Lassa Fever

The virus can be transmitted through direct contact with urine and droppings of an infected rat, through touching objects or eating food contaminated with these materials, or through cuts or sores. These rats often scavenge on human food remains or badly stored food. Contact with the virus also occurs when a person inhales tiny particles in the air contaminated with rodent excretions. It is also possible to contract the disease person-to-person.

Early symptoms include fever above 38.5 degrees C, headache, sore throat, coughing and intestinal discomfort. Lassa fever was identified in a Nigerian village in 1969, when two missionaries died of the disease; it was named after that same village.

Who is at risk of Lassa fever?

Any traveller to areas where Lassa fever is endemic (that is: the infection is present in low levels) is at risk. This includes Western Africa including Nigeria, Sierra Leone, Liberia, and Ghana.

How can I prevent Lassa fever?

Travellers should take care with storing unused food in rat proof containers and ensure that accommodation is free from rodents by maintaining a suitable level of hygiene. Travellers should also contact their GP immediately at the first sign of fever on returning from a trip overseas.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Japanese Encephalitis

In those humans who are infected 95.5% remain asymptomatic. While infection rates are small, of those who develop symptoms the disease is fatal in around 25% usually occurring within the first 10 days. Of those who survive up to 50% are left with brain damage. Symptoms include fever, headache and vomiting. Recovery can take many months in those who survive.

Who is at risk of Japanese Encephalitis?

Any traveller to areas where Japanese Encephalitis is endemic (that is: the infection is present in low levels) is at risk. This includes areas of the Far East and Southeast Asia.

How can I prevent Japanese Encephalitis?

For those at high risk a good vaccine is available and suitability should be discussed with a health professional. For low risk areas and short trips, bite prevention is the best method of prevention. Repellents should be applied from dusk to dawn.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Human Immunodeficiency Virus (HIV)

Infection with the virus can leave a person asymptomatic. Alternatively symptoms can occur within 4-12 weeks of coming into contact with the virus.

The symptoms closely resemble glandular fever and are known as the prodrornal seroconversion illness, as the body begins to develop antibodies. Some people also develop a rash at this time with a temperature. After this period the virus can remain dormant for up to 15 years when the CD4 count begins to drop and lymphadenopathy develops.

HIV infection can resemble many symptoms and eventually, when the immune system is unable to cope, AIDS infection occurs. After diagnosis of AIDS, death often occurs within 20 months (UK figures).

Who is at risk of HIV?

HIV is a global problem. Once predominant in Africa, it is now present worldwide. Those who work with blood products in their occupation are at high risk, as are those who choose to engage in practices that increase the risk of infection. Most new infections occur in developing countries with areas of highest risk being Africa and Southeast Asia.

How can I prevent HIV? 

Currently we have no vaccination for protection against HIV and the best method of prevention is personal protection. Personal prevention is essential, such as using a condom when engaging in sexual activity, avoiding tattoos, dental treatment or other practices which involves puncturing the skin, or using equipment which may have been inadequately sterilised. Backpackers and those working long term overseas should consider carrying with them a medical kit.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Hepatitis B

It is spread from person to person through contact with bodily fluids i.e. semen, saliva, tears, vaginal fluid or urine and blood.

Symptoms of the diseases range from an asymptomatic response, to flu like symptoms and a general feeling of unwell. At this stage many recover from the disease, however some go on to develop abdominal pain, jaundice which can last up to eight weeks. At this stage a person will either produce antibodies to the virus or go into full liver failure, which can result in death.

Who is at risk of Hepatitis B?

Hepatitis B is found worldwide. Areas of high endemicity include Tropical Africa, South America, Southeast Asia, Parts of China and the Pacific Basin, where a carrier rate is estimated to be 8% of the population.

However, those in high-risk groups are of a greater risk wherever they are in the world. High-risk groups in travellers include those who are health workers and haemophiliacs.

Also those exercising high risk behaviour while travelling should equally consider vaccination:

  • those practicing sexual activity outside of a monogamous relationship
  • injecting drug users
  • practising homosexuals
  • those engaging in contact sports
  • those planning to undergo medical or dental treatment abroad – Health Tourism
  • prolonged stay (more than 3 months) in risk areas
  • those adopting children from high risk areas
  • chronic medical conditions
  • those visiting family and friends in high risk areas

How can I prevent Hepatitis B?

Vaccination is available for those at risk and should be discussed with a health care provider. Vaccination is available free for those at high risk, such as health care workers. For routine travel to high-risk areas a cost is usually incurred and prices will vary from place to place. All travellers whose lifestyle puts them at risk should consider vaccination.

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Personal prevention is also essential, such as using a condom when engaging in sexual activity, avoiding tattoos, dental treatment or other practices which involves puncturing the skin. Backpackers and those working long term overseas should consider carrying with them a medical kit.

Hepatitis A

What is Hepatitis A?

This disease is a viral infection, which can be silent. The incubation period is 15-50 days followed by no signs, or pyrexia, headache, nausea, vomiting, abdominal discomfort for 2-7 days. Urine darkens and stools pale as the infected person moves into a jaundice phase. Fever then resolves and they are no longer infectious. Recovery can take several months.

Who is at risk of Hepatitis A?

Hepatitis A is seen worldwide. Areas of high risk are Central and South America, Africa and Southern Asia out to Indonesia. Medium risk areas include Southern and Eastern Europe across the Russian Federation and Greenland. Low risk includes the rest of the world.

How can I prevent Hepatitis A?

Vaccination, or screening for antibodies in those over 40 years of age, is the best and most effective way of preventing Hepatitis A. Even with vaccination, travellers should be aware of good food and water hygiene. Avoiding potentially contaminated food and drink can prevent most cases of Hepatitis A among travellers. The disease is often considered asymptomatic in those under the age of 10 and vaccination is often discouraged. However, it is important to understand that transmission can still occur and therefore vaccination should still be considered where the risk of infection is high.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Ebola

What is Ebola?

It displays itself with flu like symptoms, vomiting and bloody diarrhoea up to 10 days after contact with the virus. After 10-15 days, bleeding occurs through the mouth, nose and eyes. Some victims see blood seeping through the skin, which can result in painful blisters. The virus is usually transmitted via the urine of infected rats in situations of poor hygiene.

Who is at risk of Ebola fever?

Any traveller or person working in a medical situation in areas where Ebola fever has been reported. This includes Western Africa Zaire, Gabon and Uganda. Travellers to these areas should be aware of Government Travel advisories to such areas.

How can I prevent Ebola fever?

Travellers usually do not venture to areas where Ebola is a risk. However any traveller to an area where disease is spread due to poor hygiene, should take care with storing unused food in rat proof containers and ensure that accommodation is free from rodents by maintaining a suitable level of hygiene. Travellers should also contact their GP immediately at the first sign of fever on returning from a trip overseas.

 

Links

Ebola virus disease – World Health Organisation (WHO) fact sheet

CDC resources page – with information about the 2014 Ebola Hemorrhagic Fever outbreak

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Diphtheria

What is Diphtheria?

It is a fatal disease. After contact with the disease the incubation period is about 3 days, after which symptoms occur in the form of fever, tiredness and sore throat. This develops with the production of a thick grey exudates and difficulty in swallowing.

Who is at risk of Diphtheria?

Any traveller to an endemic area; that is: an area where the disease is constantly present with low levels of infection. Areas of high infection include Eastern Europe as well as developing countries.

How can I prevent Diphtheria?

The best method of protection is vaccination. In the UK, diphtheria vaccination is part of the routine immunisation programme and is given in a combined vaccine with tetanus as a primary dose and reinforced for the purpose of travel. Current UK guidelines state that as for tetanus vaccine, a total of five doses of the vaccine are considered to give lifelong immunity. It is also important to recognise that a mild form of diphtheria can still occur in immunised people.

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Preventing Dengue Fever

A recent report by Public Health England reported that over half of the Dengue Fever cases in the UK were from travellers to SouthEast Asia.  Other destinations included East Africa, America and the Caribbean.

Today 2.5 billion people worldwide live in areas that are at risk of infection. Humans contract the disease when bitten by an infected mosquito.

Mosquitoes remain infected all their lives.  They can  pass on infectivity to their eggs. In some parts of the world monkeys are also able to pass on infection to mosquitoes. Areas where you can get the disease are increasing.

After a bite from an infected mosquito, the virus circulates in the blood for 2-7 days, causing a feverish illness with headache and muscle pains similar to flu. Sometimes people get a rash.

Who is at risk of Dengue Fever?

Any traveller to Dengue Fever risk area; that is, an area where the disease is constantly present with low levels of infection. The UK data suggested that most cases reported in the UK have travelled to Southeast Asia, Southern Asia, East Africa, Caribbean and South and Central America.

How can I prevent Dengue Fever?

In many countries efforts are made to combat the vector through control of breeding sites. For the traveller, mosquito bite prevention is the only method of preventing Dengue Fever.  Also areas where Dengue Fever exists are also areas where Zika Virus Disease could also exist.

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Cholera

It is present in parts of the world where sanitation and hygiene are poor. The incubation of cholera ranges from a few hours to five days and first presents with very bad, watery diarrhoea sometimes loosing up to a litre an hour! It is at this stage that rehydration is very important.

Who is at risk of Cholera?

Any traveller to areas where Cholera is endemic (that is: the infection is present in low levels) is at risk. This includes parts of South America, Africa and parts of the Middle East and India, and in Asia.

How can I prevent Cholera?

The best way to prevent any diseases causing diarrhoea is to be very careful with food and water while in an endemic area. Food products that could potentially put a traveller at risk and that should be avoided include raw fish and seafood products, and any food that has been washed in potentially unclean water. Proper cooking of food and adequate boiling of water will protect the traveller from contamination through food and water. Strict personal hygiene is also essential.

Vaccination is not usually advised for travellers. If you are going to an area where Cholera is present, however, it might be wise to carry a letter from a GP stating that the vaccine is not indicated. Some travellers also would be advised to carry with them a sterile needle pack in the event that a border guard insists on vaccination!

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Chikungunya

When the infected mosquito first bites a person the incubation period is usually 3-7 days after which a fever develops. Fever can last from a few weeks to months. It can likewise be accompanied by aching, painful joints, nausea, vomiting and a rash. The Swahili word for Chikungunya means “bent up” a position often taken by those with the disease due to the intense pain. Tiredness and fatigue can also last for months.

No deaths have been reported due to Chikungunya and following the disease a person is believed to develop life long immunity.

Who is a risk of Chikungunya?

Travellers and those living in areas of Africa and Asia where the disease is endemic are at risk. Areas of infection are very similar to those of Yellow Fever. The same mosquito (Aedes aegypti) is responsible for the spread.

September 2006 saw epidemics in the islands of the Indian Ocean, particularly Reunion. More than 115 travellers returning from this area were reported to be infected (ProMed). Cases are also increasing in India.

How can I prevent Chikungunya?

At present, a vaccine does not exist and the main way to prevent Chikungunya is prevent bites in the first place.

Travellers should be aware of the risk and take necessary action to prevent bites.

No prevention medication exists for Chikungunya and those diagnosed are advised to rest, drink plenty of fluids, and take regular painkillers.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.