Doctors warn travellers against winging it

Headed to Bali? Beware of rabies and hepatitis. Thailand? Don't drink the water. Africa? Yellow fever is rife in some countries. India? Typhoid could kill you.

Health officials have expressed concern that record numbers of Australians are skipping vaccinations before they travel and that exotic diseases such as typhoid are on the rise among returning tourists.

"Typhoid is nasty and it can kill you," said Dr Tony Gherardin, the national medical adviser for the Travel Doctor TMVC network of clinics.

The clinics this week released data that typhoid cases among Australians have more than doubled since 2005 and that 2.8million Australian travellers have gone without vaccinations in the past five years.

"Typhoid is a bacterial disease from contaminated food or water," Dr Gherardin said. "The germ invades the gut and multiplies in your body. It is usually characterised by very high fever."

The World Health Organisation reports that typhoid kills more than 200,000 people a year, 90per cent of them in Asia.

There were 134 cases of the disease among Australians in 2011, up from an average of 50 in previous years, according to the Department of Health and Ageing's national notifiable diseases surveillance system.

Dr Gherardin is concerned that more than 50 per cent of travellers skip vaccinations. "There is a high level of complacency and a lack of awareness [of the consequences]," he said.

Several small surveys done by travel health groups and vaccine companies, including surveys of outbound tourists at airports, point to the low figures of people taking vaccinations.


The president of the Australian Medical Association, Dr Steve Hambleton, called on travellers to show responsibility.

"They have to think about their personal risks but also the risks to their country of origin. We only have to look back to a diphtheria death in Queensland in 2011. It was imported from overseas by the boyfriend, given to the girlfriend, and she died.

"Disease like measles are also being brought back into the country. Measles does not occur here any longer but can be brought back by travellers who have not been vaccinated. It is highly contagious and has a mortality rate."

Dr Hambleton said the lobbying against childhood immunisations may have rubbed off on travellers. "It broadly increases community suspicion," he said.

"But there are also those who are too busy and just don't get around to it. If we could give them a nudge by letting them know the pros and cons, they would be likely to have the vaccinations."

The medicos urge travellers to protect themselves from "the basics" such as malaria, tetanus, measles, mumps and rubella. Vaccine prices range from $25 for flu to $250 for Japanese encephalitis. Flu is required annually but others such as Japanese encephalitis only once.

"It would be fair to say that if you cannot afford the vaccines you should not be travelling in the first place," Dr Hambleton said.

Travel consultant Stefan Hellmuth, 36, works for adventure travel company Intrepid and is a stickler for vaccinations and preventive medicines when he goes globetrotting.

"I have been to more than 100countries," he said. "I always take the appropriate precautions. It's just a safety thing.

"I had a friend who years ago travelled to Mali and he came back with malaria.

"It is one of those malaria types that is recurring and he falls badly ill about once a year with headache, fever and dry mouth. "He gets violently ill. He will never get rid of it in his life."


TYPHOID Transmitted by contaminated food or water. The salmonella bacteria causes fever and can be fatal. Can be avoided with vaccination. Common in India, Pakistan, Sri Lanka, Afghanistan and parts of Africa and South America.

INFLUENZA Easily transmitted. Vaccination provides 70% protection for about a year.

RABIES Transmitted by infected animals. Causes headache, fever and paralysis. Can be fatal. Common in Asia and Africa.

HEPATITIS A Food or water-borne disease common in developing countries. Infects liver, causes fever.

HEPATITIS B transmitted by blood, body fluids. Can be fatal or chronic. Can be avoided with vaccination.

JAPANESE ENCEPHALITIS Flu-like symptoms with fever and brain inflammation. A 30% chance of being fatal. Transmitted by mosquitoes.

YELLOW FEVER Carried by mosquitoes in Africa, south and central America. Can result in kidney and liver failure before death. Vaccination reduces risk.