The Travel Doctor
Traveller's medical & vaccination centre

I am travelling to Brazil via New Zealand in late March, staying four days in Rio De Janeiro, then boarding a cruise ship that will sail the coast of Brazil with day stops at two or three ports then onto European ports. Is it compulsory under these circumstances to have immunisation for Yellow Fever? Also I have been informed that Hep A and Typhoid are recommended. Are these necessary for such a short time in the country? I am worried that the officials in Brazil may not let me stay or on the other hand may not let me leave!

The yellow fever vaccine is required for 2 different reasons, which can be a little confusing... More..

I am a fit and healthy 32 y.o. and currently trying to get pregnant. Vietnam is our ideal destination and we would love to go this Aug. If I was to get pregnant between now and then I would be 1-6 months pregnant. Would Vietnam be a safe destination to travel, specifically we were hoping to do a trip along the Mekong, go to Hanoi and Halong Bay and end up in Hoi An. All up we would travel for about 14 days. We did have all our vaccinations last November for this trip but unfortunately had to cancel. Your advice would be very much appreciated.

Pregnancy and travel are not incompatible, but sensible planning is essential.... More..

I am required to self-inject with Eprex three times per week. They require refrigeration but not freezing. Some time ago I enquired of a couple of airlines as to whether they would store my injections in their refrigerator. I was advised that I would have to carry them as hand luggage packed in dry ice; as this didn't seem practical, I gave the idea of travel by air away. Can you give me any advice, please.

While travelling with injecting medications is tricky, it is not impossible... More..

Hi, we are going on holiday to Phalaborwa and the children need to take something for malaria. What can they use and with that can they still get sick?

Malaria is still present in the northern area or South Africa, around Kruger National Park... More..

My Husband and I are going to Thailand in February. We are taking a day tour up to the River Kwai and Tiger Sanctuary Do we need malaria tablets?

In short, no you don't, as the risk of malaria transmission in that area now is so low that antimalarial medications are more trouble than protection for that particular situation... More..

Hi, we are going on holiday to Phalaborwa and the children need to take something for malaria. What can they use and with that can they still get sick?

Malaria is still present in the northern area or South Africa, around Kruger National Park... More..

My daughter is traveling to Zambia in November on a school trip and then onto Victoria Falls in Botswana. I have been getting conflicting information in regards to yellow fever.

Victoria Falls is on the border of Zambia and Zimbabwe, neither of which countries fall into the "Yellow Fever Endemic zone" as... More..

I am visiting South Africa (Jo'burg, Cape Town,) then flying into Nairobi, Kenya and going onto Arusha in Tanzania (visiting Serengetti National Park, Lake Manyara and Ngorongoro Crater). My local GP says I don't need Yellow Fever or Cholera - is this correct? He said I only required Vivaxim Syrum Vaccination and Malaria tablets to be taken whilst there.

The GP is unfortunately not correct. Many GPs are not up-to-date with travel medicine information... More..

Can you advise if I would have any problems taking my CPAP machine for my sleep apnea on an aircraft ex Australia and into Europe?

CPAP machines are generally accepted on board aircraft, and many travellers prefer to hand carry them to prevent possible damage in checked luggage... More..

Hi, I have just returned from Bali and been diagnosed with Dengue Fever. I have been advised by my doctor that I should reconsider my travel plans. I love Bali and hate to think that my last trip was literally my last. What is the REAL risk of me returning?

Dengue fever is a viral illness caused by the 4 strains of the dengue virus, all transmitted by mosquito bites in tropical areas around the world... More..

Group Travel to Kiribas - My 16 yr old daughter is travelling to Kiribati for 2 weeks in Sept with Venturer Scouts. What health precautions and immunisations will she need to take?

It is great that Venture Scouts do some interesting and exciting travel, but there are some health risks, even in the Pacific... More..

Hi, we would like to do an escorted group tour to China early next year, but she has a severe reaction to MSG in food, with both vomiting and diarrhoea. Is there any kind of medication for this problem, or do we just have to give up on the idea of going there?

While MSG is used commonly in China, that is true for most Asian countries, (and quite widely in restaurants in Australia and in many foods as flavour-enhancer number 621)... More..

I am travelling to the UK in Mid July via Beijing where I will do some sightseeing. I take a lot of Medications due to medical problems. One of these is OXYCONTIN. Is it okay for me to take into China? I will have a large supply with me as the stopover is at the beginning of a 9 week trip.

Travelling with medications is a common issue, and in general most over-the counter medications are without problem, with the exception of some cold/flu medications, and some weight-loss products... More..

Hi, I am going to spend one year in Tanzania leaving end of June 2010 - going to Moshi near Mt Kilimanjaro, doing medical research. Do I need to have rabies vaccine? I know I need Yellow Fever vaccine. Do I need any other vaccine: Cholera? Typhoid booster (I had Vivaxim in late 2006)? Anything else?

For anybody planning one year in rural Africa doing medical work, means there are a very wide range of important health issues to consider before your travel... More..

My wife and I are to move to Asia to work. My wife is about to begin IVF treatment and we are wondering whether she can have the required vaccinations or whether we need to postpone IVF.

There are a number of vaccinations that are generally recommended for living in Asia... More..

Hi, I am planning a trip to Brazil in mid-July and will be in my second trimester (of pregnancy) and plan to stay in Brazil for between 4 - 6 weeks travelling up North (Rio, Bahia, Sao Paolo and then Londrina including the Igaucu falls. I am 38 years-old and this is will be my first child. I am concerned about the risks of pandemic influenza, malaria and dengue fever. I will also need a few vaccinations before I go and am worried about any potential affect these may have on my unborn child. My final concern is that I may be very uncomfortable if I stay as long as I plan to stay because of how big I may be! Can you help with some independent and sound information please?

You have raised several important issues for pregnant travelers... More..

Hi , I am planning to take 16 students to West Timor in November. Are there any vaccines required or suggested?

Yes, West Timor is part of Indonesia that is less developed than the common tourist areas... More..

Hi, I am planning a trip to Brazil in mid-July and will be in my second trimester (of pregnancy) and plan to stay in Brazil for between 4 - 6 weeks travelling up North (Rio, Bahia, Sao Paolo and then Londrina including the Igaucu falls. I am 38 years-old and this is will be my first child. I am concerned about the risks of pandemic influenza, malaria and dengue fever. I will also need a few vaccinations before I go and am worried about any potential affect these may have on my unborn child. My final concern is that I may be very uncomfortable if I stay as long as I plan to stay because of how big I may be! Can you help with some independent and sound information please?

You have raised several important issues for pregnant travelers... More..

Hi, I am travelling to India in June for a month or so with my son who will be 11 months old during that time. I would like to know what immunizations he needs to take before travel and how many weeks before he can take them.

For any children, the first immunisation issue is that they are up-to-date with their routine vaccine schedule... More..

We are travelling to South America in July and are wondering about the need for taking something for Cholera before we go. One doctor has prescribed Dukoral suspension and the other did not. Also is the drug Diamox available here (for altitude sickness).

Cholera vaccine is rarely indicated for travellers, because travellers are not usually at risk of getting cholera, which is a disease of local populations. ... More..

I suffer from osteoarthritis and take codeine for flare-ups, I find it is the only drug that effectively deals with the pain, I also have a lot of allergies that preclude me taking other drugs, I have tried many and been unable to tolerate them, my husband and I are leaving next week for UK, passing through UAE and I have just been told I cannot carry codeine through UAE, can you tell me if there are any circumstances under which I can carry codeine, i.e. prescription, doctors letter etc., as I don't want my holiday in Dubai to be spoilt by pain and inability to get around.

The issue with travelling with codeine is that some countries, notably most Middle East ones, Singapore, Malaysia and others, consider that codeine is a potential drug of abuse and addiction, and therefore illegal or restricted in their country... More..

My husband and I are travelling to the United States of America for three weeks in March this year. Some friends suggest that before we leave we should visit our local GP, obtain a prescription for a antibiotic, have it filed and take it with us. They say it is best to have it with you rather than go to a ndoctor over there. What do you think? Obviously, we would only take the tablets if we needed them. Is there anything else we need to do medically in preparation before we go to the USA?

All travellers should consider their health issues before travel, no matter how "safe" they perceive the destination. ... More..

Hi, my family and I are heading to Malaysia for three weeks, spending some time in Sarawak - mainly Kuching & visiting nearby National Parks, then heading across to Peninsula Malaysia & up to the east coast to a resort island off Terrenganu. We have received mixed advice regarding vaccinations, malaria precautions etc - one travel agent advising we did not need any. Could you please advise our best approach.

Indeed, the travel agent is not correct in advising that no health precautions are required. While the trip is not high-risk, it is absolutely appropriate that vaccination and consideration of malaria risk is done... More..

I am planning on traveling to Vanuatu soon and was wondering if we need to take any precautions other than the usual cover up between dusk and dawn. We are staying at a top resort and will be doing some day tripping as well. Do we need to take malaria tablets with us?

Malaria does occur in the islands of Vanuatu, but is not a significant risk around the capital Port Vila or the resorts there.... More..

Is there a current outbreak of cholera in Moscow? What preventative measures can I take against cholera?

Cholera is not a disease of travellers, but rather a disease of local populations who have only access to contaminated water and no effective way of cleaning their water ... More..

Hi, I travelled to Africa in November this year and got bitten by a tsetse fly in Tanzania in Lake Manyara. It was only one bite and the bite location did not swell up. Is there a blood test to determine if I have been infected? Do you recommend I get any tests? Should I wait and see if I get any symptoms?

As you know, tsetse fly bites can transmit the disease trypanosomiasis, also known as African sleeping sickness. ... More..

I have just contracted Dengue Fever for the second time in 3 months in SE Asia. I am planning on returning there in 3 weeks. Is there a way of finding out what strains I have caught, and what strains are prevalent in specific areas? I have been warned by my GP not to return as a third infection could be very severe. Is that correct?

Dengue fever, spread by mosquitoes in tropical areas, is caused by 4 different types of dengue virus, and protection against one unfortunately does not give protection against the others, so the illness can be contracted up to 4 times. ... More..

I will be heading to Hong Kong with my partner next Monday, I was told by my doctor getting the h1n1 vaccination shot wasn't needed, is this true?

No, not true. It is important that all Australians are protected against the pandemic H1H1 2009 virus by getting the new free vaccine. ... More..

We are travelling to India in January until April 2010 with our son who is 4 years old. He has been to India twice before, for similar lengths of time, and has never been sick. He has all the Australian required vaccinations for his age, as well as he received rabies and japanese enchephilitis vaccinations when he was 1 year old as advised.

What about Hep A or typhoid. Is this something I need to consider for a child ? I also have a strong leaning towards eastern medicine practices and would prefer not to subject my son to unnecessary medical procedures.

Indeed your son is at risk of these common diseases in India, and we would strongly advise vaccination. ... More..

I will be travelling with my family to Ho Chi Min city and Nah Trang for 10 days in Jan. We all have our normal vaccinations that are up to date. What other ones will we need? As we have children who live in other cities organizing these will be logistically challenging. What ones do we need to have?

Vietnam is a great family holiday destination but some travel vaccines are advised in addition to the "routine" vaccines which of course now includes pandemic influenza vaccine ... More..

We are heading over to Bali very soon and concerned about rabies. Is it advisable to have a rabies vaccination before we go? We will be doing a little travel on a bike tour through villages and rice paddies but mostly staying around the more inhabited areas.

Rabies appeared in Bali last November, and has infected dogs in the southern Kuta area and surrounds. There are many dogs in Bali, and the local authorities are struggling to introduce an effective control program ... More..

We are going on a Panama Canal cruise in Jan 2010. Our ports of call will be Miami, Cartgena, Puntarenas, Puerto Quetzal, Huatolco, Acapulco, Cabo San Lucas, and Los Angeles. We have been to our local travel clinic and were advised we did not require a typhoid fever vaccination as we would not be eating off the ship, however fellow passengers who went to the same clinic and were advised they required this vaccine as food is brought on board in various ports and may not be safe. We are confused and wondered what is your opinion.

Unfortunately this is not an uncommon situation. Firstly, there can be several reasons that any two travelers going on the same trip can get different advice, as their medical history, previous vaccines, comfort with risk, can all affect any specific recommendation. ... More..

We are travelling to Tanna Island in Vanuatu. We are staying at remote bungalows. The hosts of our accommodation have said the water comes from a well in the village and is clean and safe to drink. Is water from a village well safe or should we still treat the water in some way?

We would not suggest drinking village well water directly without some kind of treatment, eg boiling or treating first. ... More..

My 16 year old daughter is going on a school exchange to Port Elizabeth in South Africa in a boarding school environment for 6 weeks. I am wondering if she needs to be vaccinated for anything before she goes?

You are right to ask about travel vaccines, because although a boarding school in a developed city represents much the same issues as at home in Australia ... More..

We want to travel to Asia next April with two children, one will be two and half and the other will be four months. Once in Asia we are happy to go to a resort such as Phuket etc. We really don't want to vaccinate our children as we feel they will be too young for this. Is it safe for us to go? If not, is there anywhere in Asia which is safe for us to go?

Most family holidays can be accommodated if a safe destination is selected. A tourist environment like Phuket provides a suitably safe location for families, as high-risk disease like malaria is not present. ... More..

I am travelling to West Timor for 2 weeks with my 5 month old in July. My GP did not recommend for either of us to take malaria medication since I am still breast-feeding. After reading up on the internet it looks like we should take malaria preventative medication? Are there any other medications we should be taking in case of gastro or is the baby too young? I am concerned we were not told to take any preparations aside from me getting my usual vaccinations for Indonesia.

You are quite right to be concerned, because malaria is a significant issue in West Timor, including the outskirts of the capital Kupang, and especially in the rural areas. Gastro-intestinal disease is also very common. ... More..

I am due to fly out to the USA in 2 weeks time. Should I be concerned about this new Swine Flu?

This outbreak of human cases of swine (pig) influenza is an emerging threat. As of today (Monday 27th April), there have been reports of more than 60 deaths having occurred in Mexico, and several milder cases, with recovery, in the US, Canada, New Zealand and France. ... More..

I am hoping to travel to Thailand/Vietnam and Cambodia or to Peru (hike up to Machu Pichu) next year. I have certain food allergies (egg and peanuts in particular) and am aware that the Yellow Fever vaccination isn't recommended for people who have an egg allergy. Are there any other vaccinations that I might need for these locations that I should avoid?

We are careful with the Yellow fever vaccine, as it is associated rarely with allergic reactions in people who are very allergic to eggs (if major anaphylactic reactions only), just like the measles-mumps-rubella vaccine which also is a live vaccine associated with rare allergic reactions. If a person can eat eggs, or foods with eggs (cakes, etc), they will have no problem with getting the vaccine, or if they have had the MMR vaccine before, they should have no problem. ... More..

Unfortunately this now is a real concern. Traditionally Bali has been free from rabies which has been known to be present on many other Indonesian Islands. In late 2008 sick and dying dogs appeared and then human cases of rabies after local people had sustained dog-bites. ... More..