Visit a doctor for advice on vaccinations, travel medicines and other travel health issues. Specialist travel doctors are ideal, and some GPs have a special interest in travel medicine. Visit the doctor six 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 depend on the country and region you’re visiting, and this is where the expert knowledge of a travel doctor comes in handy.
Even if you’re from that country originally, you may have lost immunity to some diseases and be at risk, particularly if you’re spending a long time there, living in the same conditions as locals (as opposed to travelling on tourist buses and staying in sanitised, air-conditioned hotels) or travelling to remote areas.
No matter where you’re going, make sure your childhood vaccinations are up to date. This includes tetanus, whooping cough, measles, mumps and rubella. Hepatitis B is part of the standard vaccination schedule for children, but many adults may not have been vaccinated for it. Consider getting the series of shots (there are three) for lifetime protection.
If you’re over 65, a travel doctor may advise you to get a pneumonia vaccine before travelling overseas. All travellers should consider the influenza vaccine (flu jab) to reduce their chances of getting struck down in a place where medical care is hard to come by.
Diseases to avoid
The following list will give you a general idea of what disease you’re up against in certain regions:
Rabies (Africa, Asia, South America) A fatal virus transmitted in the saliva of animals (usually dogs but also bats and monkeys) through a bite or licking broken skin or mucus membranes (eg lips). Whether you need this series of jabs depends on the type of trip you’re taking and how quickly you’ll be able to get treatment – you’re not so likely to need it on a package tour stopping at tourist spots.
Malaria (Africa, Asia, Central and South America) Malaria is a parasite carried by mosquitoes and kills about 600,000 people a year. Anti-malarial drugs are available but can have serious side effects. For holidaying in areas with some risk – but not high risk – of malaria, experts in travel medicine are increasingly recommending the use of standby emergency treatment rather than preventative medicine. The main advantage is that travellers won’t need to suffer the side effects of taking preventative medicines when they’re unlikely to contract the disease – and when used in conjunction with repellents and physical barriers, may be the most appropriate anti-malarial strategy.
Yellow fever (Africa, South America) A virus carried by mosquitoes. Some countries require a yellow-fever vaccination certificate as a condition of entry into the country.
Hepatitis A (Africa, Asia, South America) This viral disease of the liver is transmitted through contaminated food and water. In addition to a straight hep A vaccine, there is a combined hep A and B vaccine or a combined hep A and typhoid vaccine.
Typhoid fever (Asia, Africa) This bacterium is usually transmitted by handling food with dirty fingers. Vaccination is highly recommended if travelling to areas where sanitation is poor.
- Japanese encephalitis (Asia, PNG) Viral brain infection transmitted by mosquitoes.
- Tick-borne encephalitis (Europe, Asia) A vaccine is usually only recommended for people spending a long time hiking, camping, etc.
- Meningitis (Africa) Potentially fatal inflammation of the membrane covering the brain, passed person to person through droplets, and can be caused by bacteria, viruses or fungi – bacterial meningitis is the most serious.
- Cholera (Asia, PNG) A bacterial disease causing severe diarrhoea.
Smartraveller has flagged the following health issues for these popular destinations. Some diseases mentioned here are only a risk at certain times of the year, in certain areas (rural, mountainous, forested, etc) or only occur during occasional outbreaks. Your travel doctor can give you the most up-to-date advice. The information was up-to-date in November 2013 – check the smartraveller website for the most recent advice.
CHINA – Japanese encephalitis; malaria; rabies; hand, foot and mouth disease; poliomyelitis.
FIJI – Water-borne, food-borne and other infectious diseases (including typhoid, hepatitis, leptospirosis, tuberculosis, measles and mumps); dengue fever; filiariasis; ciguatera poisoning from eating reef fish.
GERMANY – tick-borne encephalitis in forested areas, particularly in the south.
HONG KONG – Dengue fever; water-borne, food-borne and other infectious diseases (including tuberculosis, hepatitis, scarlet fever and hand, foot and mouth disease).
INDIA – high incidence of food-borne, water-borne and other infectious diseases (including meningitis, cholera, typhoid, hepatitis, tuberculosis, diphtheria and rabies); mosquito-borne diseases (such as dengue fever, malaria, Japanese encephalitis, chikungunya and filariasis); black henna tattoos.
INDONESIA/BALI – Mosquito-borne diseases (including dengue fever, malaria, Japanese encephalitis, chikungunya and filariasis); water-borne, food-borne, parasitic and other infectious diseases (such as cholera, hepatitis, measles, typhoid and tuberculosis); rabies; black henna tattoos; methanol-contaminated alcoholic drinks; magic mushrooms.
JAPAN – Japanese encephalitis; measles; drug restrictions, including codeine and pseudoephedrine.
MALAYSIA – Mosquito-borne diseases (including dengue fever, malaria, Japanese encephalitis, chikungunya and filariasis); marine stings; water-borne, food-borne and other infectious diseases (such as hepatitis, tuberculosis, cholera, and hand, foot and mouth disease).
NEPAL – Mosquito-borne diseases (including dengue fever, malaria, Japanese encephalitis); food- and water-borne bugs (such as typhoid, cholera, leptospirosis, hepatitis and rabies); conjunctivitis after monsoon season; altitude sickness. Ensure your travel insurance covers helicopter evacuation if you’re trekking in the mountains.
NEW ZEALAND – injury risk from adventure sports activities. Make sure your insurance covers these activities.
PAPUA NEW GUINEA – Cholera is endemic; mosquito-borne diseases (including dengue fever, malaria, Japanese encephalitis, chikungunya and filariasis); tuberculosis; typhoid; hepatitis; marine stings.
PHILIPPINES – Mosquito-borne diseases (including dengue fever, malaria, Japanese encephalitis and filariasis), water-borne, food-borne, parasitic and other infectious diseases (such as cholera, typhoid, hepatitis, tuberculosis, measles, meningitis and rabies); freshwater diseases contracted while swimming (including bilharzia/schistosomiasis and leptospirosis); ciguatera poisoning from eating reef fish.
SINGAPORE – Mosquito-borne illnesses (including dengue fever, chikungunya fever and Japanese encephalitis); hand, foot and mouth disease.
SOUTH AFRICA – Cholera; malaria; filiariasis; water-borne, food-borne and other infectious diseases (including typhoid, hepatitis, rabies, measles, Rift Valley fever and drug-resistant tuberculosis).
THAILAND – Mosquito-borne diseases (including dengue fever, malaria, Japanese encephalitis, chikungunya and filariasis); water-borne, food-borne, parasitic and other infectious diseases (including cholera, hepatitis, measles, typhoid and tuberculosis); rabies; marine stingers; black henna tattoos.
UAE / DUBAI – Middle East respiratory syndrome (MERS) coronavirus; various water-borne, food-borne, parasitic and other infectious diseases; medication restrictions.
UNITED STATES – extremely high medical costs. Make sure you’re insured with unlimited medical cover.
VIETNAM – mosquito-borne diseases (including dengue fever, Japanese encephalitis); water-borne, food-borne, parasitic and other infectious diseases (such as hepatitis, rabies, typhoid, tuberculosis, meningitis); cholera; hand, foot and mouth disease; conjunctivitis.