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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*

Zika. Sounds more like a DJ than a disease, right?

In fact, it’s a virus passed from a person who has it to another person who doesn’t through a mosquito bite.

The symptoms of Zika virus infection are similar to the other two better-known mosquito-borne virus infections, dengue and chikungunya, which are a risk for travellers visiting tropical and sub-tropical destinations.

Zika can cause a fever, rash and joint aches, but generally milder than those of dengue and chikungunya. In fact, many people have no symptoms and are not aware they’re infected.

So, while it’s been disconcerting to see Zika epidemics sweep through the tropical world – first through Africa and more recently the Pacific, Caribbean and the Americas – relatively few deaths were expected. Certainly less than chikungunya’s relatively modest toll and far lower than dengue, with its potentially fatal haemorrhagic version.

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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 Lisa Ryan, travel nurse.

The world offers any number of travel destinations. But, calls to Travelvax Australia’s free travel health advisory service (1300 360 164) almost always start the same way.
Caller: “I’m off to South America. What shots do I need? Is malaria a risk?”
Me: (Takes deep breath) “Well, South America is a very diverse collection of countries. It’ll depend on just where you’re going, the season, type of trip, and how long you’re there. So, tell me more about your trip…”
Helping prospective travellers is all about judging the likelihood of potential health risks present in a country or region.
While the caller’s age is a factor, it’s the where, when, and how long of a journey that is critical. (We don’t discuss personal medical history. That would amount to a medical consultation over the phone, which we can’t do for legal reasons.)
So what’s the answer to the caller’s questions? I’ll get to that.
First, for anyone heading to South America (or Central America or the Caribbean), there’s been good and bad news regarding mosquito-borne diseases. 

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