Vietnam, Cambodia, Laos These are poor countries, each with its own fascinating history, geography and culture. Common itineraries in Vietnam include Hanoi, Ha Long Bay on a junk boat, the ethnic minorities in the mountainous north around Sapa, the coastal towns of Hue, Hoi An, Da Neng and Nha Trang, Ho Chi Minh, the Mekong Delta floating markets and Cu Chi tunnels. The prime attraction in Cambodia is the ancient overgrown Angkor Temple Complex near Siam Reab. Visitors to Laos head to the old Royal capital of Luang Prabang in the north, the spectaular limestone mountains of Vang Vieng , the Mekong for a cruise, and 4000 Islands near Pakse in the south. We often see school groups travelling to these countries combining aid work with a remote trek or cultural experience. The following information provides some broad and general guidelines about health risks and recommendations for this destination.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, 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.
Dengue This mosquito born virus causes a nasty illness with high fever, body aches, headaches and sometimes a rash. Occasionally serious complications occur. Peak transmission is in the rainy season. It occurs mainly in urban areas. The mosquitoes are daytime biters. Mosquito avoidance is the only prevention. There is no specific treatment but full recovery usually occurs.
Accidents Most accidents overseas occur as a result of people doing things they wouldn't normally do, in an environment they may not be entirely familiar with. Examples include motorbike accidents (wear a helmet) and injuries related to recreational activities or intoxication. Be sensible, make sure your friends look after you if you are drinking, pack a first aid kit, make sure you take out travel insurance and keep an eye on travel alerts. Landmines are still a problem in Cambodia.
STD's Many travellers - young and old, male and female - put themselves at risk, particularly with sex workers in the well-known bar districts of major centres. Pack condoms and use them. 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 Risk for most travellers is low, as the cities and most popular tourist destinations are malaria free. There is no transmission around Angkor Wat. Those travelling deep into some rural forested areas may be at risk where malaria are more common especially 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 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.
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.
Security Safety Issues 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
Travel Insurance Essential. Make sure it provides appropriate cover for your trip and activities.
Seeking Medical Help The medical system in these countries is basic. Although the main cities have clinics catering for western tourists, complicated or serious medical issues are often best dealt with by evacuation to Singapore, Bangkok or back to Australia. Blood or blood products such as rabies immunoglobulin) may not be safe.
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 these countries in the event of a tetanus prone wound.
Recommended Vaccinations for most travellers to Vietnam, Cambodia and Laos 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.