Topics on this page
Malaria Prevention and Symptoms:
Common Destinations - immunisation
requirements:
Symptoms and Treatment of common travel illnesses:
Travellers Thrombosis
(blood clots)
Meningococcal disease in African
meningitis belt.
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for a free appointment with our nurse to discuss your immunisation needs
Hepatitis A: (Havrix, Vaaqta) Recommended for travel to all developing countries.
Hepatitis B: If sexual contact or contact with blood is expected in countries with high prevalence of hepatitis B carriage.
Poliomyelitis: Booster required if more than 10 years since last booster.
Tetanus-Diphtheria: Booster required at age 45 and 65.
Typhoid: Required if travel of more than one month in conditions of poor hygiene in endemic countries.
Yellow Fever: Yellow fever is a viral disease found in parts of Africa and South America. It is transmitted to humans by a mosquito bite. Even though there is no risk of becoming infected while traveling in countries outside of tropical South America or sub-Saharan Africa (i.e., Central, East, Southern, and West), certain countries REQUIRE a yellow fever vaccination. Some countries require a Yellow Fever Vaccination for all travelers, while others require only a vaccination if a traveler is coming FROM either areas infected with yellow fever or areas where yellow fever transmission has occurred (called “endemic” areas). The endemic areas are found in tropical South America and Africa.
Malaria Prevention and Symptoms
Take precautions against biting insects.
Wear long loose clothing
Apply insect repellents to exposed skin
Stay in screened or air-conditioned accommodation
Use Bed nets, especially those impregnated with insecticide permethrin.
Medication (Prophylaxis)
Chloroquine: 300 mg once weekly, starting 2 weeks before entering malaria zone. followed by 300mg weekly and for 4 weeks after leaving
Mefloquine: 250 mg taken weekly for 3 weeks prior to entering malaria zone , followed by one tab weekly, continuing for 4 weeks after leaving.
Doxycycline: 100 mg daily, 2 days prior to entering malaria zone and continuing for 4 weeks after leaving.
Symptoms of Malaria:
Fever with or without other symptoms (sweating, chills) 8 days or more after entering malarious area.
Over time it can cause anaemia (fatigue) and an enlarged spleen
For detailed medical info on Malaria
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for a free appointment with our nurse to discuss your immunisation needs
Synermox: 500 mg tabs, take one three times a day , with food. for 5-7 days.
A broad spectrum penicillin. Useful in treating ear, sinus, chest, skin and kidney infections.
Flucloxacillin 500 mg capsules, take one four times a day, one hour before food or 2 hours after food.
A penicillin based antibiotic - excellent for skin infections.
Trimethoprim: 300 mg tabs, take one tablet daily for 3 days.
Useful in uncomplicated bladder infections.
Noroxin 400 mg tabs: take one tablet twice daily for 3 days.
A quinalone antibiotic - to be used if trimethoprim is not successful in treating a bladder infection or for severe diarrhoea associated with fevers, bloody stools or profuse watery diarrhoea lasting more than 48 hrs. Not suitable for children or during pregnancy. .
Doxycycline 100 mg tabs: Take one tab twice a day for 3 days then one tab daily for 4 days.
Useful for chest and sinus infections. This tablet can cause photosensitivity. ie, a rash on sun exposed parts of the skin. Should this occur and the rash is not tolerable, stop treatment. Not suitable for children up to 14 yrs old and during pregnancy.
Diclax - Diclofenac Sodium 75 mg tabs. take one BD for with food as required.
An non-steroidal anti-inflammatory drug - good for muscular or bone pains. Should be avoided if you have had gut ulcers . This can also trigger asthma attacks.
Codeine - 30 mg tabs. Take one to two tablets every 3-4 hours if required for cough, pain or diarrhoea.
Merbentyl 10 mg tabs: Take one three times a day for abdominal cramps.
Loperamide: one capsule three times if required for diarrhoea.
Buccastem 3 mg tabs.
Allow one tablet to dissolve between the top lip and the gum as required up to three times a day.
To treat nausea and vomiting.
Diamox 250 mg tabs:
For use in acute altitude sickness. One tablet every 12 hours at the onset of symptoms.
For detailed medical info on altitude sickness
Pacific Islands: Hepatitis A, Typhoid, Tetanus/Diphtheria, Yellow Fever certificate may be required if recently visited countries with Yellow Fever, eg some countries in South Africa or South America.
Australia: Tetanus/Diphtheria,, Yellow Fever certificate may be required if recently visited countries with Yellow Fever, eg some countries in South Africa or South America.
India: Malaria, Hepatitis A, Typhoid, Tetanus/Diphtheria, Polio, Japanese encephalitis, Yellow Fever certificate may be required if recently visited countries with Yellow Fever, eg some countries in South Africa or South America. Care re dog bites - rabies.
Nepal: Malaria, Hepatitis A, Typhoid, Tetanus/Diphtheria, Polio, Japanese encephalitis, Yellow Fever certificate may be required if recently visited countries with Yellow Fever, eg some countries in South Africa or South America. Care re dog bites - rabies.
Thailand: Malaria, Hepatitis A&B, Typhoid, Tetanus/Diphtheria, Polio, Japanese encephalitis, Yellow Fever certificate may be required if recently visited countries with Yellow Fever, eg some countries in South Africa or South America. Care re dog bites - rabies.
Hong Kong: Hepatitis A, Typhoid, Tetanus/Diphtheria, Japanese encephalitis.
USA & Canada: Tetanus/Diphtheria
Europe (Western): Tetanus/Diphtheria
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for a free appointment with our nurse to discuss your immunisation needs
Travelers Diarrhoea: A simple change in your diet and climate can cause diarrhoea. If this is not associated with other symptoms then it is not an indication of a major problem. Replacement of lost fluid is the most important treatment initially. Weak black tea with a little sugar, flat diluted fruit juice or fizzy drinks (1 part juice/fizzy 2 parts water) are all good starters. Should there be significant fluid loss either because of severe diarrhoea or because of the addition of vomiting - then gastrolyte or a medicated electrolyte replacement fluid should be taken. These are very salty and can be hard to get down. They have less taste if they are chilled. In an emergency you can make an electrolyte solution with 6 teaspoons of sugar, half a teaspoon of salt and one litre of clean water. How much do you need to drink ..well enough to keep your urine clear. If it is yellow and smelly you have not replaced the lost fluids ..so drink on.
When should I use antibiotics to treat diarrhoea? .
You should use antibiotics if the diarrhoea is associated with fevers, profuse watery diarrhoea not settling over 48 hours and if you have blood mixed in with the diarrhoea. You are best to seek local medical help as you may need analysis of a stool sample to sort out which "bug" is the cause. Local knowledge will usually get you sorted.
If you are unable to get to a local doctor Norfloxacin 400 mg twice daily for three days is usually effective. This is not suitable for children and should not be taken during pregnancy. Children should use co-trimoxazole. Amoxycillin or synermox can be given during pregnancy.
If your symptoms suggest you should use antibiotics you should avoid using gut-slowing drugs. These slow the clearing of the bug from your bowel. Examples of gut-slowing drugs are diastop, loperamide, codeine.
Giardiasis and Amoebic Dysentery should be treated with tinidazole, 2 x 500mg tabs for two doses or metronidazole, 250 mg three times a day for 10 days.
Giardia is a common parasite which symptoms include, gut cramps, nausea, a bloated stomach, watery foul smelling diarrhoea and frequent gas. Symptoms appear to be settling only to return a few days later.
Amoebic Dysentery is caused by the protozoan Entamoeba histolytica. This produces low grade diarrhoea, often with blood and mucus. Cramping abdominal pains and vomiting are less likely and fever may not be present. It will however persist until it is treated.
Intestinal Worms: These are common in rural tropical area's. Tapeworms are ingested on food such as undercooked meat where as Hookworms enter through your skin. Infestations may take some time to show up, and although they are generally not serious, but if left untreated can cause serious health problems later. A stool test provides a simple and speedy diagnosis.
Fungal and other skin infections:
Fungal: These are common when travelling in hot humid conditions. Typically a red scaly itchy area of skin - usually under the breasts, arm pits , groin or in the crease of your buttocks. These respond well to topical antifungal creams such as Canesten, Lamisil etc. Bactroban, Fucidin and steroid creams (hydrocortisone, Locoid, Elocon etc) do not help and in fact steroid creams will often make the rash worse.
Bacterial: These usually occur after mild trauma to the skin - scratches, blisters, insect bites. In tropical conditions they can be slow to heal and often require the use of oral antibiotics. If you have just one or two small lesions - Bactroban or Fucidin creams maybe all that is required. If there are multiple lesions or very large lesions then Flucloxacillin is the drug of choice and erythromycin if you are allergic to penicillin. Doxycycline and Synermox can also be used.
STD's Prevention is best ! It is best to be checked and given proper medical advice concerning treatment. You should seek a local doctor if you have any concerns. Treatment is often required for your partner.
Condoms do not always protect you from contracting an STD but are encouraged as they do decrease your risk.
Chlamydia - Doxycycline is used for 10 days for chlamydia and if you are pregnant Erythromycin for 10 days is the drug of choice. Symptoms - men, none to painful discharge from the penis. Women , none to severe pelvic pains, with or without vaginal discharge.
Genital Herpes- Zovirax (acyclovir) orally is required for genital herpes. (Painful blisters on the genitals
Hepatitis B - make sure you are immunised. If you are unsure this can be checked by a blood test.
Hepatitis C - no immunisation is available. Treatments are available through specialist clinics.
Gonorrhea - medical help should be sought so that tests can be done to confirm this condition. The right anti-biotic can vary depending on local "stains".
The symptoms in men can occur 2-14 days after exposure and include a discomfort in the urethra (pee tube) leading to pain on passing urine and eventually yellow green discharge from the urethra.
In women symptoms occur 7-21 days after exposure and cause pain on urination, going to the toilet to pass urine frequently and vaginal discharge.
Genital Warts - topical treatment - paints or liquid nitrogen. If the lesions are large surgical procedures are often used.
HIV - Do not share needles. Avoid sexual contact with strangers. Use "safer sex" principles . If you have any concerns you should seek medical help or seek help from a STD clinic or from a Family Planning Clinic if in New Zealand.
Bladder Infections (Cystitis). These are more common in woman than men. The "bug" usually comes from the bowel ( E.Coli) causing pain or irritation while passing urine and urinary frequency.
Trimethoprim 300 mg a day for 3 days is usually effective. Norfloxacin 400mg 2 daily for 3 days is usually effective if this fails.
Kidney Infection (Pyelonephritis) An infection of the kidney is a serious and early treatment should be sort. Symptoms include a general unwellness, nausea, back or loin pains, sometimes abdominal pains. There is frequently no bladder symptoms. Your should seek medical help. If help is not available Synermox 500mg three times a day for 5 days is usually effective.
Ear infections Ear ache can be excruciating. The most important first step is pain relief. Codeine 30 mg tabs, x 2 every 3-4 hours is usually effective. Paracetamol 500 mg x 2 every 4-6 hours, maximum of 8 tablets a day can be used with codeine if the pain is not settling. Amoxycillin or Synermox antibiotics are helpful but take 24 hours to take effect.
Chest Infections If you care coughing up green or yellow sputum you have a chest infection. This is often preceded by a sore throat and or a runny nose a few days prior. It often hurts in the chest to cough or on taking a deep breath. These infections are often viral, which means antibiotics are not helpful. If you are not improving over 48 hrs, or you are getting worse during that time you should seek medical help. If help is not available either erythromycin or Synermox would the antibiotics of choice.
