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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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By Dr Eddy Bajrovic*

You don’t need to go overseas to experience ‘traveller’s diarrhoea’. You can get TD by swimming in your council or backyard pool – even if it’s properly chlorinated.
Australia is currently experiencing one of its worst years in more than a decade for the parasitic disease Cryptosporidium, which is a leading cause of TD in developing and developed countries.
‘Crypto’ is a notifiable disease in Australia and there have been 3568 confirmed cases nationwide in 2015, with Queensland (1237 cases) and NSW (898) already registering more than double last year’s total. Because the disease is not severe in most healthy people, many more cases have gone undiagnosed.
Notifications of cryptosporidiosis, the disease caused by swallowing the parasites, increased by more than three times the usual average in NSW during October and November, NSW Health Director of Health Protection, Dr Jeremy McAnulty said in a statement last week.
He urged people who have, or recently had, diarrhoea to stay out of public swimming pools for two weeks in an effort to prevent widespread outbreaks this summer.

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Adventurous Australians are continuing to put themselves at risk of falling ill during or after overseas travel, with new figures showing less than half (46%) of those visiting at-risk destinations sought health advice before their trip.

Research involving more than 1000 outbound travellers has revealed that many aren’t aware of potential health risks abroad, and carefree attitudes are exposing them to potentially severe diseases.
In fact, at-risk destinations comprise over half of all resident departures from Australia (52%). At-risk destinations are those with a known risk to travellers of contracting infectious diseases that are preventable through vaccinations and other precautions.
Destinations such as South-East Asia and South America are travel hot-spots for Aussies where – for leisure and business travellers alike – there’s a potentially greater risk of illness from food and water-borne diseases, such as typhoid and hepatitis A.
“Australians are known for their love of travel and want to experience the culture and cuisine that these countries have to offer,” said Dr Eddy Bajrovic, the Medical Director of Travelvax Australia.
“But, it can expose them to many potential health risks.
“These can be avoided or prevented with the right knowledge and behaviour, which is why a visit to a travel doctor or GP should be an essential part of planning an overseas holiday.”

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By Dr Eddy Bajrovic*

Hear the words ‘hepatitis’ and ‘international travel’ together and it’s likely Hepatitis A is being discussed.
Hep A is not only spread directly from person to person, but also through food, beverages and everyday items that have been contaminated with the virus, making it one of the most persistent risks for travellers visiting any developing countries – even those staying for just a couple of weeks in better quality accommodation.
In Australia, almost all cases of Hep A are among returned travellers or from outbreaks linked to imported foods, such as frozen berries.
On the other hand, the B and C strains of hepatitis, which are transmitted in infected blood and body fluids, are common here. For Aussie travellers, infection from hepatitis B, C or the rarer fourth ‘D’ strain are usually the result of unprotected sex with an infected person, needle sharing, or via contaminated equipment used during an emergency medical procedure, acupuncture, body piercing or tattooing.
But, travellers who visit Travelvax Australia’s clinics are often surprised to hear that there’s a fifth strain of the liver disease – hepatitis E.
Like hepatitis A, Hep E is also spread by the faecal-oral route, usually when sewage contaminates water or food, particularly raw shellfish. Large-scale epidemics periodically occur in Asia, the Middle East, Africa, and Central America, especially after floods and other natural disasters.

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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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