Cholera is a bacterial disease transmitted through contaminated water and food. Outbreaks tend to occur in crowded areas like slums and refugee camps where there may be poor hygiene and sanitation facilities. The risk to most travellers is small if adequate food and water hygiene precautions are followed. There is a vaccine against cholera for those going to live or work in outbreak areas.
Diphtheria is a bacterial disease that is rarely seen now in developed countries but cases are still occurring in other parts of the world. Travellers are at risk when mixing closely with the local population in most developing countries. Diphtheria is included in the combination and this vaccine is recommended every 10 years for travel to many destinations.
Hepatitis A is a virus that affects the liver and is usually spread through contaminated food and water or close physical contact with an infected person. It is common in developing countries where sanitary conditions are poor and the safety of drinking water is not adequately controlled. Hepatitis A is prevented by eating ‘safe’ food, drinking ‘safe’ water and pre-travel vaccination.
Hepatitis B is a viral disease which affects the liver and is generally spread through blood and body fluids e.g. unprotected sex, close family contact, blood transfusion, dirty needles, reusing razors, piercings and tattoos etc. The vaccine against Hepatitis B is very effective but does require several doses to become effective so this course should be planned well in advance of travel.
This virus is transmitted via bites from infected Culex mosquitoes. These tend to be found in rural farming areas of Asia and are most active at night. Preventing mosquito bites is vital. Risk to travellers is generally very low but vaccination should be considered by those intending to spend a significant length of time in rural areas. This vaccine requires 2 doses so should be started well in advance of travel.
Malaria is a common and potentially life-threatening parasite infection found the tropics. It is transmitted by mosquitoes which tends to be most active at night. If travelling into a malarial area it is vital to avoid being bitten by mosquitoes and take appropriate malaria tablets. Any flu-like symptoms must be checked out, malaria is diagnosed through a blood test. If left untreated malaria can be rapidly fatal.
Meningococcal Meningitis can affect the brain, and transmission of the bacteria occurs via direct person-to-person contact and through inhaling infected droplets. Parts of Sub-Saharan Africa have seasonal Meningitis outbreaks, and ACWY vaccination is recommended for travellers mixing very closely with the local population during these times. The ACWY vaccine is also mandatory for pilgrims travelling to Saudi Arabia for Hajj or Umrah.
Measles, Mumps and Rubella are viral illnesses spread by the respiratory route, via coughing, sneezing etc. They are present globally in all countries of the world and are therefore could be a risk to all travellers, especially if visiting for extended periods or if living/working closely with the local population. It is vital to ensure 2 doses of MMR vaccine were received in childhood, otherwise the vaccine is recommended.
Polio is a disease of the central nervous system, usually spread through contaminated food and water. Many countries have eradicated Polio through vaccination, although it still exists in some African and Asian countries, and so cases continue to occur worldwide. Boosters are recommended at 10-year intervals if travelling to an endemic country.
Rabies virus is carried in the saliva of infected mammals (which may appear normal) and is usually spread by a bite, but licks on open wounds and scratches have been enough to transmit the virus to humans. If left untreated, Rabies is fatal, so it is vital to seek prompt medical attention and vaccinations. If treatment may be difficult to obtain then it is worth having a course of vaccinations in advance of travel. These take 3-4 weeks to complete.
The bacteria that causes Tetanus is present in soil worldwide and disease occurs when the bacteria gets into a wound or even small cut. The disease leads to uncontrollable muscle spasms and possibly death. Travellers should ensure they have had a Tetanus vaccine within the last 10 years before they travel.
Spread by the bite of an infected tick and, rarely, via unpasteurised milk. Travellers at risk include those planning to walk, camp or work in long grassy or wooded areas for extended periods especially during spring to autumn when the ticks are most active. It is important to avoid tick bites, and remove ticks promptly if found in the skin. A vaccine course is available and should ideally be started at least a month before travel.
Typhoid is spread through faecally contaminated food and water. The disease is common in areas with poor standards in food hygiene and preparation, and where suitable treatment of sewage is lacking. It is possible to contract Typhoid from shellfish, raw fruit or vegetables fertilised by ‘night soil’ (human waste). This disease can be prevented by healthy eating and drinking and pre-travel vaccination that will last up to 3 years.
This disease is spread by infected mosquitoes normally from sunrise to sunset and is endemic in parts of Sub-Saharan Africa and South America. During outbreaks it has up to a 50% mortality rate and therefore the World Health Organisation (W.H.O.) recommends vaccination against Yellow Fever if travelling to affected regions. In addition, some countries require a certificate proving vaccination before allowing entry. A single vaccination and certificate now lasts for a lifetime for most people and is available only at registered Yellow Fever Vaccination Centres. Insect bite avoidance is essential. This includes covering up with long, loose clothing, frequently reapplying repellents on exposed skin and sleeping under an insecticide treated mosquito net.
Zika is a viral infection transmitted by daytime biting mosquitoes. These mosquitoes bite an infected monkey or person and then spread the infection to others when they bite again. Zika can also be transmitted sexually and is now known to cause complications in pregnancy, therefore travel to affected regions should be avoided in pregnancy. Mosquito bite avoidance is vital for travellers.
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