Vaccine Preventable Diseases Chicken Pox Chicken pox vaccine should be considered for those who have not previously had the disease or been vaccinated. The illness is often underestimated but can have serious complications, especially in adults. Blood testing can be arranged for those who are not sure if they had the disease in childhood. Vaccination in adults consists of a course of two injections, one month apart.
Cholera Cholera is a very severe form of food poisoning causing profuse watery diarrhea. It is often fatal but fortunately also very rare in travellers. Outbreaks are usually associated with natural disasters. E Coli toxin is quite similar to Cholera toxin, and Cholera vaccine is partially effective in protecting against both, thus reducing the risk of travellers’ diarrhea. Vaccination is formulated as a drink, two doses taken one week apart.
Hepatitis A Hepatitis A is a food or 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 and together with influenza is considered the most important travel vaccine. A single injection provides immediate protection for 6-12 months, after which a booster shot provides long-term immunity.
Hepatitis B 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 can lead to chronic liver disease and liver cancer. For this reason vaccination for Hepatitis B is often recommended. The vaccine is given as a course of injections, ideally over 6 months but can be done in a shorter period of time if necessary. Starting a month prior to travel is necessary for adequate protection.
Influenza Influenza is transmitted by coughs and sneezes, and the virus is picked up by breathing it in, or by contacting it directly from infected surfaces. You can reduce the risk by:
Practicing respiratory hygiene - over sneezes and coughs, dispose of used tissues, and wash hands frequently. Use hand gel after touching nose and mouth, in public places or when traveling - use frequently, particularly before meals. Wear gloves if handling infected surfaces, birds, animals or people. Wear a mask if near other persons who are coughing or sneezing, when in crowded places. Masks must remain dry. They do not work well when wet, and should be used for as long as possible in single use, they are not designed for re-using. Your mask should be used when you need to protect yourself in getting to a safer environment.
Influenza (flu) is a common viral disease affecting the respiratory system, causing fever, headache, muscle aches and pains, sore throat, lethargy and cough. It is easily spread from person to person by airborne transmission. Secondary pneumonia may occur, especially in older people or people with chronic medical conditions which may make them more vulnerable. Outbreaks occur in most years during spring and winter (i.e. April until September in the southern hemisphere and October until March in the northern hemisphere). In the tropics influenza can occur throughout the year. Anti-viral drugs can also be useful for prevention or treatment of influenza. For prevention they can be used after a contact with a proven case of influenza, and for treatment they are reasonably effective when taken early in the illness. In Australia these can only be obtained on prescription. You can find out more information by reading our separate fact sheet on Influenza, Coughs, Colds and Chest Infections.
Japanese Encephalitis B This rare but serious mosquito born virus occurs mainly in rural areas around rice paddies in these countries, especially in the wet season (May to October). Vaccination is often recommended for longer trips or those visiting an area with particularly high risk for shorter trips
Measles, Mumps and Rubella Measles and mumps are highly infectious viruses which are spread by close contact, coughing, sneezing and hand mouth contamination. They are more commonly encountered overseas than in Australia, where they used to be common childhood diseases. Australians born since 1966 who have not received two definite doses of MMR should be vaccinated before travel. Measles is by far the most significant illness with potentially severe complications, both in un-vaccinated adults and especially in children less than 12 months who have not been vaccinated. Rubella (German Measles) is best known for the consequences to the newborn if caught during pregnancy.
Meningococcal Disease Meningitis is an infection which affects the lining of the brain. It is a rare but severe infection, passed on through close contact. There are a number of different strains of this disease. Type B is more common in Australia, whereas types ACW&Y are more common overseas. The meningococcal vaccine (type ACWY) is recommended for those who intend travelling to parts of the world where epidemics of meningococcal disease occur, in particular the ‘meningitis belt’ of sub-Saharan Africa, especially in the dry season. The Saudi Arabian authorities require that all pilgrims travelling to Mecca (for the Hajj or Umra) have evidence of recent vaccination with the meningococcal vaccine. Groups of young travellers and health care workers are thought to be at a slightly higher risk. All children aged 12 months or older receive meningococcal C vaccine as part of their childhood immunisations in Australia.
Polio Polio is a viral disease caught through contaminated food and water. It affects the neurological system, causing paralysis. Polio has made a comeback in recent years after nearly being eradicated in 2012. Vaccination rates have fallen in parts of the world where conflict has affected childhood immunisation, causing the virus to rebound. All travellers should be age-appropriately immunised against polio especially if travelling to countries where polio virus transmission still occurs. Injectable poliomyelitis vaccine should be offered to those who have not completed a 3-dose primary course of any polio vaccine, and a single booster dose should be given to adults at least once. There are mandatory requirements in place for Polio immunisation for entry into or exit from certain countries including some in Africa, the Middle East and Southern Asia (polio affected countries). This may change in the future.
Rabies 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. It is present in most countries in the world with varying risk (no risk in Australia, New Zealand or the United Kingdom). Countries that pose greatest risk to Australian travellers include India and Bali. Travellers to rabies affected countries should avoid close contact with either wild, stray or domestic animals; in particular dogs, cats, monkeys and bats. Rabies pre-travel vaccination is often recommended for young children, who are more likely to approach animals and less likely to report bites and scratches. Pre-travel vaccination requires 3 shots over 3 to 4 weeks. It does not give 100% protection, therefore appropriate wound cleaning with prompt booster doses are still necessary after a potential rabies exposure. Those not pre-vaccinated require a more complicated treatment regime to prevent rabies. This is often more difficult or impossible to obtain in less developed countries. Recommendation for pre-travel rabies vaccination is based on an assessment of the likelihood of contact with potentially rabid animals and the availability of adequate and timely healthcare for post exposure treatment.
Tetanus Tetanus is a serious disease found in spores in soil and dirt all over the world. In Australia, boosters are routinely given at age 12 and 50, in addition to the primary schedule in early childhood. If a contaminated wound occurs more than 10 years after a booster shot, another is routinely given. Due to the concerns regarding the safety of needles overseas it is recommended to get tetanus updated prior to travel if it is more than 10 years since the last booster (a 5 year cut-off is applied for high risk or adventure travel). We prefer the triple antigen vaccine which also provides protection against Diptheria and Pertussis (Whooping Cough.
Tick-Borne Encephalitis Tick-borne encephalitis (TBE) is caused by a tick-borne virus and may involve the central nervous system. The disease is prevalent in parts of temperate regions of central and northern Europe and across northern Asia. Travellers are at particular risk when hiking or camping in forested areas in endemic regions during the summer months. Safe and effective vaccines are available overseas. While no TBE vaccine is registered in Australia, a small stock of vaccine may be available for use under the Special Access Scheme (if ordered well ahead of departure by a travel health clinic). Vaccination is recommended only for individuals with a high risk of exposure. While the conventional schedule for completing the primary vaccination course takes 9 to 12 months, accelerated schedules are available.
Tuberculosis Tuberculosis or TB is a disease caused by bacteria (germs) called Mycobacterium tuberculosis that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body such as the brain, the kidneys, or the spine. For more information we have a separate fact sheet for Tuberculosis.
Typhoid Typhoid fever is a bacterial infection which is caught through ingesting contaminated food and water. Mortality is in the order of 1 in 10 in some settings. Resistance to common antibiotics is also widespread so treatment has become more difficult. Typhoid vaccine may be recommended to travellers over 2 years of age travelling to high risk regions, including the Indian subcontinent, most Southeast Asian countries, Latin America, Africa and several South Pacific nations, including Papua New Guinea. This advice is especially relevant for those travelling (back) to endemic regions to visit friends and relatives. Injectable or oral typhoid vaccines are available.
Yellow Fever Yellow fever is a haemorrhagic viral disease which is transmitted by mosquitoes. It can lead to serious illness and even death and occurs in parts, but not all, of South America and Africa. It is the one of the few diseases for which proof of vaccination may be required for entry to many countries around the world. A complicated issue, for more information read our separate fact sheet on Yellow Fever.