Make sure you are up-to-date on routine vaccines before every trip, such as:

• measles-mumps-rubella (MMR) vaccine
• diphtheria-tetanus-pertussis vaccine
• varicella (chickenpox) vaccine
• influenza vaccine

Dengue

Dengue fever is an infection transmitted by mosquitoes in tropical and subtropical areas of the world. There is no vaccine to prevent infection, so you should protect yourself from mosquito bites at all times in dengue areas.

Altitude sickness

Parts of this country are at high altitude. Altitude sickness is a risk at altitudes greater than 3000m and can be fatal. Symptoms include breathlessness, lethargy, confusion and coughing due to fluid in the lungs.

The best way to prevent altitude sickness is to ascend slowly, by less than 300m per day once over 3000m. Other tips to prevent altitude sickness include:

• Your doctor can prescribe medications such as acetazolamide to prevent altitude sickness.
• Increase your fluid intake. You may need up to seven litres every day.
• Avoid cigarettes and alcohol.
• Be aware that you are at increased risk of altitude sickness if you have experienced it before.

Chagas Disease

Chagas disease is caused by a parasite called Trypanosoma cruzi. It is spread by insects known as triatomine or “kissing bugs”, common in South America, Central America and Mexico.

You can prevent Chagas disease by:

• Avoiding sleeping in mud, thatch or adobe housees. These types of residences are more likely to harbor triatomine bugs.
• Use insecticide-soaked netting over your bed when sleeping in thatch, mud or adobe houses.
• Use insecticides to remove insects from your residence.
• Use insect repellent on exposed skin.

Soil-transmitted helminths

Wearing enclosed footwear in undeveloped areas is important to prevent hookworm. Hookworms penetrate through intact skin such as walking with bare feet, and can cause severe gastrointestinal and skin infections.

Travellers diarrhoea

Traveller’s diarrhoea affects roughly 20-50% of overseas travellers. It is caused by ingesting contaminated food or water. The bacteria that trigger the illness may appear harmless to the local population, usually because they have developed immunity to them. Symptoms include abdominal bloating, cramps, nausea, fevers and diarrhoea.

Tips to prevent traveller’s diarrhoea:

• Avoid contaminated foods such as raw or peeled vegetables, undercooked meats, unpasteurised dairy products and food from street vendors.
• Avoid drinking or brushing your teeth with tap water
• Buy bottled water to drink
• Boil tap water for at least 5 minutes before drinking it
• Avoid drinks that contain ice
• Avoid using tap water to wash your fruit and vegetables
• Wash your hands and eat at reputable restaurants.