Travel health guide

Visit your GP (or ideally a specialist travel doctor) 6 to 12 weeks before you depart, to allow time for the appropriate vaccinations — some require a series of jabs. The vaccines you need to get will depend on the country and region you’re visiting, and this is where the expert knowledge of a travel doctor comes in handy.

No matter where you’re going, make sure your childhood vaccinations are up to date. This includes tetanus, whooping cough, measles, mumps and rubella.

If you’re over 65, a travel doctor will advise you to get a pneumonia vaccine before travelling overseas. All travellers should consider the influenza vaccine (flu jab) to lessen the chances of getting struck down in a place where medical care is hard to come by.

It is vital to take out comprehensive travel insurance, as it will ensure you’re covered for general medical expenses, any existing medical conditions, hospitalisations and medical evacuation.

The Australian Government has Reciprocal Health Care Agreements (RHCA) with New Zealand, the UK, Ireland, Finland, Sweden, the Netherlands, Italy, Malta and Norway, which cover the cost of any immediate treatment you may require. However, while this provides a safety net for Australians travelling to those countries, an RHCA won’t cover a medical evacuation back to Australia, which can cost, in extreme cases, up to $300,000.

An RHCA also won’t cover any health problems encountered while travelling to and from those countries.

When purchasing travel insurance, shop around to ensure you’re not paying hefty commission rates on top. Independent research conducted by CHOICE’s Money and Rights magazine found that travel insurance can be found at as much as 40% cheaper online.

The Insurance Ombudsman Service recommends thoroughly reading the Product Disclosure Statement (PDS) and policy wording of your travel insurance policy to get a full understanding of any conditions, exclusions and limitations that may apply, what you need to do in order to make a claim and what’s expected of both you and your insurer. Also ask the insurer what activities and situations are exempt (such as adventure sports if you plan on taking part in any).

If you’re planning to use the travel insurance you can get when you buy a ticket on your credit card, obtain a copy of the policy wording from your bank or credit card provider and make sure it meets your personal needs and situation. For example, it pays to check whether the policy will cover existing medical conditions.

While sampling exotic foods and beverages is one of the great pleasures of travelling, local delicacies can also play host to bugs that could leave you seriously ill. Here are some tips to minimise your risk:

• Always wash your hands thoroughly before eating.
• In countries where the water is unsafe, drink (and brush your teeth with) bottled water — always check the seal on the bottle.
• Beer, wine and carbonated beverages are fine as long as they are in a sealed can or bottle, as is coffee or tea made with boiling water.
• Avoid ice, which may be made with unsafe water.
• Avoid undercooked, uncooked or reheated food, salads, or unpeeled fruit and veggies.
• Avoid dairy products, shellfish and food that you can see being handled.
• Opt for freshly-cooked food, peelable fruits and foods in cans or sealed packs.
• Choose busy restaurants serving local food and always use clean plates and cutlery. Don’t assume your hotel’s buffet is risk-free.

Case study

Simon from Sydney got more than he bargained for when he ordered a burger in Vietnam.

‘"In 2000 my partner and I travelled for a month in Vietnam. We were pretty adventurous with the food, eating from street vendors and trying things we couldn't even identify — all with no problems.

"About three weeks into the trip we reached Hanoi and ordered a hamburger in a tourist café —a couple of hours later I started feeling rough. I spent much of the next couple of days on the toilet with a raging temperature that was just below the 'go straight to hospital' threshold.

"Fortunately we'd bought a 'gastro pack' at the travel medical centre back in Sydney, which included the usuals like re-hydration salts, diarrhoea stopper (Loperamide, which I didn't use), antibiotics and a flowchart that gave diagnostics to work out if you should go straight to hospital, and what to do otherwise.

"A couple of days later I was still unwell but we were keen to get up into the North-West of Vietnam so I started on the antibiotics included in the pack and within a couple of hours was starting to feel better. The next day I was fine to travel."

Deep vein thrombosis (DVT) occurs when clots form in the blood vessels in the legs — it can lead to a heart attack and stroke. DVT is referred to as 'Economy Class Syndrome' because sitting in cramped conditions for long periods can increase your risk.

However, flying isn't the only risk. Research from New Zealand revealed you’re more likely to get DVT from sitting at your desk for extended periods than sitting on a plane.

Risk factors include a family history of DVT or pulmonary embolism, recent surgery, smoking, being obese, pregnant and being over the age of 40.

In order to reduce your risk during a long flight:

• Stand up and walk around regularly and do exercises such as leg stretches every half-hour.
• Drink at least one litre of water for every 5 hours you're flying. And avoid alcohol and caffeinated drinks before and during the flight.
• Wear loose-fitting clothing.
• Avoid sleeping tablets as they limit your mobility.
• Avoid leg crossing and elevate your legs when possible. Talk to your doctor if you have any risk factors for DVT.

• Visit a travel health specialist and get the appropriate vaccinations for the area you’re travelling to.
• Take out insurance to cover hospital treatment, medical evacuation, and any activities.
• To try to avoid being bitten by disease-carrying mosquitoes, pack some good repellent and a long-sleeved shirt and long pants.
• Boil, cook and/or peel food and choose bottled water.
• Avoid animals such as dogs and monkeys — they could be carrying rabies.
• Carry a traveller’s medical kit containing items such as headache tablets, antacids, antiseptic lotion, cotton wool, Band Aids or similar, latex gloves, safety pins, insect repellent and hand sanitiser. Specialised kits for diarrhoea are also available from a travel doctor.
• Have a check-up on return if you’ve been ill.

If illness strikes

Always carry your insurance company’s emergency assistance card with you and contact the company as soon as you need help — most insurance companies provide 24-hour advice to travellers. Often your insurer will make arrangements for you to have treatment.

If you suffer from diarrhoea while away (and one doctor we spoke to told us around 50% of travellers fall victim), it’s very important to keep hydrated. Seek medical attention if your symptoms last more than four days, if your diarrhoea contains blood, if you have a fever or if symptoms persist after 24 hours for children, the elderly and those with existing stomach problems.

It’s a good idea to buy a specialised medical traveller’s kit from a travel doctor if you’re travelling to areas with poor sanitation. It’ll typically contain re-hydration salts, antibiotics and Loperamide, (a 'stopper' for when you can’t afford to be glued to the toilet seat).

If you get sick after returning from overseas, tell your doctor the countries that you’ve visited in the last 12 months, since some viral, bacterial or parasitic infections can take between six weeks and a year to incubate.

Useful websites

• www.australia.gov.au/Australians_Travelling
• www.smartraveller.gov.au
• www.tmvc.com.au
• www.who.int/en
• www.welltogo.com.au
• www.cdc.gov