Swine Flu Update
‘Swine Flu’ is now officially known as
Influenza A (H1N1) and Australia currently has
more than 1200 confirmed cases across all states
and territories. This number is
expected to continue to rise. Fortunately, there
have been no deaths
recorded in Australia and the disease
appears to be mild in most people, with symptoms
similar to, but sometimes milder than, seasonal
flu.
Deaths have been recorded overseas from
Canada, Chile, Costa Rica, Dominican Republic,
Mexico, and USA, and these have primarily
occurred in recognised risk groups. Anyone who
is at risk of severe consequences from influenza
should receive their normal seasonal influenza
vaccine - this includes anyone aged 65 or over,
anyone with an underlying medical condition
(i.e. diabetes, heart disease, asthma or other
lung conditions), pregnant women and Aboriginal
and Torres Strait Islanders aged 15 years or
older.
Individuals can
reduce the risk of infection by practising good
hand hygiene and respiratory etiquette.
Hand hygiene means frequent washing with soap
and water or using an alcohol based hand wash.
Respiratory etiquette means covering your mouth
and nose when coughing and sneezing, and
disposing of tissues or washing handkerchiefs in
hot water. It is important to stay at home or
isolate yourself if you feel unwell. Your
regular doctor should first be contacted by
telephone and you should then follow the
specific advice given to you.
What about travelling?
The federal Government website ‘Smart
Traveller’ has practical information and is
regularly updated.
www.smartraveller.gov.au
As always, you should consider your general
health prior to travel, and speak to your TMA
health professional about whether flu may be a
more serious disease for you. Keep in mind
however, that some organisations currently
consider Australia a greater risk than Mexico,
due to the relative stages of the epidemic in
each country.
What about Tamiflu and Relenza?
Influenza A (H1N1) still appears to be
sensitive to these anti-viral medications and
they are being used for cases in Australia.
Tamiflu is not readily available to the general
public and travellers are unlikely to be able to
obtain doses before they travel.
BEWARE of internet
purchases of anti-virals, it is very
easy to receive fake drugs and risk your health
and waste your money.
Is there a vaccine?
Work is progressing rapidly but a vaccine
will not be available for at least two months.
The Australian
Government has pre-ordered millions of doses,
however two ‘shots’ may be required. Next year,
we will probably see seasonal flu vaccine being
given alongside Influenza A (H1N1), yet another
reason to stay in touch with your TMA health
professional.
Check for
for update s
here.
... prepared by Dr Christine Aus, Travel
Medical Alliance, Maitland and Newcastle
Beware the "Arak Attack" in Bali
| International News Agencies reported in
early June 2009 that up to 25 people died after
drinking the well-known local spirit Arak.
Bali's police said the victims, including a
British national, an Irish woman, a Dutch man
and a American woman,
died of alcohol poisoning after drinking arak
containing methanol - a toxic
chemical compound often used as an anti-freeze
or in paint.
Another 21 local residents have been treated
at Bali's main hospital.
Arak, a colourless, sugarless drink, is
distilled from palm sap or rice and commonly
used in religious ceremonies in Bali.
It is also much cheaper than imported
alcohol, which is heavily taxed. Arak has a high
alcohol content of 20 to 50 percent, making it
the drink of choice for some tourists who use it
for cocktails to get a so-called "arak attack". |
 |
Locally brewed alcohol and
spirits are a worldwide risk for unwary travellers.
The drinks can be contaminated with a wide variety of
chemicals and toxins, and contrary to popular belief,
are also not necessarily free of the bacteria and
viruses that cause travellers’ diarrhoea.
...prepared by Dr Christine Aus, Travel
Medical Alliance, Maitland and Newcastle
Question from a traveller: What is your advice
regarding yoghurt?
I have travelled extensively in the
Middle East and Iran and have often had
conversations with fellow travellers
regarding whether the eating of yoghurt
is safe. I have eaten yoghurt in places
like Turkey, Syria and Iran and not had
any problems but there has always been a
lingering doubt in my mind about whether
this is safe or under what circumstance
is it not safe. This is indeed a very good question -
like much of life, I don't have a yes or
no answer to this question for you.
Generally milk products are a little
risky, unless they have been
refrigerated, stored correctly etc. I know several patients who have become
ill from drinking a lassi - which is a
yoghurt like drink, but that is not the
same as yoghurt. I think it depends on the yoghurt - to
quote an esteemed colleague in China -
"I remember staying in an Indian home
in Hyderabad, and the little ritual
every evening of heating the milk up to
steaming temperature (not quite
boiling - i.e. pasteurized) and then
covering with a cloth until warm, and
then stirring in a teaspoon of
yesterday's yoghurt culture, and then
leaving
covered overnight.
I can't imagine any
vegetative bacteria surviving that. The
yoghurt is thick and sour and delicious.
However, commercially available yoghurt
in the food stalls and supermarkets in
Beijing tends to be much more runny and
sweeter. I worry that stuff has been
added to it after culturing, but I
haven't been told the recipe." Also to quote another esteemed colleague
in Peru - "Tell them to buy their own
yoghurt in a well recognised market or store and
make sure that it must
be of a well know brand and in a sealed bottle.
That will give some guarantee and less risk."
There is a hypothesis that the 'good
germs' in yoghurt protect from
travellers diarrhoea but there is not
much evidence to support this theory. There is some evidence that it helps if
you take antibiotics to get the gut
germs back to normal.
Read more here. My suggestion is that it is not the
yoghurt that is safe or unsafe - yoghurt
has a risk because it could be
contaminated after making it - it
could have been handled
by someone who seeds the food with dangerous
bacteria, mixes water or fruit
flavouring, stores it in place where could be
contaminated etc.
I think if the yoghurt was fresh and
'well cared for', it is probably OK (and have some Noroxin / Azithromycin
handy just in case). |
