Dr Colleen Lau is one of the founding travel doctors of the TMA Perth Clinic, and also works at the TMA Brisbane Clinic. Over the past 3 years, she has travelled around the South Pacific for tropical medicine research projects and consultancies, and has just completed a PhD in infectious disease epidemiology at the University of Queensland. In this article, Colleen provides us with information on health hazards in the South Pacific, and some snapshots from her research trips in American Samoa, Vanuatu, and the Solomon Islands.
Travel Health Precautions for the South Pacific
If you expect to find remote islands, underwater adventures, friendly smiling faces, flower garlands, tropical sunsets, coconut trees, and cocktails in the South Pacific, you will not be disappointed. On a world map, the islands look like tiny dots in the vast ocean. Close up, they are home to incredible diversity in culture, history, language, landscape, economy, and wealth. Consequently, sanitation, hygiene, and the quality and availability of health care also vary dramatically between the island nations. Although the Pacific Islands conjure images of tropical paradise, most of them are developing nations, and there are health issues that travellers should be aware of. Prevention is always better than cure, and the risk of many of the health hazards can be significantly reduced by simple precautions.
| Rainmaker Mountain, American Samoa. After a 2-hour uphill hike, the view from the top of Mount Alava is breathtaking. Everything is lush and green, because American Samoa is one of the wettest inhabited places in the world, with an annual rainfall of over 3000mm. For my leptospirosis research project, I spent 3 months there during the 'dry' season, and it rained every single day! |
Mosquito-borne Diseases
- Dengue occurs throughout the South Pacific. In most tropical areas around the world including the Pacific, the frequency and size of dengue outbreaks have increased in recent years due to a combination of demographic, environmental and climatic factors. In one of my studies from American Samoa, about 95% of adults had antibodies to dengue viruses, indicating that they had been infected some time in the past. Dengue can cause fevers, a rash, sore bones/joints/muscles, headache, and a flu-like illness. A very promising dengue vaccine is currently being tested, and will hopefully be available in a few years' time.
- Malaria is found in Vanuatu and the Solomon Islands, but there is no risk in Fiji, Samoa, American Samoa, Tonga, French Polynesia, Cook Islands, or the Micronesian Islands. In Vanuatu, malaria is found in virtually the whole country, but is low risk in Port Vila and Tafea Province (including Tanna Island, where the famous active volcano Mt Yasur is located). Malaria is also found throughout the Solomon Islands, but is low risk in Temotu Province in the far south. In Tanna and Temotu, an AusAID-funded Malaria Elimination Program has significantly reduced the number of malaria cases. If travelling to Vanuatu and the Solomon Islands, you should speak to your travel doctor about antimalarial medications. Malaria is a potentially fatal infection, but is treatable if diagnosed early. If you develop any fevers during or after travelling to the tropics, see a doctor as soon as possible.
- Chikungunya virus has spread over the past few years from East Africa to the Indian Ocean Islands and Asia, and local transmission was recently identified in New Caledonia and Papua New Guinea. There is therefore a risk that the virus will continue to spread to surrounding countries including Australia and the Pacific Islands. The infection can cause quite disabling symptoms including fever, rash, joint pain and stiffness, and severe tiredness. A large Ross River virus outbreak swept through the Pacific Islands in 1979/1980, but there have been few reports of infection since then.
When travelling in the South Pacific, it is therefore very important to take precautions against mosquito bites by using DEET-containing repellents, wearing protective clothing, and using mosquito nets or screened accommodation. Perfumes can attract mosquitoes and should be avoided.
Village health post (left) and Tanna Hospital (right), Tanna Island, Vanuatu. Health care and medical supplies are limited, especially in the more remote islands. It is always best to carry a few basic supplies, and the most common items that travellers need are medications for diarrhoea, colds and flus, and pain-killers, and simple dressings for minor wounds and injuries.