Posts Tagged ‘Pacific’

South Pacific – Other precautions

Dr Colleen Lau
Food and Water-borne Diseases

The same precautions with food and water for developing countries apply in the Pacific Islands: Cook it, peel it, boil it, or forget it! However, it is not always easy to follow these rules at all times during travel. Depending on your trip, your travel doctor might recommend vaccinations for Hepatitis A, typhoid, and travellers’ diarrhoea. It is always a good idea to have a simple medical kit with medications for treating traveller’s diarrhoea, and correct treatment could mean that you are better in a few hours rather than being sick for days or even weeks.

Kayaking in Pago Pago Harbour, American Samoa – Chosen by Lonely Planet as one of the top 15 experiences in the Pacific Islands!
Blood-borne and Sexually Transmitted Infections

Hepatitis B is common in the Pacific Islands, and an estimated 25 to 30% of the local population have chronic Hepatitis B infection. Travellers should consider Hepatitis B vaccination if they plan to live or work in the Pacific, or expect to have close contact with the local population. All Australian children are now routinely vaccinated for Hepatitis B. Sexually transmitted infections are common, and HIV is also becoming a problem.

Others

There is no risk of rabies on the Pacific Islands, but dog bites are common on some islands, and American Samoa has the unenviable reputation of having the highest incidence of dog bites in the world! Scuba diving is a popular activity, but there are few decompression chambers in the Pacific in case of mishaps. The Divers Alert Network provides information and insurance for scuba divers. Ciguatera fish poisoning is caused by marine microalgae in the tropics, and can cause nausea, vomiting, abdominal pain, diarrhoea, muscle cramps, paraesthesia, and a reversal of hot and cold sensation. It is riskier to eat large fish because they accumulate for toxin by eating smaller fish. As a general rule, if the fish fits onto a dinner plate, Ciguatera is unlikely to be a problem. It is best to avoid eating large reef fish such as barracuda and grouper. More information on ciguatera can be found in the June 2009 edition of the TMA Newsletter.

Natural hazards such as cyclones, earthquakes, and volcanic eruptions are part of everyday life, but serious disasters are relatively rare. Indeed, volcanic activity is responsible for creating many stunning and incredible landscapes throughout the Pacific, including extinct craters filled with rainforests and bats, tiny islands with sharp jagged peaks piercing the sky, abandoned villages half buried by old lava, and active volcanoes that are still erupting today.


Tinakula, Temotu Province, Solomon Islands. On a rest day from fieldwork, the local team on the Solomon Islands showed me their active volcano, which was about an hour’s boat ride from where we were working. Tinakula is only 3.5km wide, but rises 850m above the ocean, and has been uninhabited for decades because of eruptions. Even from a far distance, it is clear that Tinakula is highly active, with smoke pouring out from the top of its cone. But the true forces of nature could only be appreciated from up close, where rumblings from the volcano could also be heard and felt, and hot rocks seen spurting into the sky, and then tumbling down the hill into the ocean with a big steaming splash.

… Prepared by Dr Colleen Lau, TMA Perth and Brisbane

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South Pacific – Leptospirosis

Dr Colleen Lau

Leptospirosis is a bacterial infection that is often misdiagnosed as dengue because symptoms can be very similar. The bacteria are carried by animals (including rodents, pets, livestock, and wildlife), and excreted in their urine. Humans can become infected by direct contact with animals, or contact with water and soil that has been contaminated by animal urine. The risk of infection is especially high after flooding, because floodwaters can spread the bacteria, and wash them into rivers and streams. During flooding, people often have to wade in water and therefore have cuts, wounds, and waterlogged skin, all of which increase the risk of infection. In the Pacific Islands, recent outbreaks have occurred after cyclones and flooding on some islands including Fiji and New Caledonia. People participating in outdoor activities are also at risk because of contact with fresh water and soil. The risk of infection can be reduced by wearing protective clothing and boots, cleaning and covering wounds, and avoiding swimming in freshwater streams and rivers after heavy rainfall. The bacteria do not survive in seawater, so there is no risk of leptospirosis from swimming in the ocean.

Leptospirosis research team at work in American Samoa. Left: Unloading fieldwork gear on the remote Manu’a Islands in the far east of American Samoa. Right: Collecting blood samples and questionnaire data. Our study collected data from over 800 people from 5 islands in American Samoa, and found that about 15% of people have had previous leptospirosis infections. The study investigated environmental factors that increased the risk of leptospirosis transmission, produced maps to predict high-risk areas, and provided information to improve public health interventions.

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Island Hopping in the South Pacific

Dr Colleen Lau is one of the founding travel doctors of the TMA Perth Clinic, and also works at the TMA Brisbane Clinic. Over the past 3 years, she has travelled around the South Pacific for tropical medicine research projects and consultancies, and has just completed a PhD in infectious disease epidemiology at the University of Queensland. In this article, Colleen provides us with information on health hazards in the South Pacific, and some snapshots from her research trips in American Samoa, Vanuatu, and the Solomon Islands.

Travel Health Precautions for the South Pacific

If you expect to find remote islands, underwater adventures, friendly smiling faces, flower garlands, tropical sunsets, coconut trees, and cocktails in the South Pacific, you will not be disappointed. On a world map, the islands look like tiny dots in the vast ocean. Close up, they are home to incredible diversity in culture, history, language, landscape, economy, and wealth. Consequently, sanitation, hygiene, and the quality and availability of health care also vary dramatically between the island nations. Although the Pacific Islands conjure images of tropical paradise, most of them are developing nations, and there are health issues that travellers should be aware of. Prevention is always better than cure, and the risk of many of the health hazards can be significantly reduced by simple precautions.

Rainmaker Mountain, American Samoa. After a 2-hour uphill hike, the view from the top of Mount Alava is breathtaking. Everything is lush and green, because American Samoa is one of the wettest inhabited places in the world, with an annual rainfall of over 3000mm. For my leptospirosis research project, I spent 3 months there during the ‘dry’ season, and it rained every single day!
Mosquito-borne Diseases
  • Dengue occurs throughout the South Pacific. In most tropical areas around the world including the Pacific, the frequency and size of dengue outbreaks have increased in recent years due to a combination of demographic, environmental and climatic factors. In one of my studies from American Samoa, about 95% of adults had antibodies to dengue viruses, indicating that they had been infected some time in the past. Dengue can cause fevers, a rash, sore bones/joints/muscles, headache, and a flu-like illness. A very promising dengue vaccine is currently being tested, and will hopefully be available in a few years’ time.
  • Malaria is found in Vanuatu and the Solomon Islands, but there is no risk in Fiji, Samoa, American Samoa, Tonga, French Polynesia, Cook Islands, or the Micronesian Islands. In Vanuatu, malaria is found in virtually the whole country, but is low risk in Port Vila and Tafea Province (including Tanna Island, where the famous active volcano Mt Yasur is located). Malaria is also found throughout the Solomon Islands, but is low risk in Temotu Province in the far south. In Tanna and Temotu, an AusAID-funded Malaria Elimination Program has significantly reduced the number of malaria cases. If travelling to Vanuatu and the Solomon Islands, you should speak to your travel doctor about antimalarial medications. Malaria is a potentially fatal infection, but is treatable if diagnosed early. If you develop any fevers during or after travelling to the tropics, see a doctor as soon as possible.
  • Chikungunya virus has spread over the past few years from East Africa to the Indian Ocean Islands and Asia, and local transmission was recently identified in New Caledonia and Papua New Guinea. There is therefore a risk that the virus will continue to spread to surrounding countries including Australia and the Pacific Islands. The infection can cause quite disabling symptoms including fever, rash, joint pain and stiffness, and severe tiredness. A large Ross River virus outbreak swept through the Pacific Islands in 1979/1980, but there have been few reports of infection since then.

    When travelling in the South Pacific, it is therefore very important to take precautions against mosquito bites by using DEET-containing repellents, wearing protective clothing, and using mosquito nets or screened accommodation. Perfumes can attract mosquitoes and should be avoided.


Village health post (left) and Tanna Hospital (right), Tanna Island, Vanuatu. Health care and medical supplies are limited, especially in the more remote islands. It is always best to carry a few basic supplies, and the most common items that travellers need are medications for diarrhoea, colds and flus, and pain-killers, and simple dressings for minor wounds and injuries.

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Travel Health Information

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