mosquito-borne disease Japanese encephalitis occurs in rural areas of Japan. Protect yourself against mosquito-borne illnesses in rural areas by getting vaccination prior to travel, Take measures to avoid insect bites, and ensure your accommodation is mosquito proof. – not likely to be recommended so best to leave this out.

There have also been a significant number of cases of measles and rubella in Japan in recent years. Make sure your vaccinations are up-to-date before you travel and definitely consider influenza vaccination.

Prior to setting off on your sporting fan adventures, make an appointment with the team at Travel Health Plus to make sure you are covered.

Travel Health Plus Travel Advice for Brazil

Travel Brazil

Brazil is a country blessed with it all – powdery white sandy beaches, breath-taking rainforests and thriving, bustling cities. It’s attractions extend from colonial towns that seem to be frozen in time, tropical islands and otherworldly landscapes of mountains and waterfalls, as well as a national culture that embraces good food, great music and fabulous festivals and parties.

Often described as one of the world’s most captivating countries, Brazil offers something for everyone. The official language spoken in Brazil is Portugese.

With so much to do and see here are some of the top places to visit while travelling throughout Brazil.

Pão de Açúcar
Seen from the peak of Pão de Açúcar, Rio is undoubtedly a Marvelous City or as the locals describe it – Cidade Maravilhosa. There are many good times to make the high ascent, but sunset on a clear day is the most rewarding described by many travellers. Two cable cars connect to the summit, 395m above Rio. At the top, the city unfolds beneath you, with stunning views of Corcovado mountain and Christ the Redeemer off to the west, and Copacabana Beach to the south. Be prepared for heavy crowds however and if possible, go first thing in the morning – and avoid going on cloudy days as this will impact the view and photo opportunities!

Parque Nacional do Iguaçu
Brazil’s second-oldest national park, it was created in 1939 and protects one of South America’s most magical and majestic sights, Iguaçu Falls. Iguaçu Falls form part of the largest waterfall system in the world. The 1200m-long Waterfall Trail (Trilha das Cataratas) is one of Brazil’s premier natural experiences with a series of islands cut the river into waterfalls along the path culminating in a magnificent display of nature at Garganta do Diabo (Devil’s Throat’).

Copacabana Beach
You can’t think of Brazil without thinking of the breathtaking Copacabana Beach. Extending for some 4km, the beach is a bustling mix of locals, tourists, music and food. On Copacabana Beach the locals separate themselves out into different sections depending on their activities, and is despite it’s tag as a tourist hotspot, a visit to Copacabana Beach must be ticked off the list.

Christ the Redeemer (Cristo Redentor)
Standing atop the Corcovado (which means ‘hunchback’ in Portuguese), Cristo Redentor gazes out over the sweeping city of Rio. The mountain rises straight up from the city, and at night the brightly lit 38m-high statue is visible from nearly every part of the city. The most popular way to reach the statue is to take the red train that departs every 30 minutes, and takes approximately 20 minutes to reach the top.

The Amazon Rainforest
Named after female warriors in Greek mythology, the Amazon rainforest is the world’s largest rainforest. Covering much of northwestern Brazil, the Amazon offers a mystical experience for those who visit. The rivers are roads in the Amazon, and the slow pace of a boat trip is a uniquely Amazonian experience, coupled with the phenomenal scenery a short trip to the Amazon is a must when visiting Brazil.

Taking the plunge and booking that trip to Brazil?
Here’s some important things to consider. Brazil’s high season coincides with the northern-hemisphere winter. It’s a hot, festive time and you can expect higher prices and minimum stays (typically four nights) during Carnaval. It’s particularly busy in Rio and popular beach destinations all along the coast. If you’re headed to Brazil for Carnival then February is the time to be there.  You definitely won’t be alone though so prepare for the crowds.

Aside from July, which is a school-holiday month, you’ll find lower prices and mild temperatures in the south. July to September are good months to visit the Amazon or Pantanal. The weather is warm and dry along the coast, though it can be chilly in the south. Prices and crowds are average, though Easter week draws crowds and high prices.

The Brazilian climate can vary greatly from region to region. The coastal cities of Rio de Janeiro, Recife and Salvador are hot for most of the year while plateau cities such as Sao Paulo, Brasilia and Belo Horizonte are milder. Rainy seasons occur from January to April in the north, April to July in the northeast and November to March in the Rio and São Paulo areas.

The Australian Smart Traveller official advice is to exercise a high degree of caution in Brazil, due to high levels of serious and violent crime. Pay close attention to your personal security at all times. Avoid shanty towns (or ‘favelas’) in the big cities due to the very real threat of crime. If you are attacked or robbed, do not resist.

Brazil is currently experiencing a yellow fever outbreak. Yellow fever is a potentially fatal viral disease transmitted by mosquitoes and is preventable by vaccination. In 2018, yellow fever cases were reported in the states of Sao Paulo, Minas Gerais, Rio de Janeiro, and the Federal District. Vaccinate yourself against yellow fever at least 10 days before travelling to Brazil. You may need to show a yellow fever vaccination certificate if you go to another country from Brazil or on arrival in Australia. A Yellow Fever vaccine is only available from government licensed clinics.

There is also widespread transmission of Zika virus in Brazil. The Australian Department of Health advises pregnant women to discuss any travel plans with their doctor and defer non-essential travel to affected areas.

Brazil is currently also experiencing a measles outbreak. Measles vaccinations are readily available and need to be considered prior to travel to ensure you are covered.  Malaria is a high risk throughout Brazil. There is a current outbreak in Bahia. Other insect-borne diseases (including dengue fever and chikungunya,) are also a risk to travellers, with a higher incidence during the wet seasons. Standard immunisations for food and water borne diseases such as hepatitis A, typhoid and influenza are advisable.

Prior to setting off on your adventures, make an appointment with the team at Travel Health Plus to make sure you are covered.

travel advice Peru

Inca Trail – Peru

Inca Trail (Machu Picchu) – PeruThe Inca Trail to Machu Picchu is one of the South America ́s and possibly one of the World ́s most famous hikes and journeys and is a bucket list adventure for so many travellers around the world. As the most famous hike in South America, the four-day Inca Trail is walked by thousands of people every year. The ancient trail laid by the Incas winds its way up and down and around the mountains, twisting over three Andean passes which have collectively led to the route being dubbed ‘the Inca Trail.’

On your Peruvian adventure you can follow Inca traditions from Lima to Cusco, journey through the heartland of the Sacred Valley, see the magnificent Ollantaytambo ruins before embarking on the ultimate adventure – trekking to Machu Picchu – all whilst getting closer to the secrets of this civilisation on an absolutely breath-taking adventure.

With an incredible mix of views – from snowy mountain peaks, breath-taking rivers and ranges, and stunning forests flush with orchids, trekking from one cliff-hugging pre-Columbian ruin to the next is simply a magical and unforgettable experience for anyone. Plus, the array of Inca archaeological sites are worthy of a visit of their own!

The Inca Trail to Machu Picchu is in fact a small part of a vast network of trails and roads built by the Incan Empire over 500 years ago. The Inca trails or Qhapaq Ñanare, which means network of trails, are estimated to have covered anywhere between 23,000km and 45,000km in distance and were integral in connecting the Tahuantinsuyo Empire, which ran from Colombia and Ecuador in the North, through Peru, Chile and parts of Argentina, and stretched into Brazil and Bolivia.

Planning your trip? There are few really important things to take note of.

Peru is a year-round destination for travellers, but the dry/winter season – between May and September – is generally the most popular time for trekking. This is when the nights are cooler and there are often wildflowers blooming along the trail.

Regardless of what time of year you decide to hike in Peru, waterproof clothing and hiking boots that are already worn in, thick hiking socks, warm and cool layers of clothing, sunscreen and a fleece are integral. The weather in the Andes can be unpredictable, so you’ll want to ensure you’re well-equipped for your trek.

 The rainy season runs from November to March, taking a waterproof clothing at any time of year will come in handy for hikes. The Inca Trail also closes every year in February for maintenance.

With any travel, but especially with this type of trip, travellers must consider the potential safety hazards that come with trekking. Many areas including Cuzco and Machu Picchu, Puno and the Colca Canyon and Lake Titicaca, are above 2,500m. Due to the high altitude the air is thinner and some people can suffer altitude sickness. Altitude sickness can be fatal so it’s important to get the right advice before you travel, know how to reduce your risk, what the symptoms are and what to do if you get them, including medication (Diamox). Also, the sun is unusually strong and it’s easy to get burnt. It’s important to wear sunscreen and other sun protection, and always drink plenty of water.

As this trip involves a lot of walking to see the sites, and if you do the Inca trail, there’ll be a lot of strenuous hiking. The trip is recommended for those with a moderate level of fitness but there are also a few different trail options to suit your interests and physical capabilities. Tetanus vaccine should also be up to date.

Food and water safety is also very important, particularly in order to prevent diarrhoeal illness when trekking. Hepatitis A and sometimes Typhoid vaccine are recommended for travel to Peru as well as carrying useful medications to treat gastro.

Insect-borne diseases are found in Peru, mainly in low lying areas. According to the World Health Organization (WHO) yellow fever is widespread in Peru. Yellow fever is a potentially fatal viral disease transmitted by mosquitoes and it is preventable by vaccination. On return to Australia, you’ll need to show a valid Yellow Fever Vaccination Certificate on entry into Australia if you’ve visited Peru in the previous six days.

 There is also widespread transmission of Zika virus in parts of Peru. The Australian Department of Health advises pregnant women to discuss any travel plans with their doctor and defer non-essential travel to affected areas.

Malaria, dengue fever and other insect-borne diseases occur in parts of the country (and Dengue fever is particularly common in and around Iquitos)

Prior to setting off on your adventures, make an appointment with the team at Travel Health Plus to make sure you are covered.