welcome to medical matters i am here again with doktor norm bottom welcome again and when i travel is there anything i should do to protect myself from a shall we say all those little germs and budget are offshore will good question very cosette really is a very common theme at this time of year through the winter months import heading two warmer destinations and want to know what they can do to protect themselves and some people will come very early and some people will come the day before and saying what i need and i'm going to encourage people to come earlier or later about that prevention is bound to get our exactly solely on innovation is really important now and you try sir anything different let's say about going to let's say the u s vs mexico vs offshore sure so all the different countries regions of different countries have different illnesses and diseases that can arise that you need to be aware of so usually what will do is as a physician will sit down with a patient who is travelling to somewhere and one find out where you're baseline immunizations therapies your tetanus diphtheria polio protesters vaccines should be up to date and that should be done every ten years so you shall have your basic immunization in that's regardless of where you're going regards where you're going so just in canada in a war the united states is those diseases a flu shot is always a good idea if you're travelling through the winter months dynamic it if you can have a flu show your regardless it that way you should at least not everybody does but if you're sort of travelling through airports you're gonna be on crowded airplanes it could be in crowds of people in big cities you low exposed boats yeah cruise ships and resort some you can be exposed to potentially germs the last thing you want is to be sick where you're on your holidays disease can be very expensive and you gonna get one shot maybe per winter to spend at anita you want it didn't want you want enjoy even want to concoct feeling i want it was well if we're going to become a back on a matter that get her jet so basically you know a flu shot tetanus shots you know no matter where you going on in the world you should make sure you're up to date with your basic immunizations is really important and then from there we start looking out ok where you going what sort of diseases are endemic to that area what diseases are common months the the native inhabitants that could potentially spread to you so you probably have a compendium of all these so that you know exactly what should be applied shirt who wherever they're going well but when i actually use a website that is available to patients as well center for disease control or cdc cdc so it has is an excellent website so i use that is my resource and patients actually can get in and get the resource as well so basically you can go to the cdc website and the spot we can punch in my country are going to and you click on it and tell you basically what immunizations that you need now if somebody let's say we're going on a sixty day round the world chevreuse getting off it right that presents a bit of around as it does actually because have to know every country that they're going through and what the diseases are now in some cases some are very common through through the care be intertropical travel hepatitis b and hepatitis b so you see ads on tv now is that this time our people travelling twin wrecks which covers hepatitis b and hepatitis b nowadays many people young people special had hepatitis b immunization through school so it doesn't have to be repeated so less and less people actually need that particular vexing the twin rex but what they do need as a habit i d say part of the vaccine hepatitis aids is actually much more contagious than hepatitis b agony is more serious but not how i was unaware that people got to vaccinated in school for three separate seven that's been going on now for long after you and i let her ass well ass ever i did when i am in the last fifteen years or more was so now we have people in their sort of late twenties early thirties who have been fully organised against hepatitis b but maybe not a so you again you might remember i get hepatitis shots when i was in school but did you get the right hepatitis shots for that particular trial what you're doing is happy is very common through some of the caribbean countries some of the asian countries parts of mexico hepatitis c and that's the one you can get from contaminated food contaminated water and things like that our food handlers handled your food whose exposed a kapital say such very important i know there's gonna be one question does it cost sure most of the traveller vaccines that export from the basic ones like i talked about europe basic tenets diphtheria and flu shot are usually vaccines you have to pay for now again the hepatitis b if you ve already had it there's no need to repeat it so there's no need for a twin rex but you would need the habitat to say which is have ex vaccine which would be less expensive than having a dual so sometimes you have to pay for these differences but their southern not covered by the you owe him not covered by not for travel so and some of them are a little bit more expensive again depending on where you are going so other things will look at so happy days a and b are pretty common ones that will recommend if you're travelling outside canada usa europe your fine for through most of europe as you move in the eastern bloc countries some of the more southern mediterranean assumes you move into asia you can it be needing some of these vaccines south america is another one australia you're pretty safe there so this very few countries sweats or a europe north america except mexico australia where basic immunizations are about all you need you say you're safe if you could do australia but does that mean you don't need any vaccination but just the basic ones but the risk of habitat say hepatitis b is as very minimal through there but if you plan on doing a stopover in cambodia or vietnam on your way to the hong kong could sometimes people will do that again you have to be aware of where you gonna be stopping in what are we doing in these locations ah so in other words you should have your itinerary or points cause ports of call if you're on a cruise and wherever you shopping topping off yonder flying or taking a river crews when she gets somewhat exactly so another common one would be malaria vaccine so certain areas malaria is endemic to that area some of the malaria prevention it comes and stop it form used would start a few days before you enter that zone and then you would take for a week or two after leave that zone depending on which malaria medication that you need you say many to know you say medication hosanna injection or is it just to tell it's a pill so it's not an immunization per se it's actually were giving you the they antibiotic to use against malaria in a preventive fashion so it's just working during that time that you're there so it's not alike lifelong type of immunization like that but i say and b that you get the flu shot as you know is only once a year the tennis shot every ten years so they're all a little bit different but you have to be aware what what do i need not another they change every year know that the flu shot changes every year another flu shot that different countries sometimes new diseases will arise in those countries so you have to be aware that the resistance to different strains of malaria may change so you might need different tablets or medication when you go into that zone it changes and changes throughout the year the rainy season and dry season there's it's completely different during the dry season your wrist you're probably less during the rainy season when mosquitoes are higher there's a lot of these illnesses that more rare tropical diseases view looking at yellow fever and malaria and encephalitis some of them are mosquito borne diseases so if you're going to very humid wet country the mosquitoes just love that and they can be more likely to come after you so having certain vaccinations will be important to reduce that riskin and malaria tablets but reducing arrest you eating bet by mosquitos is important so having insect repellent sleeping with netting over top of you because unfortunately there is a bunch of diseases out their tropical diseases that there is no protection for always end right so again knowing before you go into those countries i met retford ding gay japanese encephalitis like the less less goes on i better make sure that i'm taking protection is giving my hepatitis shots not gonna protect me from getting encephalitis to protect myself against mosquito so these are unique to specific places to specific places that's right and again asia there's sort of types of diseases there are south america caribbean sometimes a bit on overlap a yellow fever is one that we do have a vaccine for but it's not easy to get the vaccines have you going to a country where there is a risk of getting yellow fever you should be immunize before you go into that country if you go into a country that is at risk for yellow fever and u donkey immunized beforehand you think you're gonna be ok in that country you want to take that risk but if you go from say one of those countries that has yellow fever in it to another country that are the country may want proof of immunization for you to enter their enter their country they know you ve can and i dont know offhand i can remember the the yellow fever countries right off the bat i think some of them are the indonesian country so let's hear going from indonesia to maybe australia and austria might say well you can't come in unless you ve had yellow fever vaccine because you ve come from a yellow fever country and we don't want the yellow fever and our borders now one of the things you said here and that's rather interesting if you're going somewhere i guess you should have an eye i can at least say i'm going to africa break will you have just going to africa doesn't cut it does it because there are probably different places in africa that you're going into the sahara versus the congo versus south africa there all different geography sent so they all carry different different diseases diseases ok how having said that how long does it take if i come to you to morrow and say i'm going to africa next week sure isn't enough time for you to get that immunization or is it will again depending on the country but i would say in general no things like the hepatitis shots if you ve not immunized against it it may take a couple weeks after your shot before you're the vaccine is actually effective so i gave you the shot today you're on the plane tomorrow then you still may be at risk for picking up that disease somebody you might not have that particular shot that's what i'm saying so how long would it take you to get it before you can actually administration then how not all the same of amazing admiration differ so again the have wrecked twin rex some those basic ones do coral which is when we use for cholera prevention and travis diarrhea prevention sometimes there are mostly pharmacies carry those so i would give you the prescription you would go to the drugstore pick it up if it's an injectable you bring it back to your family physician for everyone gave you that some of them are self administered so the duke oral which reduces risk of travellers diary and cholera in mixed with water in drink it up and you do that two weeks prior to hear your trip so you need a limited time for these things to become effective you need to make sure you have your malaria tablets they may be a little more difficult to obtain depending on the type of malaria tat what you need to your pharmacy may need two to three to seven days to bring it in and if you need yellow fever vaccine you pretty well you have to go to a travel clinic as are the only ones licensed to actually saw why the yellow fever vaccine to very expensive vaccine don't ask me what it is because i'm not sure but i've been told of the vaccines it's very expensive studies at a yet you have to go to travel tack and travel clinics are not covered throw him so you have to pay consulting fee to go in they would reveal your trip to make sure that you do qualify or require the yellow fever and then they're going to administer the vaccine and charge you whatever the causes for that your fiancee variable what i was trying to get at was few need that particular vaccine you re not have it in stock soldier if you're going in two weeks and it takes two weeks for it to become effective and you'd have to come in to see you maybe two or three weeks or prior to going away so it's not just i walked in and you give it to me now but sometimes that the pharmacies do carry some of the basic once if you're going to go anywhere through the caribbean mexico those are very common destinations the pharmacies know that they want to provide good service so they used to keep those in stock so literally i could give you a prescription for hepatitis vaccine right now you can probably pick it up next door had to the office and get your shot and you're done and then you need a couple weeks for it to become effective so at least a couple weeks ahead of time even then it's a rush is let's see there's been a run on twin rick's vaccine this week in pharmacies are running low in order to start or socked me wait a week or two you may not have your your coverage right but it is a good idea i've sir mentioned do coral another common one would be typhoid vaccine and other communist rabies vaccine let's say you're going down to work in central america for a month on an internship and you can be going through the jungle whatever you know your risk of being bit by a batter rabbit animal and even a domestick animal they will have the same laws down there as far as vaccinating your dogs against rabies you may be at risk if he had but by a dog or cat fur developing rabies so the rabies risk so there's lots of interesting information on the city website and you really have to know what am i doing i'm just going to resort in the caribbean elaine on them beach or am i gonna be going through the jungles making be eating with the locals something to be preparing oil and food and are going to be working with animals so a lot of different things that actually is spelled out on the cdc website as well so it allows you to modify your searching about so it's easy to navigate the cdc centre so easy i can do it so i'll try it at all i gotta do it anyway here s an idea knowing your plan knowing ahead of time is important make sure you get your basic immunizations you know you could say on august rabies vaccine but it won't have a flu shot but the odds of you getting flu are much higher than getting rabies and both will ruin your holiday so is there anything further you can add to that no i think you'd be prepared and always get your sun screen be ready for your trip you want to enjoy it and being good health and that doesn't matter well you're going in the middle of the summer or in the middle of the winter or any time of year exactly ass doktor bottom thank you very much for bringing us up to speed on what you need to protect yourself when you leave this country you bet thanks doctor but if you're welcome that set for this addition of medical matters if you have a topic you'd like us to discuss email us at medical matters canoe fm dot com it will do our best to discuss it on leader programme medical matters can be heard every monday at eleven forty five a m thirsty at five forty five pm and sunday at ten a m on canoe fm one hundred point nine your community radio station for the halliburton islands my name is very well help thanks for listening