Travel health: the big issues for 2016
Do we still need to worry about Ebola?
The hospital is the last place you want to end up, and never more so than when you’re travelling. Aside rom the Zika virus (read Travel advice: Zika), here are some travel health risks to be aware of before you head away.
Do I need malaria tablets?
Malaria is contracted through mosquito bites, and it can be a serious disease if not treated quickly. Its symptoms are flu-like, including high fever, chills and muscle pain. Not all mosquitos carry the infection; it’s most often found in Africa, Southern Asia, and Central and South America.
Typically, if travelling to these areas, you will need to start a course of anti-malarial tablets, which usually begins up to three weeks before travel and you continue taking them when you get home to cover the disease’s incubation period. Fake medications are an issue in countries where malaria is endemic so it’s important to consult your own doctor before travelling.
No tablets are 100 per cent effective against mosquitos, so avoid getting bitten by wearing loose, long-sleeved clothing and spraying insecticides. Mosquitos that transmit malaria typically bite after sunset so be particularly vigilant in the evening.
Do I still have to worry?
The current Ebola outbreak began in 2013 in Guinea and spread to a number of countries throughout the world, however it was in largely isolated cases. It’s no longer considered an epidemic, but flare-ups of the infectious and generally fatal disease have continued into this year.
Reported cases of the disease, which is typically marked by fever and severe internal bleeding, have been found in Sierra Leone, Guinea and Liberia. Though all three countries are counting down their incubation periods to be declared Ebola-free at the time of writing, the World Health Organisation has warned these flare-ups will continue for some time yet.
Should I get vaccinated?
A long list of countries in endemic areas of Africa and South America require a certificate of vaccination against Yellow fever before you travel. Though it’s not required, it’s recommended you get vaccinated before travelling to Argentina, Brazil, Colombia, Panama, Peru and Venezuela. Mosquitos also spread Yellow fever, though those carrying the disease are more likely to bite in daytime.
It has flu-like symptoms, including sudden fever, headache, muscle aches, nausea and vomiting.
Most people will recover from Yellow fever, but about 15 per cent develop severe symptoms after 48 hours, including jaundice, bleeding and shock. No specific treatment is available, but hospitalisation is usually necessary.
If you experience these symptoms, avoid using medications such as aspirin or non-steroidal anti-inflammatory drugs like ibuprofen as they increase the risk of bleeding.
How is it transmitted?
Because Hepatitis B and C are more often transmitted sexually or through blood or needle contact, sometimes people lump Hepatitis A in the same group. Though it can be transmitted sexually, it is more often caused by ingesting contaminated food or water.
Heptatitis A virus is found in the faeces of people with HAV infection and can enter the mouth when someone prepares food without washing their hands properly after going to the bathroom or changing a baby or similar.
Hepatitis A is a liver infection with symptoms like sudden fever, tiredness, loss of appetite, nausea, vomiting, and jaundice. Some people have no symptoms while others have symptoms that last up to six months. However, most people recover with no lasting damage.
Ice, water, fruits, vegetables and shellfish are the most likely food and drink to be contaminated, and more likely found in areas with poor sanitation and hygiene. A Hepatitis A vaccine is recommended for those travelling to developing countries.
Is it serious?
Cholera spreads in a similar fashion to Hepatitis A, through ingesting the faeces of an infected person, usually through contaminated food and water, especially in areas where sewage and drinking water are poorly treated. While all areas with poor sanitation are at risk, in the past year there have been particular Cholera warnings for Tanzania, Cuba, Dominican Republic and Haiti.
It’s an intestinal infection, which causes no symptoms for most people. Those who do have symptoms have mild to moderate diarrhoea, with or without vomiting. More rare severe cases include leg cramps, nausea and watery diarrhoea, which can lead to severe dehydration. Proper hydration and antibiotics will clear it up fairly quickly.
A vaccination is available, which also protects against E.coli, one of the most common causes of traveller’s diarrhoea.
Dengue fever and Chikungunya
What are they?
Dengue fever and Chikungunya are both debilitating viral infections that cause a sudden fever and acute joint pain. They are both transmitted by particular kinds of mosquitoes found in parts of the Tropics.
There’s no particular treatment beyond supportive care in a hospital on a drip for a few days, though rest is sometimes required for several months to recover fully.
Long trips where you’re getting a lot of mosquito bites put you most at risk, so it’s important to use an insect repellant containing 50 per cent DEET and mosquito nets to keep bites to a minimum.
For more on Zika, read here.