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By Dr Jennifer Sisson*

Felt a chill in the autumn air? It’s a sign that the 2016 influenza season is approaching.
This year, two types of flu vaccine will be available from GPs, travel clinics and some pharmacies.
However, one of the two is the better choice for Australians heading overseas.
First, let me explain why there are two vaccines.
The first is the familiar 3-strain ‘trivalent’ influenza vaccine (TIV). It’s the cheaper of the two and is suitable for most healthy people. This year’s TIV formula will protect against the three principal flu strains predicted for 2016 – A(H1N1), A(H3N2), and B/ Brisbane.
The second option is a 4-strain or quadrivalent influenza vaccine (QIV), which became available in Australia for the first time last year. The additional fourth strain in this year’s QIV protects against the B/Phuket strain.
It’s this newer quadrivalent vaccine that’s the better option for travellers, according to one of Australia’s leading experts on flu, Dr Alan Hampson, the Chairman of Australia’s Influenza Specialist Group (ISG).
“Travellers are more likely to have greater exposure to A or B flu strains that are already circulating, as well as to new strains that could emerge outside Australia – especially in Asia,” said Dr Hampson.
“Plus, the B flu viruses occasionally predominate in parts of Asia. For anyone travelling overseas, having the quadrivalent vaccine makes good sense.”

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By Dr Jennifer Sisson*

Measles. It just won’t go away.
Despite having been effectively wiped out in Australia through our national immunisation program, cases doggedly persist here due to international travel.
In fact, cases are increasing each year. Australia has recorded 70 confirmed infections in the first three months of 2016, putting us well on track to pass last year’s total of 104.
Virtually all of these cases involve Australian travellers or foreign visitors infected overseas. Just last week, NSW Health issued a public warning after separate incidents in which foreign tourists – two young children from India and two backpackers from Europe – arrived in Australia infected with the highly contagious virus.
Those at risk of developing measles in coming days and weeks not only include other passengers who shared international and domestic flights with the four, but fellow hostel guests, and the staff and patients of hospital and medical facilities where they sought treatment.

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By Dr Eddy Bajrovic*

There are many reasons to wash your hands regularly and choose food and beverages with extra care when you travel overseas.
In developing countries, traveller’s diarrhoea, hepatitis A and E, cholera, and polio are among the many diseases linked to poor sanitation and hygiene, typically from eating, drinking (or just handling) something that’s been contaminated.
Another reason is paratyphoid fever, which has become recognised as a growing risk for international travellers – especially in parts of Asia.
Collectively known as enteric fever, paratyphoid and its better-known ‘cousin’, typhoid are caused by two distinct Salmonella bacterium – Salmonella paratyphi (strains A, B, or C), and Salmonella typhi respectively.
Potentially severe and occasionally life-threatening, they cause high fever and inflammation of the intestines when ingested in food or beverages contaminated by the faeces of an infected person.

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By Dr Jennifer Sisson*

A sign at Bali’s Monkey Forest in Ubud warns tourists “Don't stare at or tease the monkeys!”
It’s very good advice. It would be even better if it told them “Don’t feed the monkeys! Don’t pat them! Stay well clear!”
But, then the woman who sits nearby selling bananas to tourists to feed the ever-hungry macaques would probably be out of business.
As it turns out she does a brisk trade. So do local doctors.
By now, you’ve probably guessed how this story goes: Aussie traveller buys bananas. Monkey jumps onto man’s shoulder to eat banana. Monkey suddenly ‘freaks out’ and bites man on head. Hard. Twice.
Anthony Wallace recently brought home his monkey memento – nasty scalp wounds. After getting basic first-aid in Bali, Mr Wallace returned to East Gosford in New South Wales to have rabies immunoglobulin injected around the wound and to begin a post-exposure course of four rabies vaccine injections to prevent infection.

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By Dr Jennifer Sisson*

Are you pregnant or do you and your partner plan to start a family soon?
If so, do you intend to travel overseas this year?
If you answered ‘yes’ to both of those questions the list of places considered safe for you to visit is shrinking rapidly due to the Zika virus.
Worrying developments continue to keep the mosquito-borne virus firmly in the headlines.
Evidence is becoming stronger that the virus is linked to a sharp increase in cases of microcephaly among infants born to Zika-infected mothers in tropical Latin America and the Pacific islands, along with other neurological conditions.
Microcephaly causes babies to be born with a smaller-than-normal head and is likely to result in lifelong brain damage.

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By Dr Eddy Bajrovic*

The world has learned something new – and worrying – about dengue fever.
An estimated 390 million people are infected with dengue fever annually and 50% of the world’s population is at risk of infection, according to the WHO.
Almost all of the 1638 Aussies who had their diagnosis of dengue confirmed through a blood test last year were infected while travelling overseas – mainly in Asia. (A small percentage was infected in North Queensland, where imported cases spark localised outbreaks each summer.)
But, only about 25% of people infected with dengue actually get its symptoms – a high temperature, headache, pain behind the eyes, rash, and severe aching of muscles, joints, and bones (the reason dengue is also called ‘breakbone fever’).
It was previously thought that it was only these ‘symptomatic’ people who were able to pass on the virus to someone else through a mozzie bite. The reasoning was that only those who were sick would have enough of the virus in their blood stream to actually infect a mosquito that bites them, before passing on the illness by biting another person who entered their territory.

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