Tetanus, Diptheria, Whooping Cough & Polio

When embarking on any overseas travel it is important to update certain childhood vaccinations to ensure active immunity. Vaccination programmes in developed countries like Australia have virtually eliminated such diseases as Tetanus, Diphtheria, Polio and Whooping Cough. However, these diseases still pose a threat to the unvaccinated traveller, especially when immediate medical assistance is not available.

Diphtheria is a respiratory disease which causes nasal discharge, fever, malaise and sore throat. A thick grey membrane may develop in the throat which can obstruct swallowing. Infection is spread by respiratory agents such as coughing and sneezing, so it is fairly easy to catch from an infected host. Complications such as pneumonia, respiratory failure and Myocarditis (inflammation of the heart, irregular cardiac rhythms) can develop and immediate medical attention is required. In serious cases, oxygen, nasogastric feeding, and surgical removal of thickened membrane may be required.

Tetanus is an acute infection which affects the nervous system. Known as "Lock-jaw" when the disease was more common, jaw stiffness and muscle spasm are a primary indication of this condition. Muscle stiffness and spasm in the neck, abdomen, back and face are characteristic, as is dysphagia (difficulty swallowing) and exaggerated reflex response. Spasm in respiratory muscles can prevent breathing causing respiratory arrest and cardiac failure which are life-threatening complications.

The spores which cause this disease are universally present in soil and will infect on contact with an open wound. Animal bites, cuts caused by rusted metal, or wounds which may have come into contact with soil are of major concern. Medical attention should be sought as soon as possible after receiving such a wound if immunity is not current. A period of 5-10 years is enough to warrant a booster injection in the event of injury, so if you are heading overseas to a place with substandard medical care, it is advisable to have the vaccination before you leave Australia.

Poliomyelitis virus causes fever, headache, stiff neck, nausea and vomiting, a sore throat and muscle weakness. If the disease is allowed to progress, paralysis, paraplegia and permanent dysfunction and deformity may ensue. Weakness in facial muscles may develop into the inability to chew, swallow or expel saliva, and fluid may be regurgitated through the nose. Overall muscle weakness and dysphagia are characteristic, and the primary danger lies in the threat of respiratory paralysis. Infection is commonly by the faecal-oral route, so personal hygiene in undeveloped areas is essential. An adult dose of vaccine is required if travelling to regions with polio, and the worldwide campaign to eradicate polio has failed. A booster injection is a once off for each person.

Whooping Cough can strike at any age and causes the sufferer 100 days of intractible coughing. Infants can die, so are usually vaccinated. Unfortunately this wears off in adult life, so re-vaccination is recommended. If you can sleep through it your partner may not and life may become pretty unbearable for both of you! Data is limited but it may be worth revaccinating every 6 years.

All these debilitating and potentially life-threatening diseases can be prevented by maintaining current vaccinations. Vaccinations are valid for ten years, and final childhood vaccination is usually given at age 4 1/2 years. An update should be administered at school at age 15 years, but this may not occur.

Vaccination

Vaccination against diphtheria, tetanus, whooping cough and polio can be achieved by a single injection. Individual components are also available, and in combinations of 2 and 3 different vaccines. These simple precautions should be taken prior to any overseas travel, even to developed areas such as Europe and America, in case medical assistance is difficult to obtain. These basic measures will ensure protection against these unpleasant and dangerous conditions.

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