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The Travel Doctor TMVC Homepage News
Homepage news articles from The Travel Doctor TMVC in Australia

• Possible Rabies on Bali - Update
  Press the Back button to return to the Travel Doctor homepage. The reports of rabies cases on Bali, have been accepted by the public health authorities as being correct, it appears that laboratory confirmation has been done in Indonesia. We now consider that rabies exists on Bali, and any animal bite or possible rabies exposure should be managed appropriately with post-exposure prophylaxis (PEP), which consists of the administration of rabies vaccines on days 0,3,7,14,28 and the use of rabies immunoglobulin in those people who are not previously immunised, and only 2 booster does of vaccine in those who are already vaccinated. Vaccinations against rabies are available at Travel Doctor-TMVC clinics, although are not generally recommended for short-term holiday stays. Historically Bali has been considered rabies-free, but rabies is an extremely serious disease, and control efforts (vaccination of dogs) will need to be introduced. Travellers who experience an animal bite on the island of Bali, should wash the wound immediately and report the bite to medical services. In Australia, those bitten travellers should attend their closest Travel Doctor-TMVC clinic.
• Malaria increase in tourists to Gambia
  An increase in the number of cases of malaria among returning travellers from the West African state of Gambia has been noted by the surveillance groups TropNetEurop and GeoSentinel over the past month with a total of 39 cases including 2 fatalities and several patients in intensive care and on ventilators. It is surprising that so many travellers have been visiting a highly endemic area without chemoprophylaxis, which indicates that pre-travel advice has been insufficient. Gambia is a popular holiday destination for Europeans because of its good resorts and easy access. Despite the fact that it is a known malaria risk country many travelers think that a quick holiday e.g a “long week-end” does not carry much risk. Unfortunately it does. Travellers from areas further away such as Australasia are more likely to seek medical advice before going to countries in West Africa but those working in the UK and Europe may be tempted to take a break to a resort in Gambia. Medical advice before travel is essential. Some travellers had been advised to use chloroquine as a single drug prophylaxis, which has been obsolete in the Gambia for at least 15 years indicating that advice should be sought from specialised travel health professionals.
• Safe Himalayan Trekking a Reminder
  With an improvement in the political situation Nepal is beginning to see a welcome increase in the number of tourists. October and November offer the best weather conditions for trekking and climbing in the Himalayas but the French Embassy in Kathmandu has expressed concern at the fact that six fatalities have been reported since the end of September, five French citizens and one Iranian. Three of these deaths resulted from accidents but three were attributed to altitude sickness. Most Australasian tourists who undertake trekking in the Himalayas do so under the auspices of reliable tourist companies who impose strict standards of safety but there remain a number of more adventurous climbers who prefer to “do their own thing” hiring guides, who may or may not be reliable, on the spot. Both types of tourist would be well-advised to discuss their plans with experienced health professionals at a Travel Doctor-TMVC clinic before embarking on what is a highly exciting but potentially hazardous adventure
• An unlikely but possible blessing from bedbugs
  Researchers at the University of Sheffield in the UK have reported to a conference of the Royal Entomological Society on a unique “immune” organ in female bedbugs which may yield some answers in the understanding of biological defense reponses. Speculatively and hopefully this might ultimately lead to techniques for preventing infections such as sexually transmitted disease or even mosquito-borne disease like dengue or malaria. The organ has been known to entomologists for a couple of centuries but its function has been unknown until current research showed it to be a sort of reservoir of white blood cells acting as a first line of defense against micro-organisms Such an organ has not been found elsewhere and has apparently evolved to protect female bedbugs from being infected by a mating male. The violent method of fertilisation used by the male bedbug whereby the penis acts like a dagger and stabs the female randomly is not unique to bedbugs - it also occurs in some arachnids where the male has to act quickly to avoid being attacked and consumed by the female, but the unsanitary conditions in which bedbugs flourish means that this somewhat strange reproductive act would be just as likely to convey potentially fatal infection to the female as it would to fertilise her eggs. The “immune organ” reduces mortality. Futuristically knowledge about bedbug defenses may one day lead to reduced human mortality.
• Let the buyer beware A warning from Hong
  Standard medications and even prescription drugs are widely available, and often cheaper, from unlicensed (and even from some licensed) purveyors in many overseas destinations, and also via the Internet. However, time and again we have reports of sub-standard drugs being purchased by travellers and the World Health Organisation has repeatedly warned about the trade in counterfeit drugs. (See for instance the posting on this site of 13th May). Of equal importance as a potential danger is the inclusion of unusual or dangerous ingredients in a preparation, unbeknownst to the customer. An example of this is a herbal preparation for treatment of arthritis which contains cortisone. A further example has recently come to light in an alert from the Hong Kong Department of Health about a preparation - Nangen Zengzhangsu - sold for erectile dysfunction which contains an ingredient used for the treatment of diabetes. This could lead to a life-threatening situation of low blood sugar. Travellers must not rely on obtaining safe and reliable medication overseas so it is best to take sufficient supply of prescribed drugs for the duration of travel. To cater for the treatment of common ailments associated with travel the Traveldoctor-TMVC clinics have a range of prepared kits designed to suit the type and duration of your itinerary as discussed with the clinic doctor who can also provide a prescription for any necessary preparation not included in a kit.
• Is First World Food Hygiene always First Class?
  When visiting “Western” countries like in Europe and Nth America, can we just assume that all food is safe to eat? Quite simply the answer is ‘No, not always.’ The developed nations rely on a sophisticated public health service together with widespread public knowledge of the principles of food hygiene to protect consumers. But consider the number of outbreaks of Salmonella food poisoning reported in the press in the USA and Europe. Often this occurs inadvertently somewhere along the chain of food production, preparation and presentation or when problems with storage and preparation occur at the point of consumption. More concerning , however, is a report from France earlier this month where the Ministry of Agriculture and Fisheries stated that one in four cafes, snack bars and seafront restaurants in tourist hotspots across France are breaking hygiene rules or serving food unfit for consumption, thirty-seven establishments were shut down altogether, for failing to meet basic hygiene and food conservation rules, and allowing staff to work in dirty clothes. Such reports emphasise the fact that travel to Europe or other “developed” countries is not necessarily hazard free. This is consistent with our travellers’ reports of the rate of diarrhoeal illness while visiting Europe, and the reason we have developed our special “Tour” medical kit. It reminds travellers that a pre-travel consultation at a Traveldoctor-TMVC clinic is a wise precaution for any destination overseas.
• Kokoda trail is not a walk in the park
  Following the track of the World War II Australian armed forces across the Owen Stanley ranges in Papua New Guinea has become a popular adventure. There are a variety of tours organized by a variety of agents and most – but not all - of the organisers arrange for some form of preparatory instruction on risks and precautions. A recent news item describing the rescue by US Navy helicopter of an Australian hiker, reportedly unconscious from a low blood sodium level, from a remote village on the track does illustrate the fact that are definite health risks in undertaking the tour. The journey is a strenuous one and apart from muscle and joint problems dehydration is a major challenge, but replacement of lost fluids with plain water only is not good enough without replacement of salt lost as well. At Traveldoctor-TMVC clinics our experienced health professionals can discuss this and all other related issues and problems