Take the shots and prepare for a safe trip

Good health overseas is a matter of thinking ahead, keeping your eyes open and acting quickly. KATHERINE HOBY reports.

New Zealanders have always been great travellers. As well as travelling in Europe, young Kiwis are increasingly spending long periods in Africa, South America, Asia and India.

But on many of those continents, developing countries have poor hygiene standards, substandard drinking water, and insects and animals that spread disease.

A mosquito bite can spell disaster.

Dr Marc Shaw, of Worldwise Travellers' Health and Vaccination Centre in Auckland, says the keys to good health overseas are being prepared, keeping your eyes open, using common sense, and acting quickly if something goes wrong.

He says it is advisable to go to a travel health specialist, rather than a doctor, for a check-up. Doctors are often overworked, not up to date with the latest developments in travel medicine, and may not have time for a comprehensive examination.

"The reality is that a clinic such as mine is derived from the fact that GPs can't keep up with the constant changes of travel health, with everything they have to do. And you can't really dabble."

At Dr Shaw's clinic, a $55 consultation takes up to an hour.

He says people should come to see him about six weeks before they travel, and bring an itinerary with them.

"We need that hour as we go through a full 22-point checklist," he says.

"And people are generally so enthusiastic about their trip that all they want to do is talk about it.

"We've all been travellers so we're happy to do that, too."

The cost of vaccinations is not included in the one-off consultation.

Follow-up visits may be required for vaccinations that require three jabs, such as for Japanese encephalitis.

Costs vary from $15 for a tetanus booster, to $160 for rabies.

"People come to us expecting that we'll jab them with everything under the sun to make a buck," Dr Shaw says.

"But often we can knock two or three vaccinations off their list dependent on itinerary.

"Our job is, as a medical clinic, to give them what they need and only what they need."

Dr Shaw stresses that the number and type of vaccinations required depends on where you are travelling to, the length of stay, and type of accommodation and activity in that country.

For those setting off on a basic OE to Europe via the almost obligatory working stint in London, he recommends an updated tetanus booster ($15) and hepatitis A and B shots ($90-$130 for both).

Dr Shaw advises every traveller to pack a first-aid kit containing items such as bandages, painkillers and iodine solution.

It also pays to think about taking condoms and tampons. Some countries do not have them, or do not carry recognisable brands.

Women should think about taking a supply of their contraceptive pill.

It is generally not a good idea to go off the pill or to change brands in the middle of a trip.

Drugs manufactured in some countries are not up to standards in the Western world.

Dr Shaw also advises travellers to develop a plan of action with loved ones back home, in case something does go wrong.

THE BIG SIX


MALARIA

Prevalent in: Subtropical climes such as Africa, India, Asia. High risk in West Africa.

Spread by: Mosquito, mainly between dusk till dawn.

Watch for: Temperature, fever, sweats.

What happens? There are four main types, though all have similar symptoms and consequences - serious fever and, in some cases, complications affecting the kidneys, liver, brain and blood, which can be fatal.

If caught: Assume the worst. Get a blood test as soon as possible. Take medication, and make sure you follow the entire course through when you get home. Basic training will mean you can self-medicate in emergencies.

DENGUE FEVER

Prevalent in: West Pacific, Southeast Asia, and upper South America.

Spread by: Mosquito.

Watch for: Symptoms similar to malaria but it sometimes is called "break bone fever" because it causes severe joint and muscle pain.

What happens? Severe joint/muscle pain, fever, sweating.

If caught: There is no vaccine or cure. Take fluids, bedrest and pain relief. It lasts up to a week.

TRAVELLER'S DIARRHOEA AND STOMACH UPSETS

Prevalent in: Developing countries especially Peru, Mexico, Egypt, India.

Spread by: Unsanitary water, food and ice.

Watch for: Obvious symptoms.

What happens? Diarrhoea, vomiting, headaches.

If caught: Take fluids. Take things easy. Eat small portions of bland food.

TYPHOID FEVER

Prevalent in: India, parts of Africa.

Spread by: Food and also waterborne.

Watch for: Temperatures, constipation and then diarrhoea, sweats, fevers, high temperatures.

What happens? You get very tired, and are bedridden for a number of days, suffering sweating and temperatures.

If caught: Take antibiotics. Rest and drink lots of fluids.

RABIES

Prevalent in: Thailand, Kathmandu, India, Africa.

Spread by: Monkeys, dogs, bats.

Watch for: Numbness or tingling around the bite, temperatures, headache.

What happens? Loss of appetite, but extreme thirst. In the worst cases, the eye and facial muscles become paralysed. A coma and death follow if not treated within two days of the bite.

If caught: Prevention is better than cure in this case - get vaccinated. A tetanus booster also will help stop infection from animal bites. See a doctor immediately for post-exposure immunisation.

MENINGITIS

Prevalent in: Africa, Saudi Arabia.

Spread by: People living in close quarters, sharing utensils and other items.

Watch for: Flu-like symptoms, fever, vomiting and a stiff neck.

What happens? The above symptoms may be followed by drowsiness and a blotchy red rash.

If caught: Take medication, bedrest.

ASK AN EXPERT

If you are going overseas, consult a travel health specialist. There are several clinics in Auckland.

The information above is intended as a general guide only for travellers. Individual travel advice should be obtained. This should take into account the traveller's health, intended activities, time of year, style of travel, type of accommodation and length of stay.

Worldwise

Travel Medicine

Travel Doctor

Travel Health

International Society of Travel Medicine