Expanding
TMA Network
TMA is pleased to report we have two new members -
one in
Melbourne on St Kilda Road and other in
Alice Springs.
Respiratory
Illness And The Traveller
Respiratory illnesses are a common
source of illness and disability in the traveller. In
fact, 5 to 20% of travellers get sick with
respiratory infections; whether it is the common
URTI, acute bronchitis, sinusitis, pneumonia or
influenza. Influenza is likely to affect 1 in 100
travellers. More specifically, a recent report by
GeoSentinel Surveillance Network projecting the health
risks in travellers to China for the Olympics found
respiratory ailments were the most common syndrome
reported by China travellers from 1998-2007.
Additionally, the air pollution problems in Beijing and
other Olympic venues are expected to give rise to
increased risk of occurrence of respiratory problems for
athletes and spectators during the 2008 Olympics.
There are hundreds of known viruses that
cause the common cold; and there fore no single vaccine;
nor cure. Common colds are recognised by gradual onset
of symptoms; a scratchy, sore throat, perhaps mild
fevers and headache; mild aches and pains, sneezing and
nasal congestion. Treatment is simple paracetamol,
plenty of fluids, rest and time. This is distinct from
influenza; which is a sudden onset of symptoms that
worsen with in hours. Severe sore throat, high
temperatures, severe headache with whole body aches and
pains. Profound fatigue and weakness are invariably
present. Coughing is usual but sneezing is rare. The
patient is usually unwell for 1 to 2 weeks; and
complications of pneumonia, sinusitis, bronchitis and
middle ear infections can occur. This influenza can be
treated by anti viral agents if commenced early enough;
and should be contained the traveller's medical kit in
some cases.
Australia's 2007 influenza season was
more severe than other recent seasons, and high lighted
the importance of seasonal influenza vaccination. The
Brisbane 2007 (H3N2) strain of influenza A has now been
incorporated in the 2008 flu vaccine in the southern
hemisphere. Pre-departure influenza immunisation
should be considered for anyone leaving Australia during
the local influenza transmission season (so as not to be
ill at the time of travel or shortly after. It should
also be offered to any one leaving Australia who will be
exposed during the influenza transmission season at the
destination; i.e. Beijing. The risk of infection is
particularly elevated in people travelling in large
tourist groups; and cruise ships. Vaccination will
decrease the risk of illness to the individual during
the trip, and may also reduce or delay the risk of
introducing influenza into Australia upon returning
home.
Most important however, is the basic
lesson of avoiding these viruses:
-
frequent hand washing; and anti
septic gels;
-
avoid toughing eyes/nose/mouth unless
hands are clean
-
avoid prolonged close exposure to others
with respiratory illnesses.
...prepared by Dr Julie Burke, Travel
Medical Alliance, Yeppoon, QLD
Hope for the children of Cambodia
I was a little apprehensive travelling to Cambodia after
all I had read and watched about the mass genocide of the
1970's, the invasion of Vietnam, the legacy of land mines
and the corruption of the Government since. I had planned to
visit Cambodia back in the mid 70's but this was not
possible due to the war and the Pol Pot regime. I have
followed the events in the country until the present day and
wonder how the world could have stood by and watched such
horror.
Nothing could prepare you for the shock and horror of
visiting S21 (a school which was converted into a prison
where many innocent people were tortured and murdered by the
Khmer Rouge) and the Killing Fields. Yet on the other hand
nothing could prepare you for the wonder and magnificence of
Angkor and the ruins around Angkor Wat.
In Siem Reap after fantastic days roaming through the
Angkor ruins we went to a free concert by a Swiss
pediatrician, Beat Richner at the Jayavarman VII Hospital.
His show is called Beatacello and it is his way of raising
funds to obtain first-class medical care for children in one
of the world's poorest countries. He uses his cello in a
very entertaining way, to show guests the plight of the
Cambodian children and how government agencies as well as
the NGO's in third world countries are using inefficient
strategies resulting in what he refers to as a "passive
genocide". Nearly every child born in Cambodia since the
days of the Khmer Rouge has a form of tuberculosis that they
contract from their mother. This does not generally show up
unless tested for, but it lowers their resistance to other
diseases often causing death if not treated. Dengue fever is
rife in Cambodia and without safe blood transfusions
children presenting at the hospital cannot be treated. WHO's
recommendation of using mosquito nets is not acceptable when
the Dengue mosquito is actually active during the day!
| Anna, my 17 year old daughter, became very sick
with high fever and diarrhea which we were able to
get under control by following the instructions in
the Travel Doctor's book and using the drugs we had
brought from Australia. This was a privilege because
we are from a wealthy country. If she had been a
Cambodian unless she went to one of the three
hospitals managed by Beat Richner (pictured right)
the chance of being cured would be slim and she may
not have been able to afford the bribes to pay off
the hospital staff to receive the treatment. The
Government Hospitals are rife with corruption and
the drugs in Cambodia are of poor quality and often
prescribed incorrectly.
The Cambodian people have certainly won my heart
and it would be great to see more people like Beat
Richner working there, who are not giving handouts
but training doctors and nurses to care for sick
children and run hospitals without corruption. It
seems the Aid Agencies and WHO are using more money
on administration than helping the people and when
people like Princess Anne who is the president of
"Save the Children Fund" remarked on a visit to
Jayavarman VII Hospital in Siem Reap that before
installing modern equipment such as CT s and
ultrasound machines you first have to teach the
Cambodians to wash their hands! Washing hands won't
get rid of tuberculosis or cure a Dengue epidemic! |
Dr Beat |
To find out more go to
www.beat-richner.ch.
... prepared by Wendy Russell (a
client of TMA Yeppoon)
Avian Influenza
Although the risk of infection to travellers to areas
affected by avian influenza is currently considered low,
Australians travelling to these areas can reduce their risk of
infection:
- avoid situations where you may come into contact with
farms and live bird markets
- ensure all uncooked poultry and eggs are handled
hygienically with careful attention to hand washing after
handling
- ensure all poultry and eggs are cooked thoroughly before
consumption (proper cooking destroys the virus in poultry
and eggs)
- wash hands thoroughly after contact with infected or
potentially infected birds, their faeces or other body
fluids
- avoid contact with cats and their faeces, as there is
some evidence that they can be infected with avian influenza
The good news is an Australian-developed and manufactured
avian influenza vaccine "Panvax" has received approval in
Australia. Its use will be restricted to when an influenza
pandemic has been officially declared by the Australian
government in consultation with WHO.
... prepared by Dr Julie Burke, TMA
Yeppoon, QLD
Outbreak
Information and News
Poliomyelitis in Nigeria and West/Central Africa
18 June 2008 - Northern Nigeria is currently affected by a
new outbreak of wild Poliovirus type 1 (WPV1), which has begun
to spread internationally. In 2008, a 9-fold increase in new
cases caused by this serotype has been reported compared with
the same period in 2007. This outbreak in Northern Nigeria has
the potential to cause major international outbreaks, as
occurred in 2003-2006. This year [2008], Nigeria accounts for 86
percent of WPV1 cases in the world.
All travellers should have had 3-dose primary course of polio
vaccination and at least one subsequent adult booster.
Venezuela: dengue fever
According to postings on ProMED, approximately 27,000 cases
of dengue fever, a significant increase in the number of dengue
cases as compared to the same period last year, have been
reported (especially from Zulia state) so far this year.
Travellers to both urban and rural areas are advised to practice
daytime insect precautions.
Viet Nam: dengue fever
2 July 2008 - According to postings on ProMED, Viet Nam's
Ministry of Health has reported approximately 20,000 cases of
dengue fever so far this year, a significant increase over the
average incidence. The province with the highest numbers of
patients is Ho Chi Minh City. Travellers are advised to practice
daytime insect precautions.
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Do you have a holiday
story to tell, especially one with a medical
event?
Send it to
info@travelmedicine.com.au,
and we will send you one of our mini TMA
torches to put on your key ring - a great
help when finding your lock at night.
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The Travel Medicine Alliance