Antarctica: Icebergs and secret weapon

Dr Cormac Carey,
Medical Director, Toowoomba.

After sampling the wonderful delights of Buenos Aires we flew South to Ushuaia, the southernmost city in the world. Here, we boarded our expedition vessel RCGS ( Royal Canadian Geographical Society) Resolute, our home for the next nine nights on a calm Friday afternoon.
The weather certainly allayed the potential for the dreaded sea sickness.  Having been previously severely affected on several fishing trips,
I had researched all possible preventive options and was armed with an arsenal.

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Measles and Travellers

Dr Michael Long (TMA Narre Warren)

 

Measles in Australia is almost always imported by travellers; there have been many outbreaks of this highly contagious disease in 2018-19 in many countries. Travellers who were born after 1966 (aged under 52?) need to ensure they have had 2 doses of the measles vaccine or documented measles disease or a blood test to confirm immunity.

 

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Medical illnesses can present serious challenges overseas

by Dr Daniel Priest and Dr Donald Leitch – Shoal Bay, NSW

Have you seen random articles on Facebook etc explaining the things that annoy flight attendants? There is quite a list: clipping your toenails … who does that on a plane?? Going barefoot… that’s smelly bad behaviour. Clicking fingers for attention, requesting a temperature change, not bringing a pen (to fill in the customs forms on international flights) to name just a few.

When you travel, especially overseas, there is so much medical advice we can give. Travel doctors are passionate about giving good, relevant, up to date advice in a comprehensive way… not just a few shots and something for malaria. It is such a privilege to be of assistance to help you have a safe and pleasant trip… but we want to do it well… and that takes time and attention.

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 An African Safari

Potential travellers are now thinking about the Australian winter in 2019 and many are thinking of safaris in Africa. Common destinations include Kruger National park in South Africa, and other fabulous destinations in Botswana, Zambia, & Kenya. They will have a wonderful time, but all should consult their Travel Medicine professional before travelling, ideally at least 6 weeks in advance.

Make sure your tetanus vaccine is up to date.

 

Topics currently in the news include:
Rabies:
According to South Africa’s National Institute for Communicable Diseases, 14 confirmed, dog-related, human rabies cases (a significant increase over average incidence) have been reported since January 2018 in Eastern Cape and KwaZulu-Natal provinces. These cases are linked to an ongoing outbreak of dog rabies in the 2 provinces. Travelers should seek medical care if bitten, scratched, or licked by a dog, another terrestrial mammal, or bat.

Monkeys in Botswana

Rabies is most commonly from a dog bite.
And the BBC recently reported that a Briton has died after contracting rabies while on holiday in Morocco, health officials have said.
The World Health Organization advises that the disease occurs in more than 150 countries and causes tens of thousands of deaths every year, mainly in Asia and Africa. It says in up to 99% of cases, domestic dogs are responsible for the transmission of the virus to humans.
The UK government says north African countries such as Morocco, Algeria, and Tunisia are among 139 nations where there is a high risk of Rabies.
Rabies is a viral infection that affects the brain and central nervous system. It is passed-on through bites and scratches from an infected animal.
§ Initial symptoms can include anxiety, headaches and fever
§ As the disease progresses, there may be hallucinations and respiratory failure
§ Spasms of the muscles used for swallowing make it difficult for the patient to drink
§ The incubation period between being infected and showing symptoms is between three and 12 weeks
§  If you are bitten, scratched or licked by an animal you must wash the wound or site of exposure with plenty of soap and water and seek medical advice without delay
§ Once symptoms have developed, rabies is almost always fatal
§ Before symptoms develop, rabies can be treated with a course of vaccine – this is “extremely effective” when given promptly after a bite – along with rabies immunoglobulin if required
§ Every year, more than 15m people worldwide receive a post-bite vaccination and this is estimated to prevent hundreds of thousands of deaths
§ But effective treatment for rabies is not readily available to those in need
§ Pre-exposure immunisation is recommended for people in certain high-risk occupations and for travellers to rabies-affected, remote areas

Road trauma is the commonest cause of death in travellers. Don’t do anything you wouldn’t do at home. Motorcyclists should wear protective clothing and helmets

 

Also remember to practice safe sex to and discuss emergency anti-HIV medications.

Madagascar: Measles
According to WHO’s regional office, more than 860 confirmed cases of measles (a significant increase over average incidence) have been reported in October / November 2018.
All individuals ≥ 12 months of age born in 1957 or later (1970 or later in Canada and the U.K.; 1966 or later in Australia) without history of disease or of 2 countable doses of live vaccine at any time during their lives should complete a lifetime total of 2 doses of MMR vaccine (spaced by at least 28 days). All infants aged 6-11 months should receive 1 extra dose of MMR vaccine.

Keep your typhoid vaccine up to date, generally every 2 years

This fellow kills more people in Africa than any other animal

Democratic Republic of the Congo: Ebola Virus Disease Uncontrolled
According to WHO and international health authorities, more than 32 cases of Ebola virus disease (EVD; caused by EBOV-Zaire strain) per week are occurring, mainly in the North Kivu Province health zones of Beni, Butembo, and Katwa, as well as in the newly affected health zones of Kyondo and Mutwanga along the Ugandan border. The initial cases in Kyondo and Mutwanga health zones were known contacts of cases in Butembo and Beni, respectively. Case numbers have significantly increased in the past month due to civil unrest and community distrust of the response campaign and are likely to be underestimated due to the deteriorating response infrastructure, especially in Beni. Approximately 344 cases of EVD (including 306 laboratory-confirmed and 38 probable cases and 211 deaths) have been reported since mid-July 2018
No cases have been reported in neighbouring countries to date. Countries at risk of spread are Angola, Burundi, Central African Republic, Republic of the Congo, Rwanda, South Sudan, Tanzania, Uganda, and Zambia;
There is no vaccine yet widely available, and travellers should reconsider their need to visit such places.

Take a well-stocked medical kit with you as you can’t  obtain one at the airport.

All travellers should consult their Travel Medicine professional before travelling, ideally at least 6 weeks in advance.

 

Enjoy your travels

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Typhoid Vaccination

Written by Dr Diana Gillatt, Tanunda Medical Centre

 

So what is Typhoid Fever and where is it a problem?

Typhoid is a nasty bacterial infection you contract from contaminated food or drink, sometimes even from dust.. You would develop a fever, headache, tiredness, general aches, a rash and abdominal pain with upset bowels. It can be mistaken for malaria or other tropical illnesses. Often Typhoid will be serious enough to land you in hospital.

It tends to occur in countries with warm climates and that have poorer sanitation standards for their water and sewerage.  Your travel doctor will let you know if your planned trip will put you at risk of catching Typhoid.

Worldwide millions of cases still occur every year, and many thousands of people die. So it’s a good thing to avoid!

Vaccination is recommended, and there are different options, some vaccination can be given orally instead of by injection..

Protection from vaccination takes a couple of weeks to build up to it’s full effect so you need to seek medical advice ideally 6 weeks before departure..

 

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Walking the Camino

Carmel Limpus RN based in Ipswich

IT’S JUST A BIG LONG WALK!

During September 2017 I walked the Camino de Santiago or the Way of St James from France, over the Pyrenees to Santiago de Compostela in Spain.

I stumbled across the idea of a pilgrimage walk a couple of years ago when my Mother and the ‘Godmother’ took me to the movies to see a documentary on it.  I walked out of that theatre and thought – ‘ if those old dudes can do it, so can I’.

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Yellow Fever; To Boost or Not to boost…That is the question!

David Rutherford – TMA member Fremantle

Yellow Fever remains as relevant to travellers today as it was back in the 1700’s when it was first described. The history of the illness is fascinating.

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Bairnsdale Ulcer

Dr Andrew Karamesinis  : TMA member based in Mt Eliza, Victoria

Travellers love to come and visit Victoria, Australia,  and in particular the picturesque Mornington Peninsula.

They usually have a great time, but very occasionally it is possible to take home an unwanted souvenir in the form of a persistent skin ulcer.

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Patagonia and Punta Arenas

Dr Leo Foong TMA member in Rockingham WA

Bucket lists are there to be crossed and this I have done after getting to visit Santiago for a week and the Patagonian region and then to Punta Arenas to fly to King George Island (thereby escaping the emetic Drake Passage) for an Antarctic Cruise.

Patagonia is a region encompassing the vast southernmost tip of South America and shared by Argentina and Chile. The Andes mountains divides the two countries and forms a geographic boundary. On the Chilean side there are temperate rainforests and glacial fjords.

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Icebergs, Penguins and Remoteness

Dr Michael Tooth TMA member in Hobart

It is fair to say that anyone with the travel bug will have a wish list. For me the number one has always been Antarctica; certainly since I was 10 years old.
The very thought of icebergs, penguins, seals, and most of all its remoteness, has had me under its spell for a long time.
But you know how it is, work, family, commitments, finances all complicate life and so the warmer climes have held sway. Until now!

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