Healthy living

Risks to your health when overseas

If you are travelling overseas you should:

  • be prepared
  • understand the health risks you could face in the places you are travelling to, which means finding out about common infections and their symptoms
  • take all reasonable measures to prevent illness and injury.
Gastroenteritis

Gastroenteritis, commonly called ‘gastro’, is an infection of the digestive system. Around 20 to 50 per cent of travellers will suffer from diarrhoeal infections such as:

  • travellers’ diarrhoea
  • dysentery
  • hepatitis A
  • salmonella infections
  • giardiasis
  • typhoid
  • cholera.

These infections are caused by poor personal hygiene (cleanliness) or by eating food and drinking fluids contaminated with bacteria, viruses or worms.

Reduce your risk of getting gastro

The following precautions against gastrointestinal infections are especially important in areas of poor hygiene:

  • Always wash your hands with soap and water after using the toilet and before preparing or eating food.
  • Avoid eating or drinking salads, raw or cold seafood including shellfish, raw or runny eggs, cold meat, unpasteurised milk, dairy products, ice in drinks, ice-cream, and flavoured ice blocks. Fruit that you peel yourself is usually safe. Remember – ‘cook it, boil it, peel it, or leave it’.
  • To ensure water is safe to drink it must be kept at boiling point for at least 1 minute (or for at least 3 minutes at altitudes over 2,000 metres) before drinking. If this is not possible, then iodine tablets or water purifiers should be used – follow the instructions carefully.
  • Drinks that are usually safe from contamination include tea and coffee made with freshly boiled water, commercially canned or bottled water or carbonated drinks, beer and wine. Ensure that seals on bottles are unbroken and avoid ice in your drinks. Drink directly from the can or bottle rather than use a potentially contaminated glass or other drink container.

If you get sick

  • In the event of diarrhoea, fluid replacement is the first priority.
  • Dehydrations from loss of fluids can be dangerous at any age, but particularly so in babies and young children who can dehydrate very quickly. Remember to increase fluid intake during episodes of diarrhoea. Oral rehydration solutions (ORS) replace salt and sugar from the body. It is important to follow the instructions on the packet and mix the solution correctly.
  • Breastfeeding mothers should continue to breastfeed as normal but should supplement breast milk with ORS using a cup and spoon.
  • Do not give anti-diarrhoeal medications to children.
  • See a doctor if diarrhoea and/or vomiting are severe or persistent.
Infections transmitted sexually or by blood

If you have unprotected vaginal, oral or anal sex you face a significant risk of getting sexually transmitted infections such as:

You can get blood-borne virus infections (viruses that can be transmitted via blood) such as hepatitis B, hepatitis C and HIV through:

  • sharing injecting drug equipment (including needles and syringes)
  • unsterile body piercing or tattooing procedures
  • receiving infected blood or blood products
  • the use of unsterile (contaminated) medical equipment
  • sexual practices where blood may be involved.

The early symptoms of HIV infection can include fever, muscle aches, rash and ‘flu-like’ illness. See a doctor immediately if you think you have been placed at risk of HIV.

Precautions

Your own behaviour is the most important factor in reducing your risk of getting an STI or blood-borne virus.

  • Avoid having unprotected sex with a casual acquaintance (including other travellers) or sex workers. The proper use of condoms with water-based lubricant can provide protection against most STIs, including HIV.
  • Where possible, avoid any procedure that involves injections, transfusion of blood or blood products, surgery or skin penetration, including tattooing. Blood products in some countries may not be screened as fully as in Australia and therefore may carry HIV or other infections.
  • Consider getting vaccinated against hepatitis B.

Find out more about safer sex and ways to avoid blood-borne viruses overseas (PDF 266KB).

It is important to see your doctor on your return if you have:

  • had unprotected sex
  • been exposed to blood or blood products
  • undergone any procedure requiring puncturing of the skin with a needle or instrument.
Rabies

Rabies is a disease that can be passed from animals to people. It can be found in most parts of the world, including Africa, the Americas, continental Europe and South East Asia.

In 2012, more than 250 Western Australians travelling overseas were bitten or scratched by animals, mainly in Bali, Indonesia, and they required a course of rabies vaccinations afterwards to help minimise the risk of infection. Around 100 Balinese died from rabies in 2009-2010 after animal bites, mostly from dogs

You are at risk of getting rabies if you are bitten or scratched by an infected animal or come into contact with the animal’s saliva. Any mammal, including dogs, cats, bats and monkeys, are a possible source of rabies infection and any contact should be avoided.

Seek urgent medical attention if you are bitten or scratched by an animal in a region where rabies is known to be present, including Bali, Indonesia. You will usually need to complete a course of several vaccinations. Rabies is fatal once symptoms develop.

Diseases transmitted by mosquitoes

In many overseas countries mosquitoes can infect people with dangerous diseases such as malaria, Japanese encephalitis, dengue fever and yellow fever. These are known as mosquito-borne diseases.

Find out more about how you can avoid getting bitten by mosquitoes.

Malaria

If you are travelling tropical and subtropical areas of Africa, Asia, the Pacific, and Central and South America you are at risk of getting malaria.

Symptoms can develop as early as 6 days after being bitten by an infected mosquito and as late as months after you have left an area where malaria is known to be present.

Symptoms include:

  • fever
  • chills
  • headache
  • muscle ache
  • diarrhoea
  • malaise.

Early stages of malaria may resemble the onset of influenza.

If you become ill with a fever during or after travel in a high-risk malaria area, seek prompt medical attention and inform the doctor of your recent travel history. Malaria can be treated effectively in its early stages, but delaying treatment can have serious consequences, including death.

Preventive anti-malarial tablets can only be effective if taken exactly as directed. You usually need to start the tablets before you leave and you should continue taking them for a period after you return.

See your doctor to discuss the best anti-malarial treatment for your destination and length of travel. There is still a risk of contracting malaria even after taking anti-malarial drugs.

Yellow fever

Yellow fever occurs in parts of west and central Africa and South America. Although it is a rare cause of illness in travellers, you must be vaccinated if travelling to or from countries where the disease is present.

Most countries have regulations and requirements regarding the need for yellow fever vaccination. Your travel agent or doctor will be able to advise you if vaccination is necessary. Yellow fever vaccinations are given by WA Health approved yellow fever vaccination providers (PDF 175KB). A Yellow Fever International Certificate of Vaccination remains valid for 10 years.

Find out more about yellow fever (external site).

Dengue fever

This disease occurs worldwide in tropical and subtropical regions. Many Western Australians acquire dengue fever overseas, mostly in Bali, Indonesia, and other popular destinations in south-east Asia. Most people get infected during and after the rainy season.

Symptoms include severe headaches, high fever, joint and muscle pain, nausea, vomiting and rash. Dengue haemorrhagic fever, a severe form of the disease, is rare among travellers, but can be fatal.

The mosquito that carries dengue is usually found near or inside human dwellings and bites during the day.

There is no vaccine against dengue fever so it is important to avoid being bitten by mosquitoes – use insect repellent and stay in air-conditioned and/or screened accommodation.

Japanese encephalitis

Japanese encephalitis is found mainly in China, India, parts of South-East Asia and the Pacific. It is commonly found in rural, rice growing areas where pigs are present.

In tropical areas occasional cases occur throughout the year. In subtropical and temperate regions, outbreaks tend to occur at the end of the wet season (April to October).

Mild infections may go unnoticed. Symptoms of severe infection include headache, high fever, reduced consciousness, confusion and fits.

Vacccination is recommended if you plan to make frequent trips to, or spend more than 1 month in, high-risk rural areas.

Talk to a travel medicine specialist if you are planning to visit a high-risk area.

Zika virus

Zika virus is transmitted to humans through the bites of infectious female Aedes mosquitoes, most commonly Aedes aegypti.

Zika virus infection causes an illness known as Zika virus disease which shows symptoms such as a mild fever, rash, conjunctivitis, muscle or joint pain, and tiredness.

Since 1947, Zika virus activity was limited to parts of Africa, with occasional small outbreaks in Asia. However, it has recently spread to the Pacific Ocean, Central America, the Caribbean and South America.

Research suggests that Zika virus infection in women during the first trimester of pregnancy may also be linked to abnormal foetal brain development, known as microcephaly, which can result in permanent brain damage to the unborn baby.

Currently there is no vaccine or specific treatment available to cure Zika virus disease. However, drinking plenty of oral fluids and paracetamol for relief of fever and body aches and pains may help to manage the disease.

Protect yourself against mosquitoes

Anti-malarial drugs and yellow fever vaccination are only partially effective and do not protect you against other diseases transmitted by mosquitoes. The best protection is to avoid being bitten by mosquitoes.

Find out more about how you can avoid getting bitten by mosquitoes.

Schistosomiasis (bilharzia)

Schistosomiasis (bilharzia) is a disease caused by parasitic worms found in Africa, parts of Asia, South America and the Caribbean.

You can get this infection from swimming, wading, rafting, washing and/or drinking water from freshwater streams, canals and lakes that contain immature schistosome worms (larvae).

Symptoms may include skin itch or rash at the time of exposure.

Chronic infection of the liver or bladder can cause:

  • diarrhoea
  • abdominal pain
  • enlarged liver and spleen
  • pain on passing urine
  • urinating more often
  • blood in the urine.

To minimise the risk of larvae penetrating (breaking through) your skin after brief or accidental water exposure:

  • towel dry exposed areas briskly
  • apply 70 per cent alcohol or methylated spirits to the skin.

Avoid walking in the shallows or edges of any water.

Wearing shoes in areas of poor hygiene (cleanliness) will offer protection to against hookworm and other parasites that can penetrate (break through) your skin. Shoes also reduce the risk of stepping on discarded injecting drug equipment and getting a needle-stick injury.

What if I get sick after I come back to Australia?

Symptoms of some diseases may take days to months to develop after you have returned home. If you become unwell tell your doctor of any overseas travel undertaken within the previous 12 months.

More information

Remember

  • Discuss your travel plans with your GP well in advance.

Acknowledgements
Public Health

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

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