Travel Health

I have a childhood friend who is an epidemiologist – meaning that she’s an expert in public health and outbreaks. I’ll call her Dr Guest.

Dr Guest embraces her profession. When you visit she monitors the amount of times you go to the toilet, and takes an interest in what you do when you are there. More than four visits a day and you have a health problem that might infect everyone and you shouldn’t be in the house.

When I did have an interesting gastro intestinal problem after a few years of living in countries that were a bit dodgy health-wise and had to do poo tests she rang my doctor and asked for my poo, for research purposes. Weirdly they wouldn’t give it to her even though I rang and gave the green light.

She has worked with the government on food outbreaks and is currently working in the area of vaccinations.

So those are her bonafides. Over the years we have discussed health outbreaks, causes and general macro-health issues and she has some useful things to say for both travellers and non-travellers.

This is not an official medical warning, and shouldn’t be treated as such. It is a summary of discussions and some internet research.

The current Zika virus highlights the fact that each year there is a new virus or global health epidemic and travelers always need to be aware of these.

But the common problems haven’t gone away and it doesn’t hurt to be reminded of good hygiene every now and then.

Take the advice of travel health centres or your local GP in regard to vaccinations (see AggieB’s adventures with La Rage in a previous blog). People travel so much these days that going to places like Bali can seem like an extended trip to the beach, but you are much more likely to catch something in Bali than at home. Measles is spreading so make sure your jabs are up to date. You are also at much higher risk of catching a diarrhoeal disease such as Salmonella or Campylobacter, and mosquito-borne diseases such as Dengue Fever and Chikungunya, and be aware of that the Zika virus is speaking – mainly in tropical areas.

In countries where mosquito-borne diseases are a risk, always use an insect repellent, you will need one that contains DEET or picaridin. Sleep in a room with screens or use a bed net. Wear long sleeved shirts and pants. DEET has its own issues, so you should make yourself familiar with the problems of over-use.

To reduce your chance of catching a diarrhoeal illness, wash your hands before eating. Wash your hands with soap ideally for up to two minutes if you’ve been to the bathroom or if you’ve been handling dirt, animals etc. If there is no soap then use hand sanitisers that you can buy in any supermarket and carry with you. But be aware that most hand sanitisers are not effective against the most common gastroenteritis viruses. Check any TV show that features surgeons to see the correct way to wash your hands.

If you are eating out, avoid salads and undercooked eggs.  Recently cooked food is best, not food that has been sitting around. To get some fresh food, go for fruit that you can peel yourself, such as bananas or oranges. If you are eating at home, you should always wash your vegetables. In western countries you can often get away with not washing them, although who knows what chemicals have been used along the way. Vegetables bought from open or wet markets will have been polished or washed in one way or another. In some places fruit is spat on to polish it up. If you have doubts about the food, wash it with water containing chlorine tablets.

If you have concerns and don’t have any water or chlorine tablets, then the biggest danger are vegetables that are grown in water (e.g. water cress, sprouts) so don’t buy them and go without.

Whether to drink tap water or bottled water? There are situations when it is better to drink boiled water from the tap. For example, one situation that a lot of travellers are familiar with is the need to save cash where possible and tap water is cheaper; many people, myself included, have environmental concerns about plastic bottles; not all bottled water is sterile and you should stick to reputable brands. It is also important to avoid ice blocks in your drinks.

How long should water be boiled to be safe? According the CDC article it should be at proper boiling point, with bubbles and steam, for at least one minute. That’s easy! .

The best place to get information about the regions that you are travelling to is the local travel health centre, as we said above. You can also check the WHO website for information. The Australian government also has Smartraveller, providing the latest information and alerts and other countries will have something similar.

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