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Take condoms with you, and use them. That’s the message to young Aussie backpackers following a study showing high rates of unsafe sex with new partners among young international travellers heading to full moon parties in Thailand.
British researchers say high-risk sex among young travellers attending the hugely popular all-night beach parties on Koh Tao and Koh Phangan is fuelling the global spread of sexually transmitted infections (STIs) such as chlamydia, HIV and gonorrhoea (including antibiotic-resistant strains like Neisseria gonorrhoea) along with unplanned pregnancies.

What the study found

In a survey of 1238 young single travellers - including 72 Australians – visiting Thailand, the researchers found that overall almost 40% had sex with a new partner. Of these, 37% had unprotected sex.
The survey also revealed:
- UK and Swedish backpackers were most likely to have unprotected sex, at rates of 49% and 46% respectively.
- Australians had a 30% rate of unprotected sex.
- Most likely to practice safe sex were Canadian and German backpackers, with up to 80% consistently using condoms.
- Backpackers were more likely to have sex with travellers from other countries, while males are also likely to use local sex workers.

STIs – who’s at highest risk?

In 2013, a 14-year study of STI patterns and rates among 112,180 international travellers found that the type of infections varied among different classes of travellers.
Those most likely to be diagnosed with an STI were:
- Male travellers
- Younger adults
- Businesspeople
- VFRs (Visiting Friends and Relatives abroad)
- Short-stay travellers (less than 30 days)
- Immigrants
- Travellers who had not sought pre-travel medical advice
The most common travel-related STIs where non-gonococcal or other unspecified urethritis, acute HIV infection, and syphilis. For men, urethritis and epididymitis were most common, while cervicitis topped the list of STIs for women. 

Condoms have some limitations

Condoms are as important as sunscreen, personal insect repellent, and sanitising hand gel.
While condoms are widely available overseas, their quality can vary. Our advice is:
- Take your own from Australia: You can be sure of their quality.
- If you purchase them overseas, first check the expiry date and make sure the pack carries a recognised quality assurance mark.
- Use only water-based lubricants with latex condoms.
It’s important to remember that condoms have limitations.
Condoms WILL protect against: HIV, Hepatitis B and C, gonorrhoea, chlamydia, and syphilis.
Condoms WILL NOT prevent: Genital herpes, genital warts, pubic lice, or scabies.
Read more about male and female condoms and how to use them correctly. 

Safe sex is smart – at any age

Enjoying sun, sea and sex on holiday is not just for 20-somethings: a separate British study published in the journal, Sexually Transmitted Infections found that older holiday-makers – one-in-20 men and one-in-40 women aged 35 to 74 – had a sexual relationship with a new partner while travelling abroad.
Researchers found that those travellers who found a new sexual partners abroad were also more likely to engage in risky behaviour, such as unprotected sex. They concluded: “These proportions are likely to increase as older people maintain good health, have the financial means to travel, and are now more likely to experience partnership breakdown.”
Regardless of age, if you’ve had unprotected sex while abroad, have a sexual health check-up – including a screening for STIs – through your GP, a sexual health clinic, or a Travelvax Australia clinic as soon as possible after you return.
A thorough check-up provides reassurance and ensures there is no delay in treatment if you returned home with an STI. Just as importantly, by getting diagnosed and treated early you could help prevent the spread of antibiotic resistant infections in your community.

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Whether you’re heading to Brazil for the Games in August or just taking a short winter break in Fiji, the last thing you’ll want to bring home is dengue, chikungunya or Zika.
With no vaccines available to travellers for these nasty viruses, avoiding infection means dodging mosquito bites.
But, what really prevents bites from the aggressive, day-time biting Aedes species that transmit all three diseases, or other biting insects?

A new US study published in Consumer Reports compared the effectiveness of insect repellents. It confirmed what we knew: Products containing any of 3 active ingredients — DEET, Picaridin, or oil of lemon eucalyptus — work well against Aedes and Culex mosquitoes and Lyme disease-carrying deer ticks, while those marketed as ‘natural’ offered little protection, especially against Aedes mozzies.
But, the active ingredient’s concentration is just as critical. Repellents containing 15% - 30% DEET provide long-lasting protection against mosquitoes and ticks, while others with 7% DEET didn't work well against Aedes mozzies. (DEET is safe for children, and pregnant and lactating women, too.) 
A product containing 20% Picaridin was the study's top overall repellent, but one containing a 5% concentration of Picaridin scored far lower. Oil of lemon eucalyptus was the only naturally occurring compound to do well in the tests: Other plant oil-based products containing cedar, citronella, lemongrass, or rosemary provided little protection and often failed within 30 minutes. Once again, they were particularly ineffective against Aedes mosquitoes.

What works, what doesn't

A recent article by Beth Skwarecki neatly sums up the state of play as to what works and what doesn’t when it comes to products that claim to repel insects:
Wristbands and pricey gadgets don’t prevent mosquito bites. A wristband protects only your wrist, while ultrasonic devices don’t work at all.
Clip-on devices. They protect you from bites, but only if you sit still.
Some plants are natural repellents. But, planting them nearby isn’t enough.
Insect traps can be problematic. They may attract more mosquitoes than they kill.
Candles provide partial protection. There is some benefit – depending on which way the wind is blowing. Citronella candles don’t seem to work any better than plain candles.
Insecticide-treated clothing is worth the trouble. But, treated clothing works best with long sleeves and pants, and used in conjunction with an effective topical repellent applied to all exposed skin.

So, for now at least, the proven options are still the best – regardless of the maker’s claims, or how convenient or appealing the flashier gimmicks might appear.
But, select the repellent right for you (including kids) and read the label closely.

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An insect-borne disease that can cause permanent scarring is nearing epidemic levels in parts of the Middle East and East Africa, posing a risk to Australian travellers visiting the regions.
Until recent years cutaneous leishmaniasis was largely contained to areas around Aleppo and Damascus in Syria. However, Syria’s war has done three things: Created ideal conditions for the insects to breed, prevented infected people from being treated, and caused the mass migration of millions of refugees into previously non-infected neighbouring countries, especially Turkey, Lebanon, and Jordan.
Described by doctors as ‘catastrophic’, the outbreak of the ‘Old World’ disease is now affecting hundreds of thousands of people living in refugee camps or trapped in conflict zones.
An epidemic is also occurring in Eastern Libya and Yemen, scientists say in a new report. Yemen reports around 10,000 new cases each year and with Yeminis migrating to Saudi Arabia, it’s highly likely leishmaniasis will also surface there.
The conflict and mass displacement in Syria has also created the risk of tuberculosis, measles and polio, along with cholera and brucellosis, highlighting the importance of travellers to the Middle East receiving routine ‘childhood’ immunisations, if required, along with other vaccines that may be recommended for their individual itinerary.

More about leishmaniasis… Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. There are two main forms – cutaneous and visceral – both transmitted by bites from infected sand flies. The former causes disfiguring skin ulcers, while the latter results in severe systemic disease that is usually fatal without treatment. India, Bangladesh, Nepal, Sudan, South Sudan, Ethiopia and Brazil account for 90% of visceral leishmaniasis, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia, and Syria, as well as the South American countries of Brazil, Colombia, Peru, Bolivia and Argentina. Read more on the disease and prevention

How leishmaniasis is treated… Therapy varies, depending on the clinical form of leishmaniasis, the infecting species and the region where infection is acquired. It usually consists of oral or parenteral medication, or a topical medication used on the effected area. Travellers concerned that they may have been infected through sand fly bites should call Travelvax on 1300 360 164, or see an infectious disease specialist or their GP.

How to prevent it… There are no vaccines or drugs to prevent leishmaniasis. Prevention relies on avoiding sand fly bites by:
- Where possible, staying indoors between dusk to dawn, when sand flies are most active.
- Wearing long sleeves and pants, shoes and socks when outdoors – especially after dark.
- Apply insect repellent containing DEET, Citriodiol or Picaridin to exposed areas, including under the edges of sleeves and pant legs.
- Sleeping in any air-conditioned or well-screened room, or...
- Sleeping under a bed net.
- Spraying with a knock-down insecticide may provide some protection. Fans inhibit the movement of sand flies, which are weak fliers.
Sand flies are so small (approximately 2–3 mm) that they can pass through the holes in ordinary bed nets. Although closely woven nets are available, they may be uncomfortable in hot climates. Buying a net treated with permethrin or another contact insecticide will enhance the effectiveness of your bed net.
DIY kits are available to treat bed nets and clothing.
Read more about leishmaniasis and how to prevent infection.

Like to know more?
If you have questions regarding upcoming travel to the Middle East, including routine, recommended or required vaccinations, please contact Travelvax Australia on 1300 360 164. We can provide no-cost, no-obligation country-specific advice and arrange for a pre-travel medical consultation at a Travelvax Clinic.

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By Dr Eddy Bajrovic*

If you develop diarrhoea, nausea, vomiting, painful stomach cramps, with or without fever, it is a safe bet you’ve got acute infectious gastroenteritis or ‘gastro’.
Gastro comes under the term ‘traveller’s diarrhoea’ or, more colourfully, Pharaoh’s Curse, Bali Belly, or Montezuma’s Revenge (depending on where you encounter it).
Traveller’s diarrhoea (TD) is a very common travel complaint: half of all travellers visiting a developing country for a 2-week stay will experience it to some degree, according to the experts at the US Centres for Disease Control and Prevention (CDC).
Whether your symptoms are mild or severe, how effectively you treat them will usually determine how quickly you recover. More on how to treat TD and when to use ‘stopper’ drugs and antibiotics later in this article.
As your appetite returns, it’s just as important that you eat and drink the right things to help your recovery.

Read more ...

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By Dr Eddy Bajrovic*

These days, finding uncrowded breaks in overseas destinations like Indonesia, the Maldives, Mexico or the Pacific islands means exploring ever more remote locations.
Unless you can afford a five-star option, that often means living like the locals with very basic sanitation and dodging disease-carrying insects far from reliable medical help.
Illness or injury can not only put an end to your surfing odyssey, but may mean not-always-safe local medical treatment, or very costly evacuation and repatriation, followed by weeks – or months – out of the water.
Keeping the dream afloat means getting yourself and your kit prepared well before departure. 

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While more than half of Australians in the travel-loving 65-plus age bracket are at risk of pneumococcal pneumonia, only 1-in-5 is vaccinated against the potentially fatal disease, a national survey has found.

Conducted by Lung Foundation Australia as part of Pneumonia Awareness Week (May 9–15), the survey found 52% of people aged over 65 are at increased risk of contracting the bacterial infection through an existing medical condition or lifestyle factors – particularly current or past smoking.
Despite this higher risk, 40% of over 65s surveyed weren’t aware that a pneumococcal vaccine exists.
Often fatal, pneumonia affects the small sacs in the lungs which, in a healthy person, fill with air with each breath. Pneumonia infections (bacterial, viral or fungal) cause the lungs to fill with pus and fluid, which makes breathing painful, causing coughing and limiting oxygen intake.
Pneumococcal pneumonia, caused by the bacterium Streptococcus pneumoniae, is the only bacterial pneumonia for which vaccine protection is available.
A single dose of pneumococcal vaccine is recommended for adults when they reach 65 and is free for them under the Federal Government’s National Immunisation Program. Those who have a medical condition, such as cardiac, liver and congenital diseases, are at risk of infection and may require additional doses to ensure that they are adequately protected.

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