Travel vaccinations

Overseas travel is good for your health, provided you have your travel vaccination shots and take certain health and lifestyle precautions, as Julie Hare reports.

Have vaccinations and travel

• Vaccinations - what you need and when
• Before you travel - a checklist
• Ghastly gastro
• Avoiding jetlag
• Women on the move

Vaccinations - what you need and when

Yellow fever: Required by all travellers to infected areas of South America and Africa. If you try to re-enter Australia after being in an infected area, and don't have a valid certificate of vaccination, you may be quarantined for up to six days the incubation period of the disease.

Cholera: According to the Commonwealth Department of Health, the current vaccine is not very effective. However, a number of countries, including Pakistan, India, Malta and Tanzania, insist on immunisation. Check with your State department of health, or a travel clinic, about which other countries require cholera vaccination.

Typhoid: Not required in any country, but recommended for travellers to Asia, Africa and Latin America.

Hepatitis A and B: A combined vaccine is now available. Highly recommended for most overseas travellers.

Polio: Still prevalent in many countries. Most Australians are vaccinated during childhood, but a booster may be necessary.

Tetanus: Highly recommended for all travellers. You are advised to have boosters every 10 years, and youre even better off if you have an ADT (Adult Diptheria Tetanus) shot.

Rabies: Although the disease is widespread through Asia, Europe, Africa and the Americas, it is not considered necessary to be immunised unless you will be working with or handling animals. Dont take risks by feeding or petting animals in these areas, especially dogs and wild animals such as monkeys.

Meningococcal meningitis: If you are travelling to Nepal, Brazil, Mongolia, Vietnam or Africa, vaccination against this disease is recommended.

Malaria: Malaria cannot be vaccinated against but personal insecticide and clothing and nets soaked in permethrin are effective. If you are travelling to the Pacific, Asia, Africa or Central and South America, you will need anti-malaria tablets. Start taking the tablets two weeks before departure and for at least one month after leaving the area. Also, you should always wear insect repellents, keep your skin covered at and after dusk, and always sleep under mosquito nets if youre staying in non-air-conditioned accommodation.

Other diseases: Mosquitos are responsible for a number of other diseases, including yellow fever, dengue fever (all tropical areas), Ross River Fever (South Pacific Islands) and Rift Valley Fever (Egypt and Central Africa). You can also be bitten during the day, so make sure you take precautions. Rabies, TB and Japanese Encephalitis are also potential problems.

Vaccinations vary in price, depending on the type and where you get it done. People who should seek specialised medical advice before being vaccinated include pregnant women and the immuno-suppressed (ie people with cancer or HIV).

Before you travel - a checklist

Travel Clinics Australia recommend the following steps:

• Have a thorough medical check-up at least six weeks before you leave
• Make sure your vaccinations and medications are up to date
• Pack a medical kit
• Have a dental check-up
• Have an eye-sight check-up
• Ensure passport and visas are up to date
• Pick up tickets
• Organise travel insurance (including emergency evacuation cover)
• Get travellers cheques are credit cards
• Leave a copy of your itinerary with a responsible person who you can contact while away
• Take spare spectacles, lens and glasses prescriptions and any medications you require. Carry photocopies of prescriptions with you.

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Ghastly gastro a fact of travelling life

Travellers gastro, or diarrhoea, is the most common ailment of those travelling abroad, particularly to developing countries.

"While gastro is rife among overseas travellers, you can reduce the risk, if not avoid it altogether," says Dr Cohen.

There is a three-rule guide to gastro prevention: boil, bottle and peel.

Of course, some destinations are a lot more risky than others. Travellers to the US, Canada, Japan, the UK and parts of Europe have little behaviour modification to contend with. However, those heading for Asia, Africa and South America need to be extra careful.

"If you cant get bottled water, then only drink water that has been boiled for ten minutes," says Dr Cohen. "Longer, if you are in high altitude. Avoid milk and dairy products that have not been pasteurised or treated (long life milk). And remember, freezing does not destroy micro-organisms, so avoid ice in drinks and ice-cream.

"Fruit and vegetables that you can peel, such as bananas and oranges, are usually OK, but avoid thin-skinned fruit such as apples, grapes and stone fruit.

"All food should be thoroughly cooked and eaten hot. Dont eat reheated or pre-cooked food. Also avoid cold meat, cream, raw seafood and shellfish (such as oysters, crabs, prawns and lobsters) and fruit and vegetable salads."

Personal hygiene is essential. Always wash your hands after you go to the toilet and before you put anything in your mouth. Also, brush your teeth using only bottled or boiled water.

"If you do get gastro, the important thing is to get plenty of rest and drink lots of fluids," Dr Cohen says.

Avoiding jetlag

There are many theories about what causes jetlag and how to lessen its impact. According to Judith Carne, the secret is sunlight.

"I worked for Qantas for ten years and frequently suffered jetlag," she says. "Then I heard a theory that sunshine on the pineal gland will correct your diurnal rhythms (internal day-night clock) very rapidly. It really works. So go and sit in the sunshine for a couple of hours after landing. Don't try and sleep it off in a darkened room".

Carne says the other important thing is to not overload your system during the flight. "Don't eat too much, and for every alcoholic drink, make sure you have a glass of water or a soft drink."

Another theory suggests that the impact of flying east to west has a much gentler effect on the body than flying west to east.

Travel clinics Australia recommend you break your flight with stopovers and don't recommence flying until your body has adjusted to the local time zone.

"Dehydration is quite easy to avoid. Simply get up and walk about the plane every hour or two, and don't drink too much alcohol. Drink plenty of water instead".

Women on the move

Women travelling alone or with other women need to take some extra precautions to ensure their personal safety.

There are some basic rules:

• Avoid the types of places where you may be at risk
• Avoid taking public transport at night and very early in the morning
• Be careful about what you wear and observe local dress codes, particularly in Muslim countries
• Be very careful about holding eye contact with people you don't know.

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