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Australia

Health & safety

Before you go

Further reading

Lonely Planet’s Healthy Travel Australia, New Zealand & the Pacific is a handy, pocket-sized guide packed with useful information including pre-trip planning, emergency first aid, immunisation and disease information, and what to do if you get sick on the road. Travel with Children, from Lonely Planet, includes advice on travel health for younger children. Other recommended references include Traveller’s Health by Dr Richard Dawood (Oxford University Press) and International Travel Health Guide by Stuart R Rose, MD (Travel Medicine Inc).

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Insurance

If your health insurance doesn’t cover you for medical expenses abroad, consider getting extra insurance – check www.lonelyplanet.com/bookings/insurance.do for more information. Find out in advance if your insurance plan will make payments directly to providers or if it will reimburse you later for overseas health expenditures. In Australia, as in many countries, doctors expect payment at the time of consultation. Make sure you get an itemised receipt detailing the service and keep the contact details of the health provider.

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Internet resources

There is a wealth of travel health advice to be found on the internet. The WHO (www.who.int/ith) publishes a superb book called International Travel and Health, which is revised annually and is available online at no cost. Another website of general interest is MD Travel Health (www.mdtravelhealth.com), which provides complete travel health recommendations for every country and is updated daily.

It’s usually a good idea to consult your government’s travel health website before departure, if one is available:

Australia (www.dfat.gov.au/travel)

Canada (www.travelhealth.gc.ca)

UK (www.dh.gov.uk) Click on ‘Policy and guidance’, then scroll down to ‘Health advice for travellers’.

USA (www.cdc.gov/travel)

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Medical checklist

- Antibiotics

- Antidiarrhoeal drugs (eg loperamide)

- Acetaminophen (paracetamol) or aspirin

- Anti-inflammatory drugs (eg ibuprofen)

- Antihistamines (for hayfever and allergic reactions)

- Antibacterial ointment in case of cuts or abrasions

- Steroid cream or cortisone (for poison ivy and other allergic rashes)

- Bandages, gauze, gauze rolls

- Adhesive or paper tape

- Scissors, safety pins, tweezers

- Thermometer

- Pocket knife

- DEET-containing insect repellent for the skin

- Permethrin-containing insect spray for clothing, tents and bed nets

- Sun block

- Oral rehydration salts

- Iodine tablets or water filter (for water purification)

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Since most vaccines don’t produce immunity until at least two weeks after they’re given, visit a physician four to eight weeks before departure. Ask your doctor for an International Certificate of Vaccination (otherwise known as ‘the yellow booklet’), which will list all the vaccinations you’ve received. This is mandatory for countries that require proof of yellow fever vaccination upon entry, but it’s a good idea to carry a record of all your vaccinations wherever you travel.

Bring medications in their original, clearly labelled containers. A signed and dated letter from your physician describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity.

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Required & recommended vaccinations

If you’re entering Australia within six days of having stayed overnight or longer in a yellow fever–infected country, you’ll need proof of yellow fever vaccination. For a full list of these countries visit the World Health Organization (WHO; www.who.int/wer) or Centers for Disease Control & Prevention (www.cdc.gov/travel) websites.

If you’re really worried about health when travelling, there are a few vaccinations you could consider for Australia. The WHO recommends that all travellers should be covered for diphtheria, tetanus, measles, mumps, rubella, chickenpox and polio, as well as hepatitis B, regardless of their destination. Planning to travel is a great time to ensure that all routine vaccination cover is complete. The consequences of these diseases can be severe, and while Australia has high levels of childhood vaccination coverage, outbreaks of these diseases do occur.

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Dangers & annoyances

Crime

Australia is a relatively safe place to visit but you should still take reasonable precautions. Don’t leave hotel rooms or cars unlocked, and don’t leave your valuables unattended or visible through a car window. Sydney, the Gold Coast, Cairns and Byron Bay all get a dishonourable mention when it comes to theft, so keep a careful eye on your belongings in these areas.

Some pubs in Sydney and other major cities carry posted warnings about drugged drinks, after several reported cases in the past few years of women accepting a drink from a stranger only to later fall unconscious and be sexually assaulted. Women are advised to refuse drinks offered by strangers in bars and to drink bottled alcohol rather than from a glass.

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In transit

Deep vein thrombosis (DVT)

Blood clots may form in the legs (deep vein thrombosis, or DVT) during plane flights, chiefly because of prolonged immobility. The longer the flight, the greater the risk. Though most blood clots are reabsorbed uneventfully, some may break off and travel through the blood vessels to the lungs, where they could cause life-threatening complications.

The chief symptom of DVT is swelling or pain of the foot, ankle or calf, usually – but not always – on just one side. When a blood clot travels to the lungs, it may cause chest pain and breathing difficulties. Travellers with any of these symptoms should immediately seek medical attention.

To prevent the development of DVT on long flights, you should walk about the cabin, perform isometric compressions of the leg muscles (ie flex the leg muscles while sitting), drink plenty of fluids and avoid alcohol and tobacco.

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Jet lag & motion sickness

Jet lag is a common problem when crossing more than five time zones, and it results in insomnia, fatigue, malaise or nausea. To avoid jet lag, try drinking plenty of (non­alcoholic) fluids and eating light meals. On arrival, expose yourself to sunlight and readjust your schedule (for meals, sleep etc) as soon as possible.

Antihistamines such as dimenhydrinate and meclizine are usually the first choice for treating motion sickness. Their main side effect is drowsiness. A herbal alternative is ginger, which works like a charm for some people.

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While you're there

Sharks & crocodiles

Despite extensive media coverage, the risk of shark attack in Australian waters is no greater than in other countries with extensive coastlines. There’s also low risk of an attack by tropical sharks on scuba divers in northern Australian waters. Great white sharks are now few in number in the temperate southern waters. Check with surf life-saving groups about local risks.

The risk of crocodile attack in tropical northern Australia is real but predictable and largely preventable. Discuss the local risk with police or tourist agencies in the area before swimming in rivers, water holes and in the sea.

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Snakes

Australian snakes have a fearful reputation that is justified in terms of the potency of their venom, but unjustified in terms of the actual risk to travellers and locals. Snakes are usually quite timid in nature and, in most instances, will move away if disturbed. They have only small fangs, making it easy to prevent bites to the lower limbs (where 80% of bites occur) by wearing protective clothing (such as gaiters) around the ankles when bushwalking. The bite marks are very small and may even go unnoticed.

In all cases of confirmed or suspected bites, preventing the spread of toxic venom can be achieved by applying pressure to the wound and immobilising the area with a splint or sling before seeking medical attention. Firmly wrap an elastic bandage (you can improvise with a T-shirt) around the entire limb, but not so tight as to cut off the circulation. Along with immobilisation, this is a life-saving first-aid measure.

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Spiders

Australia has a number of poisonous spiders. The Sydney funnel-web spider causes severe local pain, as well as generalised symptoms (vomiting, abdominal pain, sweating). An antivenin exists, so apply pressure to the wound and immobilise the area before transferring to a hospital.

Redback spiders are found throughout the country. Bites cause increasing pain at the site, followed by profuse sweating and generalised symptoms (including muscular weakness, sweating at the site of the bite, nausea). First aid includes application of ice or cold packs to the bite, then transfer to hospital.

White-tailed spider bites may cause an ulcer that is very slow and difficult to heal. Clean the wound thoroughly and seek medical assistance.

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Heat exhaustion & heatstroke

Very hot weather is experienced all year round in northern Australia and during the summer months for most of the country. Conditions vary from tropical in the Northern Territory and Queensland to hot desert in ­northwestern Australia and central Australia. When arriving from a temperate or cold climate, remember that it takes two weeks for acclimatisation to occur. Before the body is acclimatised, an excessive amount of salt is lost in perspiration, so increasing the salt in your diet is essential.

Heat exhaustion occurs when fluid intake does not keep up with fluid loss. Symptoms include dizziness, fainting, fatigue, nausea or vomiting. The skin is usually pale, cool and clammy. Treatment consists of rest in a cool, shady place and fluid replacement with water or diluted sports drinks.

Heatstroke is a severe form of heat illness that occurs after fluid depletion or extreme heat challenge from heavy exercise. This is a true medical emergency, with heating of the brain leading to disorientation, hallucinations and seizures. Prevent heatstroke by maintaining an adequate fluid intake to ensure the continued passage of clear and copious urine, especially during physical exertion.

A number of unprepared travellers die from dehydration each year in outback Australia. This can be prevented by following some simple rules:

- Carry sufficient water for any trip, including extra in case your vehicle breaks down.

- Always let someone, such as the local police, know where you are going and when you expect to arrive.

- Carry communications equipment of some form.

- Stay with your vehicle rather than walking for help.

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Hypothermia

Hypothermia is a significant risk, especially during the winter months in southern parts of Australia. Despite the absence of high mountain ranges, strong winds produce a high chill factor that can result in hypothermia even in moderately cool temperatures. Early signs include the inability to perform fine movements (such as doing up buttons), shivering and a bad case of the ‘umbles’ (fumbles, mumbles, grumbles, stumbles). The key elements of treatment include moving out of the cold, changing out of any wet clothing into dry clothes with windproof and waterproof layers, adding insulation and providing fuel (water and carbohydrate) to allow shivering, which builds the internal temperature. In severe hypothermia, shivering actually stops – this is a medical emergency requiring rapid medical attention in addition to the above measures.

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Insect-borne illnesses

Various insects can be a source of irritation and, in Australia, may be the source of specific diseases (dengue fever, Ross River fever). Protection from mosquitoes, sandflies, ticks and leeches can be achieved by a combination of the following strategies:

- Wearing loose-fitting, and long-sleeved clothing.

- Application of 30% DEET to all exposed skin and repeating every three to four hours.

- Impregnation of clothing with permethrin (an insecticide that kills insects but is believed to be safe for humans).

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Surf beaches & drowning

Australia has exceptional surf, particularly on the eastern, southern and western coasts. Beaches vary enormously in their underwater conditions: the slope offshore can result in changeable and often powerful surf. Check with local surf life-saving organisations and be aware of your own expertise and limitations before entering the water.

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Ultraviolet (UV) light exposure

Australia has one of the highest rates of skin cancer in the world. Monitor your exposure to direct sunlight closely. Ultraviolet exposure is greatest between 10am and 4pm, so avoid skin exposure during these times. Always use 30+ sunscreen; apply it 30 minutes before going into the sun and repeat applications regularly to minimise damage.

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Bat lyssavirus

This disease is related to rabies and some deaths have occurred after bites. The risk is greatest for animal handlers and vets. The rabies vaccine is effective, but the risk of travellers contracting bat lyssavirus is very low.

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Dengue fever

Dengue fever occurs in northern Queensland, particularly from October to March, during the wet season. Also known as ‘breakbone fever’, because of the severe muscular pains that accompany it, this viral disease is spread by a species of mosquito that feeds primarily during the day. Most people recover in a few days but more severe forms of the disease can occur, particularly in residents who are exposed to another strain of the virus (there are four types) in a subsequent season.

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Giardiasis

Giardiasis is widespread in waterways around Australia. Drinking untreated water from streams and lakes is not recommended. Use water filters and boil or treat water with iodine to help prevent the disease. Symptoms consist of intermittent bad-smelling diarrhoea, abdominal bloating and wind. Effective treatment is available (tinidazole or metronidazole).

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Hepatitis C

This is still a growing problem among intravenous drug users. Blood transfusion services fully screen all blood before use.

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HIV

In Australia, human immunodeficiency virus (HIV) rates have stabilised and levels are similar to other Western countries. Clean needles and syringes are widely available at all chemists.

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Malaria

Although isolated cases have occurred in northern Queensland, malaria is not an ongoing problem in Australia. The risk to travellers is low.

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Meningococcal disease

This disease occurs worldwide and is a risk if you have prolonged stays in dormitory-style accommodation. A vaccine exists for some types of this disease, namely meningococcal A, C, Y and W. There is no vaccine presently available for the viral type of meningitis.

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Ross river fever

The Ross River virus is widespread throughout Australia and is spread by mosquitoes living in marshy areas. In addition to fever, it causes headache, joint and muscular pains and a rash, and resolves after five to seven days. Other symptoms however can take longer to resolve.

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Sexually transmitted diseases (STDs)

Rates of STD infection are similar to most other Western countries. The most common symptoms are pain while passing urine, and a discharge. Infection can be present without symptoms, so seek medical screening after any unprotected sex with a new partner. Throughout the country you’ll find sexual health clinics in all of the major hospitals. Always use a condom with any new sexual partner. Condoms are readily available in chemists and through vending machines in many public places, including toilets.

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Tick typhus

Cases of tick typhus have been reported throughout Australia, but are predominantly found in Queensland and New South Wales. A week or so after being bitten, a dark area forms around the bite, followed by a rash and possible fever, headache and inflamed lymph nodes. The disease is treatable with antibiotics (doxycycline), so see a doctor if you suspect you have been bitten.

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Viral encephalitis

Also known as Murray Valley encephalitis virus, this is spread by mosquitoes and is most common in northern Australia, especially during the wet season (October to March). This potentially serious disease is normally accompanied by headache, muscle pains and sensitivity to light. Residual neurological damage can occur and no specific treatment is available. However, the risk to most travellers is low.

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Availability & cost of health care

Health insurance is essential for all travellers. While health care in Australia is of a high standard and not overly expensive by international standards, considerable costs can build up and repatriation is extremely expensive. Make sure your existing health insurance will cover you – if not, organise extra insurance.

Australia has an excellent health-care system. It’s a mixture of privately run medical clinics and hospitals alongside a system of public hospitals funded by the Australian government. There are excellent specialised, public health facilities for women and children in Australia’s major centres.

The Medicare system covers Australian residents for some of their health-care costs. Visitors from countries with which Australia has a reciprocal health-care agreement are eligible for benefits specified under the Medicare programme. There are agreements currently in place with New Zealand, the UK, the Netherlands, Sweden, Finland, Italy, Malta and Ireland – check the details before departing from these countries. In general, the agreements provide for any episode of ill-health that requires prompt medical attention. For further information, visit www.health.gov.au/internet/wcms/publishing.nsf/content/ozhealth-visitors.

Over-the-counter medications are widely available at privately owned chemists throughout Australia. These include painkillers, antihistamines for allergies, and skin-care products.

You may find that medications readily available over the counter in some countries are only available in Australia by prescription. These include the oral contraceptive pill, most medications for asthma and all antibiotics. If you take medication on a regular basis, bring an adequate supply and ensure you have details of the generic name as brand names may differ between countries.

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Health care in remote areas

In Australia’s remote locations, it is possible there’ll be a significant delay in emergency services reaching you in the event of serious accident or illness. Do not underestimate the vastness between most major outback towns; an increased level of self-reliance and preparation is essential.

Consider taking a wilderness first-aid course, such as those offered at the Wilderness Medicine Institute (www.wmi.net.au). Take a comprehensive first-aid kit that is appropriate for the activities planned, and ensure that you have adequate means of communication. Australia has extensive mobile phone coverage but additional radio communication is important for remote areas. The Royal Flying Doctor Service (www.rfds.org.au) provides an important back-up for remote communities.

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Travellers’ diarrhoea

Tap water is universally safe in Australia. All water other than tap water should be boiled, filtered or chemically disinfected (with iodine tablets) to prevent travellers’ diarrhoea and giardia.

If you develop diarrhoea, be sure to drink plenty of fluids – preferably an oral rehydration solution containing lots of salt and sugar. A few loose stools don’t require treatment but if you start having more than four or five stools a day, you should begin taking an antibiotic (usually a quinolone drug) and an antidiarrhoeal agent (such as loperamide). If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking chills or severe abdominal pain, you should seek medical attention.

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