Dr Simon Thatcher Health HQ Southport
Most travellers have heard Yellow Fever vaccine is compulsory to enter Australia after Peru. While not compulsory, it is recommended. Yellow fever vaccination is required to cross borders to many other South American countries you may visit. It is also one of the haemorrhagic viruses (like Ebola) with a high fatality rate, so if you are going to the Yellow Fever areas of Peru it will be recommended whether you need it for customs or not.
Travel medicine is a form of risk assessment. We evaluate the risk of getting a disease, the consequence of getting the disease (is it mildly incapacitating or fatal?), the risk from the prevention (vaccine or medication) and the effectiveness of the prevention. We ask about what the traveller is prepared to pay to avoid that risk. It is a form of insurance.
Can you afford to take a 1 in 1000 risk of missing 3 months of work after your trip and is it worth spending $100 to avoid that? This would be a question for travelling to Peru for 1 month and whether Hepatitis A vaccine would be worthwhile.
Can you afford of 1 in 100 risk of missing 5 days of your once in a lifetime expensive, short holiday and would it be worth $20 to avoid that? This would be a question on whether influenza vaccine is worthwhile if you are doing the Inca trail.
Doctors are conservative by nature and the answer to the above questions will usually be yes.
You as an individual might be happy to take the risk and save the money and spend it on Cusquena beer T-shirts. If you have a mortgage and 2 children in school you might prefer to avoid the risk a lot more!
The person who thinks base jumping is a low-risk sport activity will be different to the person carries a large stick while walking their Chihuahua.
What about taking malaria tablets? Is it worth it to take malaria tablets for 3 days in the Amazon in an upmarket lodge in the dry season? What if the travelling is kayaking through the Amazon for 8 weeks living in villages? Travellers occasionally get malaria and even more occasionally die. Malaria tablets have side effects and cost money and if the traveller does not take them properly will have limited efficacy. Prevention of mosquito bites is more important than taking malaria tablets but both together are extremely effective. I had a young traveller who was meant to be taking malaria tablets for a kayaking trip in the Amazon but stopped them because he didn’t like the side effects and he got malaria. He was very sick when he got back to Australia and had lost half his red cells so he was very anaemic but he survived. Was this a good choice?
On a short trip, you would want low side effect medication even if it costs a little more per day. On a longer trip, you might accept more side effects to save money. You may choose not to take malaria tablets but then you have to know what the symptoms of malaria are and if you are not near medical care you must be able to treat yourself for malaria.
A full travel medicine consultation will assess risks and discuss choices. Forewarned is forearmed and ignorance is not bliss when travelling to less developed countries such as Peru.
More info on Yellow Fever
