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Yellow Fever – changes in regulations and the Olympics

Yellow Fever – changes in regulations and the Olympics

03 June 2016

The Olympic Games is just around the corner and Yellow Fever has been hitting the news recently.

Outbreaks in Angola and neighbouring African countries have sparked vigilance with international airports checking travellers have had the mandatory vaccination.
Brazil will welcome thousands of African Games competitors and spectators raising very real concerns for the spread of the virus. Just this week, the WHO confirmed an outbreak in Peru involving 25 cases – more than the nation’s combined total for 2014 and 2015.

Changes in the regulations in Australia will become effective from June 16th for all travellers over 9months of age visiting any Yellow Fever endemic country. This will mean that;

• Current Yellow Fever certificates, more than 10 years old are still valid.
• You will no longer need to get a booster every decade. (There may be some yet-to be-announced exemptions which your Travel Doctor will be able to inform you of).
• Anyone who gets the YF vaccine for the first time will never need a booster but will still need to prove they have had the vaccine by producing their International certificate stamped and signed by a licensed vaccination centre.

Alternatively, a certificate of waiver may be accepted.

Of course Yellow Fever is not the only mosquito borne disease to be aware of;

Zika Virus is also prevalent in Brazil and pregnant women are advised to avoid travel to Zika infected countries. Please discuss these risks carefully with the Travel Doctor before travel.
Malaria, Chikungunya and Dengue Fever occur in Brazil so proper precautions need to be taken and will be discussed at your consultation.

Preventing mosquito bites may be the most important thing you can do to protect your health while you’re away, your Travel doctor will be able to best advise you of appropriate precautions.

Traveller’s Diarrhoea

Diarrhoea is an unfortunate reality and most common complaint of travelling to developing countries.
Diarrhoea is generally defined as three or more loose bowel motions within a 24-hour period, with at least one other symptom such as fever, nausea, vomiting, abdominal pain or cramping, or blood or pus in the stool.
There are numerous opportunities in developing countries for food to become contaminated. These include fertilisation of crops with human faecal material, inadequate storage and transport of food, unreliable refrigeration and unhygienic food handling practices. Although the eating of food bought from street vendors can enhance cross-cultural experiences, inadequate sanitation and refrigeration carries a risk of travellers’ diarrhoea.
Contaminated water is a less likely cause of travellers’ diarrhoea than contaminated food because there are generally lower concentrations of organisms in liquid than solid foods. Commercially bottled water is generally safe. Carbonated beverages are generally too acidic to sustain enteric pathogens and may therefore be safe to drink. The fermentation process involved in the brewing of beer usually ensures safety from bacterial contaminants, although promoting beer as the preferred beverage may pose other concerns. Travellers may also be exposed through washed food and utensils, ice, cleaning teeth and swimming in fresh water, and unpasteurised dairy foods

Contaminated water is a less likely cause of travellers’ diarrhoea than contaminated food because there are generally lower concentrations of organisms in liquid than solid foods. Commercially bottled water is generally safe. Carbonated beverages are generally too acidic to sustain enteric pathogens and may therefore be safe to drink. The fermentation process involved in the brewing of beer usually ensures safety from bacterial contaminants, although promoting beer as the preferred beverage may pose other concerns. Travellers may also be exposed through washed food and utensils, ice, cleaning teeth and swimming in fresh water, and unpasteurised dairy foods

Prevention

Education

Applying the general rule of ‘boil it, cook it, peel it or forget it’ seems reasonable when choosing foods and drinks, but is often not practical. Few travellers are able to comply with strict dietary recommendations and some evidence has suggested no association between dietary mistakes and the incidence of travellers’ diarrhoea.
Conscientious hand washing while travelling is important. Although soap and water are not always available, waterless hand disinfecting agents (e.g. alcohol hand wipes and premoistened towelettes) are convenient alternatives.

Water purification

Water may be purified by heat, filtration or chemical disinfection. Boiling is the most effective way of producing water that is safe to drink. Bringing water to the boil will kill the common organisms that cause travellers’ diarrhoea. If no other choices are available, tap water that is too hot to touch (>56°C) is also relatively safe to drink once it has cooled.

Filters that exclude particles greater than 0.2 x 10-6 m in diameter are effective against most bacteria and parasites but do not protect against viral pathogens. Therefore, water filtration using units without iodinated columns should, if possible, be followed by chemical disinfection using chlorine-based or, preferably, iodine-based water purification tablets. Adding orange juice crystals or vitamin C to iodine-treated water may improve its often unpalatable taste.

Vaccination

Vaccination against gastro-intestinal diseases such as hepatitis A, typhoid and cholera should be considered where appropriate. Hepatitis A is the most common vaccine-preventable cause of travel-related disease, with typhoid less likely and cholera even less so for the average short term traveller. There is also evidence that Cholera vaccination is partly effective for traveller’s diarrhoea.

Discuss in detail at your travel consultation.

Published by Travel Clinics Australia.
http://www.travelclinic.com.au/

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