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By Dr Eddy Bajrovic*

Last week, I stressed that travellers need to be wary if they develop a fever after visiting a tropical country.
It might be malaria, which can sometimes be rapidly fatal without urgent medical treatment. Each year, around 500 Australians return home with the mosquito-borne parasite multiplying in their blood.
However, the dengue virus has become a much more common cause of post-travel fever, with 1427 confirmed cases here to date this year – most of them imported from Asian countries. (Mind you, these are just a tiny fraction of the estimated 390 million annual cases of dengue that occur in 128 countries where 3900 million people are at risk of infection, according to World Health Organisation data.) 
While dengue has conquered the world in the past half century, two other mozzie diseases are now hot on its trail. The chikungunya and Zika viruses are also entrenching themselves in tropical Africa, the Asia-Pacific, and the Caribbean-Americas regions.
Each of these three can be very painful, disrupting every aspect of life for weeks (even months), while one form of dengue can be deadly. So, it’s more important than ever that Aussies visiting a tropical country avoid mozzie bites.

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By Dr Eddy Bajrovic*

Travellers don’t always return from overseas refreshed and rejuvenated.
Instead of being fighting fit they’re fighting off jet lag, a fever, a rash, diarrhoea, or persistent pain.
At least 50% of travellers who’ve visited a developing country report a post-travel illness, according to the Manual of Travel Medicine.
By far the most common infections are gastro and respiratory infections, followed by skin diseases, and sexually transmitted or urinary tract infections.
But, not all post-travel illnesses are actually related to the trip: Many are routine infections just as easily caught at home. Most of these illnesses disappear in a few days without treatment.
So, it’s important to know when you don’t need to see a doctor… and when you do.

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By Tonia Buzzolini*

After decades of safe-sex campaigns, we’re all aware of the potential risk of blood-borne infections like HIV and hepatitis from unprotected sex.
It’s sensible to use a condom with a new partner – whether travelling overseas or at home.
But, many travellers don’t associate these diseases with having a holiday tattoo and body piercing, while the risk of infection from a pedicure or manicure seems even more remote.
After all, it’s so common to see young Australians lining up for a new ‘tatt’ or piercing in places like Bali and Thailand.
Even older women who may not be into body art regard a manicure or pedicure as an essential part of their Asian holiday experience.
The good news is there are steps travellers can take to reduce the risk of infection.

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By Dr Eddy Bajrovic*

Picture this: A female fly catches a female mosquito.
But, instead of making the luckless mozzie her next meal, the lady fly secretes glue-like substance that fixes her eggs onto the insect’s body before releasing it.
And, as mosquitoes do, she soon bites an animal or person to take a blood meal, and one or more of the tiny larva that have hatched from the fly’s eggs then burrow in through the puncture wound or simply into the skin.
As snug as a bug under the skin of its unwitting host, the larvae begin to grow… and grow.
Over the next 5-8 weeks a red sore becomes a boil-like lump. Then something rather peculiar happens: a pin-sized hole appears on the top.
It allows the now-plump maggot to breathe until, finally, it emerges as a Mini Me-sized version of the extra-terrestrial creature from Alien.
Eeeeeek! Where’s Sigourney Weaver when you need her?

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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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