If you’re going backpacking Asia then maybe you should read this!
Polio is back, and Typhoid is close behind!
Polio is a disease which the world has spent a lot of time and money on in eradication attempts . Programs have successfully eradicated new ‘wild polio’ cases to date from all but 2 countries; Afghanistan and Pakistan. Nigeria has recently been removed from this list. Sadly, there are cases of health professionals being killed in various militant attacks on health centres in the past 3-5 years as a result of various misinformed campaigns, which have linked vaccination with the spread of HIV and other perceived threats. These are tragic cases and it is a tribute to the enduring work of many that the world is continuing its efforts, despite the various and complex issues it faces. Our thoughts are with the families of health professionals injured or killed in the line of their duty.
The vaccine used overseas in developing countries is an oral live virus (3 drops on your tongue, the same as most Australian children born before 2005), but unfortunately about one person for every million doses becomes infected with the virus from an accidental mutation, hence why it is the less preferred version and not in wider circulation. The World Health Organisation has stressed that “ending polio for good requires eliminating both wild and vaccine-derived polio”. Notably Laos has recently suffered a case of this vaccine-derived polio, and this is a new setback to the global plan to eradicate the crippling disease. There have also been vaccine derived cases that have resurfaced in Mali and also the Ukraine, the latter possibly as a result of the recent migration.
Genetic sequencing suggested the virus strain in Laos, which resulted in the death of a young boy, has been circulating in the area of Bolikhamxay province which has low immunization rates for more than two years. It is known that for every case found there will probably be another 200 cases which go undetected, and further spread is therefore possible through the inadequte sewerage systems. There is no cure for polio as yet, which attacks the nervous system and can cause irreversible paralysis within hours of infection.
While there is relatively limited travel to and from this area in Laos and extra immunization campaigns are planned in response to this outbreak, all travellers to Laos, Mali and Ukraine are now advised to make sure they have had the full childhood course and at least one dose of injectible vaccine in their adulthood (after age 18). For many this means another injection, as those born in Australia since 1986 have not had a polio vaccine since they were 5 years of age. This puts all travellers (and in particular backpackers) to Laos at risk, as many of them fall into the age bracket of 18-29yo.
This outbreak and new risk to travellers is an excellent example of why travellers need to seek up to date information from dedicated travel medicine practitioners who use proper (daily updated) databases to source their information. Each traveller needs to have the correct vaccines prescribed and due to their expense, a proper rationale for each vaccine needs to be developed or unnecessary vaccines may well be given, and as a result money spent on the wrong products! Having a precise itinerary and your vaccination history will also save you money!
Typhoid has also been reported in Kuala Lumpur, source yet to be identified, 32 cases in the last 2 months. Vaccination to all developing countries is recommended to avoid unnecessary illness.
Preventative measures are what are focused on at your TMA Clinics across Australia. Specially trained doctors and nurses have gone the extra mile to specialize in this area. They have Certificates of Travel Health, Diplomas of Travel Medicine and many have Masters Degrees. This means you have a body of people that are focused and up to date on this subject and will ensure you are educated, vaccinated and indoctrinated on how to stay health while away and come home healthy to share your travel stories.
Because you don’t want to have to seek treatment somewhere like this!
Author: Dr. Brian Gilbert