China Where to start in describing this vast country? The worlds most populous, with 18000 km of coast, huge geographic and climactic variation from the cool far north to the tropical south and mountainous east, megacities, a huge rural population, the worlds longest lasting continuous civilisation and until recently a rampant economy. Culturally there is great diveristy as well, although the Chinese government attempts to keep a tight reign on dissent. Most travellers have a fairly uneventful trip from a health point of view . Commonest destinations include the Forbidden City in Beijing, Teracotta Warriers in Xian, Yangtze river cruises, the Great Wall, ultramodern Shianghai, Guilin's verticle limestone and Tibet via railway to high altitude. The following information provides some broad and general guidelines about health risks and recommendations for these destinations. This should not be taken as a substitute for personal consultation with a doctor with experience in travel health.
Most Common Health Issues Travellers’ Diarrhoea This is the one most travellers to developing countries experience sooner or later, with watery diarrhoea and sometimes vomiting. It is caused by bacteria, such as E.coli, Campylobacter, Salmonella and Shigella. Careful food and drink choices (no tap water), as well as hand hygiene, help in prevention. It is treated with rehydration if mild but if inconvenient, with a ‘bowel stopper’ such as loperamide (Gastrostop or Immodium) and if more severe or persistent, with an antibiotic or giardia treatment. These are best obtained prior to travel as many medications sold over the counter are fake. We stock kits containing all of these medications but as some are prescription items, you will need to make an appointment to see one of our doctors.
Accidents Road accidents are extremely common due to the volume of traffic, lack of road rules and lack of rear seatbelts and helmets for bikes. Leave driving to the locals (obtaining a licence is difficult anyway). Be sensible, make sure your friends look after you if you are drinking, pack a first aid kit, make sure you take travel insurance and keep an eye on travel alerts.
STD's Business travellers to China often put themselves at risk, where offers of massage may lead to something else, especially after drinking. Unprotected encounters carry a high risk of STD's, including HIV, Chlamydia, Gonorrhoea and Syphilis and even using condoms doesn’t always prevent Herpes or genital warts. See a doctor on return if you have put yourself at risk and abstain until you are given the all clear.
Animal Bites Dog bites carry the highest risk for rabies, although any mammal wound that breaks the skin should be considered a risk monkeys included. Immediate and thorough irrigation and cleaning of animal wounds is essential, followed by a course of shots, which may require evacuation to a country that carries safe immunoglobulin if not pre-vaccinated for rabies (see seeking medical help below). A tetanus booster may be necessary if not up to date. Animal wounds are also prone to becoming infected and appropriate antibiotics should be used at the first sign of spreading infection.
Malaria This disease is very rare in travellers to China, except those travelling to rural parts of the far southwest Yunnan province or to Hainan Island in the wet season. The mosquitoes bite from dusk onwards, so mosquito avoidance (DEET repellent, sleeping nets) at this time in these areas is important. Seek advice from a travel health doctor as to whether malaria preventative medication is necessary or advisable.
Japanese Encephalitis This rare but serious mosquito born virus occurs mainly in rural areas around rice paddies in most regions, especially in the wet season June to October. Highest risk is in Guizhou, Shaanxi, Sichuan and Yunnan provinces. Vaccination is often recommended for longer trips or for those visiting an area with particularly high risk for shorter trips.
Bird Flu Sporadic cases occur, nearly always in locals who have direct contact with sick poultry. As a precaution, avoid live bird markets and farms and ensure bird products are well cooked (including eggs). Flu vaccine does not protect against this form of flu.
Pollution This is a significant problem in the large cities, especially Beijing, where air pollution is often well above acceptable standards and may lead to exacerbation of respiratory problems in tourists as well as chronic health issues in the local population.
Altitude Sickness Only a problem if travelling to Tibet. See our fact sheet on altitude sickness.
Security, Safety Issues and Natural Disasters Keep an eye on the Australian Government’s smart traveller website for the latest advice. Watch your valuables. Keep a copy of all travel documentation in a separate place from the originals. China is prone to massive earthquakes, typhoons, floods and landslides.
Travel Insurance Essential. Make sure it provides appropriate cover for your trip and activities.
Seeking Medical Help The medical system in rural areas is basic. Although the main cities have clinics catering for western tourists, communication problems and cultural differences mean complicated or serious medical issues are often best dealt with by evacuation to Hong Kong, Bangkok or back to Australia. Blood or blood products (such as rabies immunoglobulin) may not be safe. Ambulances are often unavailable so taxis are often used if immediate transport to hospital is required. Many over the counter medications are fake or substandard, so carrying your own medical kit for treatment of common ailments is important.
Vaccinations Routine Vaccinations for all travellers All international travellers should be up to date or immune to the following as these are transmissable diseases which may have serious complications:  Measles  Chickenpox  Influenza - especially for the elderly or those with underlying medical conditions In addition a tetanus booster if more than 5- 10 years since last vaccinated is advisable to avoid having to get a booster shot in China in the event of a tetanus prone wound. Recommended Vaccinations for most travellers to China Hepatitis A is a food and water borne virus that infects the liver and causes jaundice. Many people in the developing world have natural immunity, but travellers generally do not. The vaccine is very safe and effective, a single injection providing immediate protection for 6-12 months, after which a booster shot provides long-term immunity. Hepatitis B is a blood borne virus, but may also be sexually transmitted. Accidents, injuries and sometimes even medical treatment in the developing world can expose travellers to this disease. Hepatitis B is highly infectious and can lead to chronic liver disease and liver cancer. All children and young adults born since 1990 in Australia have generally been vaccinated Other vaccinations to consider Rabies is a virus spread from infected animals to humans through bites, scratches and exposure to saliva. If not properly treated and rabies develops, the disease if fatal. Travellers should avoid close contact with either wild, stray or domestic animals; in particular dogs, cats, monkeys and bats. For travel to these countries, vaccination against rabies is often recommended for those at particularly high risk, for example working with animals or touring/biking through rural areas. Typhoid fever is a bacterial infection which is caught through ingesting contaminated food and water. Resistance to common antibiotics is also widespread so treatment has become more difficult. Japanese Encephalitis, spread by the Culex mosquito, is a rare but very dangerous brain infection encountered in South and South East Asia, extending as far north as Japan and Russia. There are now 2 very effective vaccines available. Risk is mainly in rural areas, particularly in the wet season and near rice paddies. Vaccination should be considered for extended travel, or short term travel to an area where there is a current outbreak. Cholera- although this disease is very rare, because the vaccine provides some cross protection against common E Coli diarrhoea, vaccination may be recommended for certain individuals.