Travel medicine – Dr Sailer’s medical practice in Munich

Yellow fever

Widespread in areas of South America and Africa and required by law for the countries in these areas

Hepatitis B

Severe and common disease in many third world countries and emerging economies. Transmission through sexual contact and blood.

Hepatitis A

Severe and common disease in many third world countries and emerging economies. Transmission through poor hygiene (water, food, smear infection)

Typhus

Disease in many Third World countries and emerging economies. Transmission through poor hygiene (water, food, smear infection)

Cholera

Rarer disease in many third world countries and newly industrialising countries. Transmission through poor hygiene (water, food, smear infection). This vaccination has gained in importance because it appears to be effective against the most common pathogens of traveller’s diarrhoea.

Japan. Encephalitis

This viral infection leads to severe infections in exceptional cases. Useful in exceptional cases for certain trips or travellers.

Rabies

As this is an absolutely fatal disease that is transmitted by bite or scratch injuries from mammals (saliva, blood), it should definitely be carried out when travelling to endangered areas, especially when children are travelling who cannot always state whether they have had risk contact. A rigid vaccination schedule must be adhered to when travelling!

Tetanus, diphtheria, polio

These vaccinations, which are also necessary for Central Europe, should always be up to date, especially due to the omnipresent risk of tetanus.

Travellers’ diarrhoea

see cholera

TBE

Required when travelling or staying in certain endemic areas of central and north-eastern Europe

Pneumococcal vaccination and influenza vaccination

Indicated for risk groups. Outside Europe, the flu season is staggered.

Meningococcal vaccination

Meningococcal infection often occurs as a fatal disease in young people, which is why it is not only necessary when travelling to exotic countries (required by law for pilgrimages to Mecca).

Advice on and implementation of the necessary and medically advisable vaccinations prescribed for your planned trip and further advice on preventive and therapeutic measures during your trip, in particular advice on existing chronic illnesses (e.g. diabetes, vascular, heart and lung diseases).

Malaria prophylaxis is used to prevent infection with malaria pathogens. Vaccinations against malaria are currently being developed. Prophylaxis is still carried out by taking tablets before and during the journey. Three drugs are currently medically advisable (Mefloquine, Lariam, Malarone). The prescription is made individually according to personal circumstances, the countries being travelled to and the travel arrangements.

To support malaria prophylaxis, good insect protection should be ensured (see: Protection against insects, parasites, etc.). Furthermore, stand-by medication may be sufficient for some countries you are travelling to.

Course of the malaria disease

Nowadays, malaria is mainly spread by the bite of a female anopheles mosquito, which transmits the malaria pathogen (plasmodia). After infection, fever often occurs – with chills when the fever rises and sweating when the fever drops.

Other symptoms and complications include Impaired consciousness (which can extend to coma), paralysis, seizures, anaemia (blood deficiency) and acute kidney failure, gastrointestinal tract symptoms (such as diarrhoea). Lung involvement can occur in up to 10 % of cases. Hypoglycaemia may occur in pregnant women and children.

Sitting for long periods on aeroplanes, trains and buses without moving the legs sufficiently can lead to circulatory problems in the leg veins. This in turn can lead to leg vein thrombosis if you have a predisposition, pre-existing conditions or are taking certain medications. Depending on the duration, type of transfer and individual pre-existing conditions, individual preventive measures (wearing compression stockings, regular movement of the legs, administration of medication that inhibits blood clotting) are necessary.

The first-aid kit should be tailored to the country being travelled to and the individual needs of the patient. A sufficient quantity of any necessary long-term medication must be carried, and the times at which the medication is taken should be adapted to the time difference in the country being travelled to. It should also contain easy-to-use medication for typical travel complaints. This also includes adequate sun protection for the skin.

• Advice on special features of medical outpatient and inpatient care
• Common illnesses in the destination country and appropriate first aid after contact with poisonous animals or animal bites such as spiders, scorpions, snakes, poisonous fish and jellyfish
• First aid measures for travel and seasickness, heat illness, jet lag, barotrauma, barotitis

Necessary hygiene and protective measures against insects, parasites, harmful animals and plants should be observed in order to prevent infections of the respiratory organs, the gastrointestinal tract and the skin. They protect against mites, skin fungus, lice, fleas, predatory bugs, mosquitoes, horseflies and the diseases they transmit, such as malaria, sleeping sickness, dengue fever, schistosomiasis and yellow fever.

These include: prudent behaviour (in the jungle), proper protective clothing, mosquito nets, insect sprays, repellents, food and clothing hygiene.

Consultations, examinations and vaccinations for travel medicine and malaria prophylaxis and the necessary vaccines and medication are services that you have to pay for yourself as they are not illness-related. Increasingly, statutory and private health insurance companies have begun to reimburse the costs of travel vaccinations and, if necessary, malaria prophylaxis, as they serve to prevent and avoid infection and thus reduce later treatment costs. Furthermore, diseases should not be brought into Germany.