* By Ruth Anderson
Cuba is poised to emerge from its time warp.
So, if the Caribbean island famous for missiles (well, briefly), Castro, Hemmingway, cigars, and fabulous music is on your travel Bucket List, take my advice. Go soon.
Cuba is the hot travel destination right now, going on the number of calls Travelvax Australia’s free travel health advice line (1300 360 164) is currently getting from Australians keen to find out more about staying healthy in Cuba.
Cuba has always held a special romance for travellers, but I suspect that with the 65-year freeze in diplomatic relations between Cuba and the USA finally thawing, an avalanche of American tourists will soon be queuing to visit the island.
I visited Cuba in 2002. To me, it will always be the sizzling sounds of the Buena Vista Social Club, bars churning out Mojitos, Daiquiris, and Cuba Libres, the fusion of Spanish–Caribbean cuisine, and city streets resplendent with classic American cars (held together with chicken wire) and Spanish colonial architecture.
Ahhh, Cuba. Experience it – soon.
Basic travel vaccinations advised
For all its charms, Cuba holds much the same health risks as other developing island nations in the Caribbean Basin – mainly food-, water-, and insect-borne infections. While there are no mandatory vaccinations required for travel to Cuba, some are recommended.
Firstly, any routine (i.e. ‘childhood’) vaccinations – measles, mumps/rubella (MMR), diphtheria/tetanus/pertussis (dTpa) – should be current.
A seasonal flu shot has also become routine simply because international travel inevitably involves close contact with people from across the globe and the virus is transmitted year-round in the tropics. In addition, Canadians have long taken ‘winter sun’ holidays in Cuba, so it very likely that the northern hemisphere flu strains will be circulating in Cuba – especially with the way now open for Americans to obtain visas, too.
Hep A vaccine strongly recommended
Cuba has intermediate to high rates of Hepatitis A (a study showed 90% of Cubans had been infected by their late teens). So, vaccination is recommended for all travellers – regardless of length of stay or level of accommodation. The virus is transmitted through contaminated food or water, or handling common, everyday objects, making personal hygiene and safe food and water choices equally important.
These days, vaccination against Hepatitis B is generally recommended for most travellers. Consider it if you are planning a longer stay in Cuba, will be in remote locations, or if a new sexual partner, needle sharing, acupuncture, dental work, body piercing, or tattooing are possibilities. Also, Hep B vaccination is advisable if you travel overseas regularly. A combination Hep A-B vaccine is available, as well as vaccines for each strain of the virus.
Typhoid is present in most developing regions, including the Caribbean. However, it’s generally a low risk for short trips staying in resorts or hotels. Consider vaccination if you’re an adventurous eater or plan to visit smaller cities, towns, or rural communities, where exposure to typhoid is more likely (again through contaminated food or water) – or if your travels often take you to developing countries.
Rabies is present in Cuba, but the potential for short-stay travellers to be infected is very low (vaccination is usually advised for longer stays, those working with animals etc.) That said, it’s important for all travellers to avoid contact with any animals – especially dogs – and know what to do if they’re bitten.
Limited outbreaks of cholera have occurred in Cuba in recent years, mainly due to the large-scale, ongoing epidemics in nearby Haiti and the Dominican Republic. Again, vaccination is not recommended for short visits.
Dengue, Chikungunya present
As for insects, there’s good news… and not so good news. The good news malaria is not present in Cuba, although it is a low risk on some other islands in the tropical Caribbean.
However, dengue fever is widespread in Cuba – including Havana and other large cities – just as it is throughout the entire region. There were nearly 850,000 cases in Latin America and the Caribbean to September last year, including 470 deaths from severe dengue.
Another mosquito-borne disease, Chikungunya has been at epidemic levels in the region for almost 2 years, island-hopping across the Caribbean into Central America, and now forging a path southward in South America. (Between December 2013 and September 2014, 650,000 cases of Chikungunya, including 37 deaths, were reported in the region.)
Being a ‘novel’ disease (that is, new to the region), the local people have no resistance to Chikungunya. Fortunately, its symptoms are usually not as severe as dengue’s can be.
Pack an effective repellent
There are no vaccines or medications to prevent infection for either of these nasty viruses, so avoiding mozzie bites is essential.
The two species of Aedes mosquitoes that transmit them are daytime feeders and breed in urban settings around hotels, resorts, and homes – anywhere there are people. While they bite at any time during the daylight hours, they’re most active at dawn and dusk.
Preventing bites is a matter of covering up, wearing light-coloured clothing, foregoing mozzie-attracting perfumes or aftershave and, most importantly of all, applying insect repellent when outdoors.
Ensure your insect repellent contains an effective active ingredient. Look for N,N-Diethyl-meta-toluamide (DEET), Picaridin, IR3535, or oil of lemon eucalyptus on the label: All protect well for varying lengths of time when used as directed.
Traveller’s diarrhoea commonplace
Cuba’s tap water is not reliably safe to drink. (Stock up on the local bottled water, Ciego Montero for long bus or car journeys as it’s not always available outside cities.)
While the occasional cholera outbreaks pose a low risk, traveller’s diarrhoea (TD) is more common among visitors and can mean a day or more of inconvenience and discomfort. To treat TD, I always carry treatment medication and sachets of rehydration solution in my first-aid kit.
Since 2010, medical travel insurance has been compulsory for foreigners visiting Cuba. Travellers are routinely asked to show proof of coverage at Customs.
If you arrive without it, you will have to purchase a policy from Asistur, the government-operated insurance company.
The lowdown on health
The Lonely Planet has lots of great information on Cuba, including health and medical details.
It advises that free medical treatment is available for Cubans, but not visitors. Servimed is the Cuban government’s health service for foreigners, with 40 centres offering primary care and specialty services, with walk-ins accepted.
While outpatient treatment at international clinics is reasonably priced, emergency treatment or a hospital stay can be expensive for a sick or injured traveller.
Expect doctors and hospitals to require payment in cash, whether you have travel health insurance or not. A life-threatening medical problem may warrant evacuation to Florida and since the bill can run into tens of thousands of dollars, your travel insurance should cover this eventuality.
Travellers to Cuba should bring any medications they may need – pharmaceuticals are often in short supply in pharmacies. I recommend a well-stocked travel medical kit.
For more details…
The best time of the year to visit is from March through May, ahead of the June to November hurricane season.
Finally, check the Australian Department of Foreign Affairs’ website, smartraveller before you go. It offers travel advisories and advice on Cuba, and you can register your itinerary and personal details in case a problem arises.
*Ruth Anderson is a specialist travel nurse with Travelvax Australia.