A poll at a recent webinar of over 100 members of the Chamber of Commerce revealed most business did not have a current Travel Health policy. Very few systems were in place to protect either the travelling staff, or those who are sending them overseas. This is scary.
Read More »Our Toowoomba members’ clinic has been very busy all year with Korean backpackers seeking Q Fever Vaccine prior to working at the local meat works.
This initially presented a few problems with language barriers but we have had the Q Fever pre vaccination questionnaire translated into a Korean format (many thanks to Jon Barrell TMA member in Daylesford Vic) .
Other News from the Toowoomba Clinic
Our Wilsonton practice has just completed a much needed makeover with new carpets and a complete repaint, which has drawn wonderful compliments from both staff and patients alike.
We have two new doctors Dr Richie Jaggi and Dr Emma Gradner-Smith also doing weekly sessions which has improved our ability to provide extra appointments.
Our nursing staff pool has also expanded and we have now have four dedicated travel medicine nurses, Natalie Webb, Rebecca Eaton , Belinda Rowney at the Wilsonton Medical Centre and Emma Kropp.
New TMA Member at Brookwater/Springfield
My Life Medical Group opened a new state of the art General Practice within the Mater Health Centre at the entrance to Brookwater Golf Club earlier this year.This a rapid growth area of South East Queensland and a new direct rail line opens there very shortly. Dr Cormac Carey is providing travel medicine consultations at the clinic and appointments can be made on 3199 3299.
Happy Q Fever Patient
Brookwater Clinic
St Andrews Hospital Practice
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Prepared by TMA member Toowoomba/Brookwater
For most travellers to the USA the risk of dengue fever would low on the list of health issues, however the following report of a dengue fever outbreak adds a sobering reminder to practice mosquito avoidance measures even in first world countries.
According to the Texas Department of Health, 6 laboratory-confirmed, locally acquired cases of dengue fever, the first locally acquired cases since 2005, have been reported in Cameron County in southern Texas State since early November 2013. Additionally, 23 laboratory-confirmed, locally acquired cases have been reported in Martin, St. Lucie, and Miami-Dade counties in Florida State since August 2013. Sporadic cases without sustained transmission are reported in central and southern Florida State each year. Travellers are advised to practice daytime insect precautions.
Read More »Prepared by TMA member Toowoomba/Brookwater
In August 2013, Médecins Sans Frontières (MSF/Doctors Without Borders) started a rabies intervention in the east of the Democratic Republic of Congo after an alarming number of people were bitten by rabid dogs, and at least 10 people died. Doctors will provide PEP to people bitten or scratched by a suspected rabid dog in the Lemera region in the province of South Kivu this hyperlink.
MSF teams struggle to help in an isolated area of South Kivu
After decades of conflict and instability in the Democratic Republic of Congo, measures to control canine rabies have not been implemented, and data on the size of the problem is simply not available.
“The current rabies situation now affecting humans in Lemera is exceptional and must be urgently addressed,” said Dr Jantina Mandelkow, who is leading the MSF team. “We’re doing all we can but we urge others to recognise the severity of the situation and commit resources to its containment and resolution.”
– See more at: https://rabiesalliance.org/media/news/rabies-control-measures-implemented-in-dr-congo#sthash.8vJCL33A.dpuf
MSF teams struggle to help in an isolated area of South Kivu
Read More »Prepared by TMA member Narre Warren
It is now over a month since Typhoon Haiyan (called Yolanda in the Phillipines) struck the Philippines on 8/11/13. The worst hit provinces were Leyte and Eastern Samar, which experienced sustained winds of 270 kph, gusts of up to 312 kph, and a storm surge in coastal areas as high as 7 metres. Not all travel is for pleasure. Typhoon Haiyan travel advice is be prepared and be informed.
The official death toll from the Phillipines Government is approaching 6000, the injury toll 27000, and 1800 people as of mid December 2013 are still listed as missing. These figures are considered by most to be conservative.
Enormous international aid efforts are underway. Significant infrastructure damage has caused problems with sanitation, food supply, electricity, transportation, shelter, communications, security, and medical care.
This all has implications for people who are considering travelling with aid organisations, or in those visiting relatives and friends to help them.
The following advice applies to both groups of travellers:
1 Take a kit with you from your travel medicine clinic to treat diarrhoea; diarrhoeal illnesses are likely to be more common after a disaster where serious flooding has occurred. Follow the usual safe food and water precautions advised by your travel clinic
2 Use mosquito repellents with more than 30% DEET to prevent mosquito borne illnesses such as Dengue Fever and Chikungunya. Mosquitos will breed in greater numbers around flooded areas. The areas worst affected by Typhoon Haiyan are the islands of Leyte, Samar and Cebu; they are not affected by malaria so malaria tablets are not required for these islands.
3 Be vaccinated for Hepatitis A and Typhoid; update your tetanus injections as debris clearing will often result in injury. Have a flu injection, and speak to your travel Doctor about other vaccines you may need.
4 Avoid injury—most deaths after a natural disaster are due to blunt trauma, crush-related injuries, and drowning. Use caution around damaged or down power lines,
water-affected electrical outlets, and interrupted gas lines.
5 Avoid stray or frightened animals. Seek medical help immediately if you are bitten or scratched by an animal and wash out the wound. Consider rabies vaccination before you go, or seek rabies vaccination within 48 hours of any animal bites.
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Prepared by TMA Member Boronia
Decompression Sickness (DCS) is also known as Acute Decompression Illness (ADI) or, more colloquially, as the ‘bends’ (because the pain involved can bend a person).
DCS in the setting of scuba diving or deep-sea diving, refers to an illness caused by an overly rapid ascent to the water’s surface.
During a scuba dive, the diver absorbs additional quantities of oxygen and nitrogen into the blood and tissues. The nitrogen is dissolved into the bloodstream, where it remains during the dive. Once a diver begins their ascent, the surrounding water pressure decreases. If this transition occurs too quickly, the nitrogen does not have sufficient time to leave the bloodstream and be exhaled via the lungs. Instead, nitrogen bubbles form in the bloodstream which can enter tissues throughout the body.
Factors increasing risk of DCS
Symptoms of DCS
Approximately fifty percent of divers with DCS develop symptoms within 1 hour after surfacing, 90 % within 6 hours and 98 per cent within the first 24 hours.
Generally, the sooner the symptoms develop, the more serious the DCS is likely to be.
DCS symptoms vary significantly because nitrogen bubbles can lodge in different parts of the body. The symptoms experienced are largely determined by the where the bubbles ultimately lodge. eg. bubbles that lodge in the joints will cause joint pain; bubbles under the skin can cause a blotchy rash/itching; bubble formation in the spine may lead to limb weakness/ paralysis, etc.
Early Management of DCS
Seek medical treatment as soon as any symptom of DCS is noticed. If available, apply 100% oxygen by mask ASAP to help relieve some symptoms and reduce oxygen-deprived tissue injury. Treat dehydration, maintain blood pressure and prevent shock.
Hyperbaric oxygen therapy in a high pressure chamber reverses the pressure changes that cause the nitrogen bubbles to form. The bubbles redissolve and can then be exhaled by the lungs.
Prevention of Decompression sickness
Avoid flying within 24 hours after diving (increasing altitude during a flight will further decrease pressure in the bloodstream, hence potentially increasing bubble formation and exacerbating injuries).
Divers’ Emergency Service (DES)
This is a free phone consultation service for diving-related medical emergencies. They can also provide the location of the nearest hyperbaric chamber.
24 Hour Hotline:
ph: 1800 088 200 (toll free from within Australia)
618 8212 9242 (if calling from outside Australia
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Dr Deb Mills
Moisture, warmth, carbon dioxide and odour all attract ‘mozzies’, and some unlucky people seem to be genetically more delicious to mosquitoes.
Cover up – long sleeved, light coloured clothes
Try and avoid being outside when they are biting. If you are outside between dusk and dawn, wear treated, long sleeved shirts, long pants, and long socks. Light coloured clothes are best. Dark colours attract mosquitoes. Strong scents also attract them, so avoid perfumes etc.
30% DEET is the best
‘DEET’ (Diethyl toluamide) is clinically proven to be the most effective mosquito repellent to apply on your skin e.g. Repel™ or Rid™. Repellents work by blocking the receptors on the mosquitoes antennae. A concentration of 30% DEET is recommended for adults under conditions of intense mosquito exposure. Concentrations greater than 50% DEET are usually not recommended. In field trials, DEET products on the skin have been found to be more effective than coils, ‘mozzie plants’, citronella candles, sonic repellers, and UV light lures. DEET can damage plastics, synthetic fabrics, leather and painted or varnished materials so be careful with eye glasses, cameras etc. DEET has no effect on cotton, wool or nylon or skin(!) DEET has been on the market for 45 years and side effects are rare if used properly.
Apply regularly
Apply regularly as per instructions on the bottle (for 30% DEET usually every 4-5 hours). Don’t forget your neck and ankles. Use just enough repellent to lightly cover your skin. You do not need to saturate your skin. Never use repellent over cuts, wounds or inflamed skin. After application, wipe or wash the repellent off your palms to avoid inadvertent contact with your eyes, mouth and other sensitive areas. Don’t apply repellent to children’s hands if they are likely to put their hands in their mouth. Ideally, wash off the repellent when you no longer need it.
Sleeping precautions
Sleeping in air-conditioned or well-screened rooms is the ideal. Use a ‘knock down spray’ if necessary to remove stray mosquitoes. The next best plan is to sleep under a permethrin-treated mosquito net. Check there are no holes in the net, and tuck the edges under the mattress. If mosquitoes are already inside the net, spray them with insecticide before you go to bed. As a last resort burn mosquito coils, cover exposed skin in insect repellent, and sleep next to a fan.
Did you know … mixing sunscreen and repellent?
When sunscreen is required, apply sunscreen first, wait 20 minutes and then apply repellent. Combination products are not as effective.
Read More »A recent study looking at the accuracy of tablet splitting, found large variations in dose in some of the splits. Some tablets are easier to split than others, and some drugs are more dangerous than others if you get the dose slightly wrong.
The major finding of the study was this “Based on our results, we recommend use of a splitting device when splitting cannot be avoided, for example when the prescribed dose is not commercially available or where there is no alternative formulation, such as a liquid.”
Tablet splitters can be purchased from most pharmacies. More info.
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| Generally we felt reasonably secure but all bags must be held close and be closed firmly. Pick pockets do well. Loose items disappear quickly. We let our guard down in the last 15 minutes before leaving the conference hotel (5 star) and were rewarded with one of our bag being stolen: Camera, chargers for phones, power converters, medical kit and coats. Take care with your goods.
Madrid is more metropolitan and Spain’s largest city. You can taste all of the flavours of Spain here. We found the smaller places of good value and with a very large variety of good wholesome, well priced food. We found free Flamenco bars where the passion was as strong as the alcohol in the beverages. Parks open at 10am and people are flooding in at 8-9pm while the daylight still shines.The bigger cities come alive from 9pm onwards. The art word reigns supreme in Madrid, followed closely by the History of Spain in both Museums and architecture. There are amazing shops that sell genuine armoury still made in the famous Toledo factory. Cross bow 25E, just don’t expect to get it through customs. Your local shopping mall has the men’s section complete with underwear, suits and leather coats, selection of fishing gear, knives for hunting as well as a full Gun collection. Everything a real man needs. Central Spain. We had a brief one day visit to Avila and Segovia. The change in foods, wine and scenery was incredible. You first pass near the highest mountains in Spain, complete with ski resorts, then along amazing cliffs and ravines. Out from here lies the fertile central Spanish plains. Central Spainproduces some of the most amazing wines in Spain, re-noun especially for their Red wines, the whites are not to be dismissed. Their suckling pig, plethora of hams, cheeses and extensive variety of Horticultural produce is impressive. |
Lessons learned on the Trip:
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Travel Health Information
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