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By Dr Eddy Bajrovic*

She thought she’d avoided the terrible disease.
Bitten by a stray dog at a market near her North Bali village in July, the local woman twice tried to obtain the rabies vaccine without success. At the time, stocks were critically low across the island.
Instead, she had to content herself with cleaning the wound.
It wasn’t enough: Two months after the lethal virus lurking in the dog’s saliva began its relentless journey through her nervous system to her brain, the mother of three suddenly fell ill and died – Bali’s fifteenth rabies victim of 2015.
A brief report in local media told the tragic story on the eve of World Rabies Day (Monday, Sept 28).
Her needless death was another grim reminder that there are no short cuts with rabies. Fail to get effective treatment and rabies is fatal - always.

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By Dr Eddy Bajrovic*

There’s good news for Aussies planning to visit a malaria-infected country: The odds of avoiding the mosquito-borne disease have improved dramatically.

Over the last 15 years, the number of global cases of malaria has fallen by 37%, while the number of deaths has plummeted by a staggering 60%, according to a landmark World Health Organisation (WHO) report, ‘Achieving the malaria MDG target’**.

The vast majority of malaria cases and deaths occur in children in sub-Saharan Africa, which is where global malaria control and eradication measures have been concentrated.

But, international travellers have benefitted too: 15 years ago, around 1000 Australian travellers returned from an overseas trip with malaria. This year there have been just 153 cases.

The worldwide drop in malaria infections since the year 2000 means that the MDG (Millennium Development Goal) goals aimed at halting and reversing the incidence of malaria – especially in the more heavily infected regions – are being met.

In financial terms, the cost of beating malaria has been – and will continue to be – high. To ensure success, annual funding for malaria will need to triple – from US$ 2.7 billion today to US$ 8.7 billion by 2030.

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By Dr Eddy Bajrovic*

A crowded cabin is no place to get seriously sick.

But, illness during an international flight is not uncommon, occurring on around one in every 600 departures, according to a review of mid-air medical emergencies published this month in The New England Journal of Medicine**.

The review was carried out to give doctors an understanding of the kind of medical issues they are more likely to encounter if a fellow passenger becomes ill.

Fortunately, the chances of treatment being available are fairly good: a doctor responded to the pilot’s call for medical assistance in almost half (45%) of the 191 in-flight emergencies reviewed in an earlier US survey in 2006.

And, even if a doctor, nurse or other health professionals are not on board, ground–based medical services are contracted to provide medical advice to flight attendants, who themselves receive mandatory training in basic procedures, such as cardio-pulmonary resuscitation.

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By Tonia Buzzolini*

As every parent knows, kids and sniffles go together like toast and Vegemite (and can be just as messy!).

But, having to cope with a sniffling, miserable child for hours on end during  a long flight is no-one’s idea of family fun. Not to mention the very real prospect of upsetting fellow passengers.

The solution (literally) is saline solution.

These over-the-counter preparations come in two forms – drops or spray mist – and are simply sodium chloride (common salt) in sterile water.

Very small kids can’t blow their nose. A couple of drops or a squirt or two of saline loosens mucous and allows it to flow.

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By Dr Eddy Bajrovic*

A leafy salad laden with freshly washed garden vegetables… It’s hard to imagine a healthier choice for lunch or dinner, right?

Light on the carbs and heavy on the feel-good factor, it’s the virtuous alternative to other not-so-healthy choices from the menu at your holiday resort or hotel, or the local restaurant.

But, a garden salad can be decidedly unhealthy overseas, as six Australian travellers learned following a holiday in Bali.

The five women and a man were belatedly diagnosed with fascioliasis, a severe liver disease caused by ingesting parasitic liver fluke worms called fasciola, whose immature forms can be found on plants grown or washed in water – particularly water cress.

All six ate salads in Bali and developed severe illness lasting many months after their holiday. Several had invasive investigations involving surgery and one even had infected sections of their liver removed when they were initially diagnosed with cancer.

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By Dr Eddy Bajrovic*

Got your sights set on Africa?

It’s one long Kodak Moment, from its vast northern deserts, to massive lakes and rivers teeming with birds, and snow-capped peaks towering above valleys and plains alive with wildlife.

But, this natural abundance comes with health challenges for visitors and these can vary according to the individual, the season, the region, and the length of stay.

You may be advised to take anti-malaria tablets and vaccinations will almost certainly be on the cards, including one that’s required for many African countries. We’ll cover the list later.

First, a couple of recent developments worth noting for travellers visiting Africa…

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