3 hours Ago By Dr Peter Hall
Covid clipped our wings, but people are travelling again bigtime. About half a million people depart New Zealand every month, many of them to tropical climes. This means travel medicine is again a hot topic, particularly as there are some important new diseases appearing on the scene and some old ones making a comeback.
I’m particularly sad about the resurgence of polio, which was a disease that we really thought we had ‘licked’ globally, but has reappeared in over 40 countries, mostly in Africa and Asia. Likewise, there was a devastating measles outbreak in Samoa in 2019 and the Western Pacific, in general, is still considered at risk. These and other outbreaks mean that travellers need to make sure they are up to date with routine vaccinations, as well as the exotic ones.
Dengue cases are increasing, particularly in the Americas and Southeast Asia. There is a vaccine but it is expensive, in short supply and not suitable for everybody, so the best prevention is mosquito bite avoidance. Sometimes when told that there is no malaria risk, people neglect insect repellents and appropriate clothing, exposing themselves to other nasties such as dengue, yellow fever, Zika and chikungunya.
Hepatitis A remains a constant threat in situations where food and water safety is questionable. Covid and influenza are the highest risk vaccine-preventable diseases in travellers. I can attest to that, having picked up covid on a trip back from the UK this year.
After nearly four years on the frontline without getting it, I was feeling a bit smug but I shouldn’t have been surprised. I believe the inflight risk is low due to nifty airflow and filtering systems on planes. I probably got it lining up in customs, or somewhere else en route.
By comparison, the more exotic diseases (typhoid, rabies, Japanese encephalitis and cholera etc.) are rarer but potentially deadly. Vietnam has had a recent surge of rabies cases and India reports tens of thousands of deaths each year from this disease.
While the risk of rabies is low, the chance of getting bitten by an animal is high, particularly in places where animals are used to interacting with humans. I’ve even heard of monkeys stealing personal items from tourists and then bartering them back for food. If bitten, it is advisable to seek medical treatment and rabies vaccination.
Pre-travel rabies shots make this much less urgent and complicated. On the whole, it’s better just not to go near anything with teeth. As scary as these diseases are, they are not the major cause of illness or death while overseas.
The most common cause is common such as a heart attacks, followed closely by accidents – road traffic and drowning. The much beloved scooter is a high-risk activity. So much so that a number of insurers require special cover if you plan to ride one on holiday.
Traveller risk is highly individual so generic information from a web site is often not adequate. A consultation with a travel medicine expert is the way to go!.
