Travel Reference
In-Depth Information
women), indigestion, heartburn, nausea and interference with the contraceptive pill. More serious side effects include ul-
ceration of the oesophagus - take your tablet with a meal and a large glass of water, and never lie down within half an
hour of taking it. It must be taken for four weeks after leaving the risk area.
Lariam (mefloquine)
This weekly tablet suits many people. Serious side effects are rare but include depression, anxi-
ety, psychosis and seizures. Anyone with a history of depression, anxiety, other psychological disorders or epilepsy
should not take Lariam. It is considered safe in the second and third trimesters of pregnancy. Tablets must be taken for
four weeks after leaving the risk area.
Malarone
A combination of atovaquone and proguanil. Side effects are uncommon and mild, most commonly nausea
and headache. It is the best tablet for scuba divers and for those on short trips to high-risk areas. It must be taken for one
week after leaving the risk area.
Other Diseases
Avian Flu
'Bird flu' or Influenza A (H5N1) is a subtype of the type A influenza virus. Contact with dead or sick birds is
the principal source of infection and bird-to-human transmission does not easily occur. Symptoms include high fever
and flu-like symptoms with rapid deterioration, leading to respiratory failure and death in many cases. Immediate med-
ical care should be sought if bird flu is suspected. Check
www.who.int/en
or
www.avianinfluenza.com.au
.
Dengue Fever
This mosquito-borne disease is becomingly increasingly problematic, especially in the cities. As there is
no vaccine available it can only be prevented by avoiding mosquito bites at all times. Symptoms include high fever,
severe headache and body ache and sometimes a rash and diarrhoea. Treatment is rest and paracetamol - do not take as-
pirin or ibuprofen as it increases the likelihood of haemorrhaging. Make sure you see a doctor to be diagnosed and mon-
itored.
Hepatitis A
This food- and water-borne virus infects the liver, causing jaundice (yellow skin and eyes), nausea and leth-
argy. There is no specific treatment for hepatitis A, you just need to allow time for the liver to heal. All travellers to In-
dia should be vaccinated against hepatitis A.
Hepatitis B
This sexually transmitted disease is spread by body fluids and can be prevented by vaccination. The long-
term consequences can include liver cancer and cirrhosis.
Hepatitis E
Transmitted through contaminated food and water, hepatitis E has similar symptoms to hepatitis A, but is
far less common. It is a severe problem in pregnant women and can result in the death of both mother and baby. There is
no commercially available vaccine, and prevention is by following safe eating and drinking guidelines.
HIV
Spread via contaminated body fluids. Avoid unsafe sex, unsterile needles (including in medical facilities) and pro-
cedures such as tattoos. The growth rate of HIV in India is one of the highest in the world.
Japanese B Encephalitis
This viral disease is transmitted by mosquitoes and is rare in travellers. Most cases occur in
rural areas and vaccination is recommended for travellers spending more than one month outside of cities. There is no
treatment, and it may result in permanent brain damage or death. Ask your doctor for further details.
Rabies
This fatal disease is spread by the bite or possibly even the lick of an infected animal - most commonly a dog or
monkey. You should seek medical advice immediately after any animal bite and commence postexposure treatment.
Having pre-travel vaccination means the postbite treatment is greatly simplified. If an animal bites you, gently wash the
wound with soap and water, and apply iodine-based antiseptic. If you are not pre-vaccinated you will need to receive ra-
bies immunoglobulin as soon as possible, and this is very difficult to obtain in much of India.
Tuberculosis
While TB is rare in travellers, those who have significant contact with the local population (such as med-
ical and aid workers and long-term travellers) should take precautions. Vaccination is usually only given to children un-
der the age of five, but adults at risk are recommended to have pre- and post-travel TB testing. The main symptoms are
fever, cough, weight loss, night sweats and fatigue.
