Travel vaccines - plan in advance

Whether arranging an adventure holiday off the beaten track, a romantic getaway in an exotic African country, or a family break closer to home, thought also needs to be given to the potential health risks of the chosen travel destination. Appropriate medical precautions - while not as exciting to plan as the actual holiday itself - will significantly reduce the incidence of serious health risks, as well as make for a better, safer holiday.

Dr Albie de Frey, The Travel Doctor's Medical Director, says that protecting against potentially life-threatening illnesses is essential, and relatively simple to do. “Vaccines have been developed to prevent a number of infectious diseases,” says Dr de Frey. “They are safe, effective and should be integral to any holiday planning. As the saying goes, prevention is better than cure. Take Hepatitis A for example, one of the most common vaccine-preventable diseases in travellers. This virus which attacks the liver is transmitted from person-to-person - particularly by those whose hands have been soiled after using the toilet or changing a nappy - and by swallowing water or food that has been contaminated by human faeces. Even travellers staying in good hotel accommodation have contracted hepatitis A, yet it is a disease that is so easily prevented. Hepatitis A is not only contracted by travellers as frequent outbreaks occur in kindergarten and school groups amongst others.” Hepatitis A caused a major outbreak in Central Europe in the last few weeks.

Hepatitis B, is a potentially fatal disease which, though not related to the hepatitis A virus, also attacks the liver. It too is easily preventable by vaccination, yet there are still about 20 million new cases reported each year, says Dr de Frey. Hepatitis B is acquired by contact with contaminated body fluids, especially blood, and is highly infectious. In fact, it is estimated to be about 50 times more infectious than HIV, and epidemics still regularly occur in many African countries. Chronic hepatitis B causes irreversible liver damage and may lead to cancer. Dr de Frey suggests that even people not planning to travel be vaccinated against hepatitis A and B as they can always be exposed to these highly infectious diseases. Hepatitis B is such a major threat to public health that it is part of the childhood vaccination programme; however that leaves most previously not vaccinated adults exposed.

Another disease which threatens travellers and homebodies alike is tetanus. Tetanus is a neurologic disease which is often fatal. There are an estimated one million cases of tetanus reported each year, with the highest proportion occurring in Africa and Asia. Dr de Frey recommends that everybody stay up-to-date with their tetanus immunisation, which provides cover for at least 10 years. Diphtheria, an acute respiratory infection with a high mortality rate, is also immunised against in the same vaccination. Travellers finding themselves in the midst of a diphtheria epidemic should stay clear of public transport, cinemas and other crowded conditions as this highly infectious disease is transmitted by droplets from the nose or throat being passed from person to person, either by coughing or sneezing. Large epidemics in old Soviet block countries drew attention to waning adult immunity in recent years alerting doctors to the need for adult boosters.

Dr de Frey says another big threat to travellers both in South Africa and in Africa, is malaria. He says malaria occurs in South Africa's low altitude areas such as the Limpopo, Mpumalanga and North Eastern KwaZulu-Natal, and in tropical Africa. “A single bite from a malaria-infected mosquito can lead to malaria. These Anophele mosquitoes usually hunt between dusk and dawn, so avoiding mosquito bites particularly during these times is a traveller's first line of defence. Covering up with long-sleeved shirts, trousers, socks and shoes, applying insect repellent regularly to exposed skin and sleeping in air-conditioned accommodation or under an insecticide impregnated -mosquito net will reduce chances of getting bitten. Taking appropriate prescription only malaria prophylaxis will help protect against the disease, and travellers noticing any flu-like illness beginning after seven days and up to six months after leaving a malaria-risk region must seek immediate medical attention to obtain a clinical diagnosis. Unfortunately, enjoying a glass of gin and tonic a day will not reduce your chances of contracting malaria.”

Travellers to many countries in Africa need to take note of Yellow Fever. Yellow Fever is an acute, mosquito-borne viral disease which kills up to sixty percent of those it attacks. There is no cure for this viral illness, but it can be easily and safely prevented through vaccination. This vaccination is compulsory for all travellers to and from many countries in equatorial Africa and South America, and must be given at least 10 days before travel to the area. Other vaccinations that could be considered is Typhoid, Meningitis and Cholera. “Travellers going to remote areas should also consider getting a rabies vaccination, as post exposure vaccine and rabies immuneglobulin may not necessarily be easy to come by. Rabies is a fatal disease that is transmitted to humans through the saliva of a rabid animal,” he says.

Dr de Frey concludes that, when planning a holiday, prevention and preparation should be the cornerstone to any itinerary. “It is also always good to take proper first aid kits, particularly when travelling to remote areas or with children, and travel insurance is essential. Another good tip is to have at least one cell phone activated on roaming in cases of emergency. And finally, it is important to remember that drinking contaminated water is one of the biggest causes of illness for travellers - so avoid doing it!”

For more advise please call the sanofi Pasteur Vaccine Helpline on 086 160 160 or consult a travel health practitioner and ask about any of the above matters.