Preventing Illness & Injury
Preventing Illness and Injury While Travelling
Over 50 % of travellers will be affected by a travel related illness, most of which are mild infections, but severe illnesses like malaria and dengue fever can be contracted in endemic parts of the world.
Many illnesses are preventable with travel vaccinations, some illnesses require preventative medications for others changes in eating patterns or personal habits will help prevent infection.
Gastrointestinal infections
Traveller’s diarrhea and other gastrointestinal infections are the most commonly reported travel illnesses, contracted from poorly prepared food or contaminated water. The following tips reduce risk of developing gut infections.
- Avoid tap water and ice in drinks
- Use bottled water, carbonated drinks, boiled water or use water purification methods
- Don’t drink unpasteurized milk or other dairy products
- Be wary of vegetables and fruits that may have been washed in local water
- Prefer fruits and vegetables that can be peeled or washed in safe water
- Eat only freshly cooked hot foods
- Avoid foods from street stalls, overall food prepared in restaurants and hotels is safer
- Avoid shellfish
- Care with personal hygiene
Medications to treat traveller’s diarrhea are safe, effective and simple to use. Antibiotics combined with antidiarrheal medications will effectively treat most diarrheal illness within 1-3 days. In some patients preventative treatment may be required.
Other illnesses
Malaria:
All countries in south and central Africa have malaria risk in at least part of the country. The highest risk of infection is in those countries in sub-Saharan Africa. Malaria prophylaxis is recommended for most travellers unless travel is limited to the larger cities such as Johannesburg or localized travel to malaria unaffected areas. If travelling to remote areas, with poor access to medical help, standby treatment for malaria may be prescribed.
Bite prevention:
Is important at night, COVER-UP — long sleeves, long pants, covered footwear—, SCREEN UP — with insect repellant—, and SLEEP PROTECTED, —bed nets / air-conditioned or screened rooms.
Traveller’s diarrhea
This is common in the first 2 weeks of travel and can be treated with antibiotics and an antidiarrheal medication if the infection will cause inconvenience while travelling, or is a risk due to pre-existing medical conditions.
Other insect-transmitted infections:
There are many other insect-transmitted illness in Africa – prevention for this illness is restricted to preventing bites.
Dengue fever:
A viral infection transmitted by mosquitoes, which bite in the day, and breed in stagnant water in built-up and urban areas. USE INSECT REPELLANT, and check accommodation for mosquitoes before settling in.
Chickungunya:
A viral illness causing fever and severe joint pain. It is transmitted by the same mosquitoes that cause Dengue Fever. The disease is found in central and southern Africa and Madagascar.
African Tick Fever:
Is transmitted by a tick bite. Tourists on safari or trekking are at greatest risk, protective clothing helps.
African Trypanosomiasis:
“sleeping sickness “ is transmitted by the daytime biting tsetse fly.
Water and soil related infections
Schistosomaisis:
Is caused by the larva of blood flukes penetrating the skin while immersed in freshwater. Swimming or watersports increase risk of infection. Travellers should not swim or immerse in freshwater lakes such as Lake Malawi or Lake Victoria or the Omo River in Ethiopia. Leptospirosis is another febrile illness contracted from freshwater exposure.
Walking barefoot should be avoided as this increases the risk of hookworm and other helminthic (parasitic worm) infections. Avoid eating vegetables that may be contaminated with soil in rural areas.
Other risks specific to Africa
Mt Kilimanjaro:
The summit is 5685m (18, 652’), and at this altitude, most climbers will get altitude sickness. Preventative medications and appropriate acclimatization may decrease risk.
Injury from road traffic accidents is common due to poor road conditions, imperfect vehicles, and lack of road rules and policing. . Be aware, ware seatbelts, and don’t travel if you feel unsafe.
Medical support
www.worldhospitalsearch.org lists JCI accredited hospitals.
In Central Africa, The Aga Khan University Hospital is located in Nairobi, Kenya.
Phone +254 20 366 2000. www.hospitals.aku.edu/nairobi
There are many excellent hospitals in South Africa, in Cape Town, Durban and Johannesburg. The Australian Embassy in Pretoria can give advice on location. www.southafrica.embassy.gov.au
SOS International – provide medical support services, their Assistance center is located in Johannesburg South Africa, with clinics located in Nigeria, Ghana, Chad and Angola. See www.internationalsos.com for more information.
Other preventable infections
Malaria
Severe illness from malaria is preventable using malaria prophylaxis medications. What treatment is used, and for how long depends on the patient and the destination. Malarone (atovaquone/ proguanil), Doxycycline and Larium (mefloquine) are some examples. These medications are taken before entering the malaria area, during stay and for a variable time after leaving the malaria area. Some patients in remote areas may require standby treatments for malaria or may need to use malaria detection kits to self diagnose if they cannot access health care if they become ill.
Some other less common illnesses like Leptospirosis can also be prevented with prophylactic medications.
Mosquito and other insect borne Diseases
Diseases such Dengue fever, Yellow fever, Chikuungunya and Malaria are transmitted by mosquito bite. Others are transmitted by tick, sand fly or bug bites. Some diseases are preventable by medication or vaccination but many are not. Travellers to at risk areas should prevent insect bites by using personal insect repellant (those containing 30 % – 50% DEET) and by keeping arms and legs covered with light coloured long pants and long sleeved clothing, and wearing covered footwear. Air conditioning or insect screens on accommodation and bed nets also reduce risk of bites.
Sexually transmitted Illness
Be aware and be safe! Sexually transmitted diseases such as HIV and gonorrhea are more common in some countries compared with Australia. Avoiding contact with sexual health workers, and using condoms reduces risk of infection.
Injury
Injury when travelling is common, mostly related to motor vehicle or motorbike accident, drowning, watersport injury and other sporting injuries. Be safe driving, especially when driving on the opposite side of the road, wear seatbelts, and follow the local road rules. Wear helmets when riding, and don’t ride a motorbike if inexperienced. Don’t swim or engage in sport when affected by drugs or alcohol.
