Aussies warned over hepatitis and meds
Medical experts in Australia are warning travellers to be aware of the risk of contracting hepatitis B and C when travelling in the Asia-Pacific region
Helen Tyrell, the CEO of Hepatitis Australia, has warned that experts are anticipating a rise in the number of cases over the coming years, based on analysis of the lifestyles of holidaymakers, their choices of destination and their holidaying habits. Hepatitis C is 10-times more prevalent in some countries in the Asia-Pacific region – including Bali, Vietnam, Thailand and the Philippines – than it is in Australia, and although there is currently a vaccine for hepatitis B there is none for C, which is referred to as ‘the silent killer’, due to the fact that many who contract it do not display symptoms for years, sometimes decades, before it begins to attack their liver, resulting in very serious health issues. The risk of cancer is also increased in sufferers.
“What we want all Australians to know before they head off on their overseas holiday is that any activity in which the skin is pierced can lead to infection with hepatitis,” said Tyrell, “and yes, that can include pedicures, tattoos and piercings, and even getting dental work done abroad.” Even a microscopic amount of blood has the potential to transmit the disease if it comes into contact with an open wound.
A lack of public knowledge about the disease in Australia has been blamed for health authorities’ pessimistic outlook, and Tyrell has welcomed the recent decision to add simeprevir, which is used to treat genotype 1 chronic hepatitis C, to the country’s Pharmaceutical Benefits Scheme. “The use of simeprevir as an addition to pegylated interferon and ribavirin to treat people with genotype 1 hepatitis C is an important step forward in the evolution of hepatitis C treatment,” she said, while also criticising the Pharmaceutical Benefit Advisory Committee’s decision to decline an application to subsidise antiviral medication sofosbuvir. “It’s a sad day when access to game-changing therapy is denied. This is a bad outcome for people living with hepatitis C.”
Medication advice
Australian travellers have also been offered advice on what to do about any medications they make take when heading overseas, in an article by Travelvax, the contents of which are easily applicable to travellers of other nationalities. “What if you want to take them overseas?” asks the article. “How likely is it that you’d be stopped and your medication or device confiscated? What if you were refused entry – or worse, detained on suspicion of attempting to important drugs that – at least in that country – are banned? These scenarios are not as rare or far-fetched as you might think, particularly in non-English speaking countries that take a hard line on drug smuggling.”
While for most travellers who take well-recognised, prescribed medications a signed letter from a GP is enough, some may need to use restricted drugs such as psychotropic or narcotic medications, and this could prove a problem – for example, the United Arab Emirates bans drugs containing codeine. Doctors of travel medicine should be able to offer pre-travel country-specific advice, although this may be a problem for regular GPs, and in Australia, for example, there are three government bodies that provide useful information for tourists. Often, however, information on restrictions that different countries impose can only be found via that country’s local embassy or consulate, and ‘more often than not’, according to Travelvax, ‘travellers are likely to be sorely disappointed with the quality of the advice embassies or consulates provide’. The organisation cites a recent study published in the Travel Medicine and Infectious Diseases journal, the findings of which painted a pretty negative picture of the quality of information provided by many consulates.
The solution, insofar as there is one, is to plan ahead as much as possible. Travellers are advised to begin their research early, maybe months in advance if possible, and to utilise resources such as the International Narcotic Control Board and websites such as Smartraveller.
“Ultimately,” said Dr Moses Mutie, head of the research team that carried out the study, “I think at least part of the answer is an official, internationally recognised certificate – just like the one for yellow fever, which is a mandatory requirement for some destinations in Africa and South America. An official certificate that is stamped and signed by an authorised medical professional or pharmacist should be enough to allow a traveller to carry legitimate prescription medicine or a device they might need [such as an oxygen bottle or neurostimulators] into a country.”