A good time to travelflu

During our summer and spring, many Australians travel to the Northern Hemisphere, taking advantage of lower costs and fewer competitive tourists. Local operators, food outlets and jaded citizens are often much more hospitable to tourists in their quiet season and contribute to a very pleasant experience.

The cooler weather may also provide great relief to those who have, for instance, experienced London in July. But lower temperatures, rain and wind, especially in crowded venues, increases the likelihood of contact with respiratory viruses, now taking hold in Europe and North America. As this article is being written – before Christmas – reports are coming in of new influenza strains, especially in China and Japan, which may or may not cause trouble throughout the world.

The actual risk to travellers will depend on many factors, but exposure to crowds in a confined space (such as aeroplanes and cruise ships) is the most important contributor to infection. Some travellers will experience disease-free holidays or business trips, only to become sick on the return flight.

The evolution of new influenza strains is oxygen to researchers and biological scientists, but yawn-provoking to most citizens who, like Matilda’s Dad, get all their knowledge from the TV. Doctors talk about flu to their patients but, if they have never experienced the disease, have no idea of what he/she is talking about. As a consequence most Australian travellers elect not to have flu vaccine before travelling. This may be a big mistake.

A serious disease

Flu is not an exacerbation of a cold or some other virus. It is a serious illness, because of its debilitating symptoms, its contribution to Australia’s absenteeism from work and its potential to kill (there are approximately 18,000 hospitalisations and between 1500-2000 deaths in Australia each year).

Flu’s propensity to prostration and exhaustion are bad enough at home, but become a serious cost and inconvenience in a foreign country. A week in a US hospital might dwarf the cost of your whole trip.

Influenza seasons differ between the hemispheres; in the North, it is mainly between December and April, in the South from July to October, but it is a year-round problem in the tropics. Of course, flu may occur at any time of year, but is at present a major risk to travellers to Europe and North America. The season has actually started earlier than usual and is mainly caused by the Influenza A/Hong Kong (H3N2) strain, protected by our existing vaccine. (The 2017 vaccine will be released in March/April, but differs only slightly from the existing vaccine.)

Management

The influenza vaccine is very cheap and offers the best value for money of any vaccine. It offers 70-90% protection to those vaccinated. Travel doctors will recommend this vaccine to all travellers at this time of year and is readily available in most GP clinics. Remember, flu vaccines are killed vaccines and cannot cause influenza – despite the ravings of a few fruit-loops in our Community.

Travellers encouraged to vaccinate include the very old, those with other chronic diseases (heart disease, lung disease, cancer, diabetes, HIV, etc), pregnant women and most Aboriginal people.

For those travellers to high risk destinations and who cannot be vaccinated for one reason or another, an alternative is:

  1. Monitoring of the flu situation in your destination country. (See: http://isg.org.au/ and http://www.influenzacentre.org/centre_GISN.htm)
  2. Strict adherence to protective measures (face masks, protective clothing, etc.).
  3. Use of antiviral drugs (Tamiflu (oseltamivir) and Relenza (zanamivir)). These must be taken within 48 hours of symptoms developing and reduce the severity and duration of influenza.

For all travellers, never leave Australia without insurance cover and make sure your insurer is aware of any chronic illness you may have.