You should avoid mosquito bites to prevent malaria.

You may need to take prescription medicine before, during, and after your trip to prevent malaria, depending on your travel plans, such as where you are going, when you are traveling, and if you are spending a lot of time outdoors or sleeping outside. Effective options would include doxycycline, AP along China-Burma border in the western part of Yunnan province and doxycycline, atovaquone/proguanil or mefloquine in Hainan and other parts of Yunnan province (NOTE: travellers to cities and popular tourist areas, including Yangtze River cruises, are not at risk and do not need to take chemoprophylaxis).

Malaria is present from North of 33º N, Jul-Nov; between 25º N and 33º N, May-Dec; south of 25º N, Jan-Dec in rural areas only of the following provinces: (at elevations of 1,500 metres and below) Hainan, Yunnan, Fuijan, Guangdong, Guangxi, Guizhou, Sichuan, Tibet (in the Zangbo River valley only), Anhui, Hubei, Hunan, Jiangsu, Jiangxi, and Shandong.

Rabies can be found in dogs, bats, and other mammals in this country, but it is not a major risk to most travellers. The vaccine is only recommended for these groups:

• Travellers involved in outdoor and other activities in remote areas that put them at risk for animal bites (such as adventure travel and caving).
• People who will be working with or around animals (such as veterinarians, wildlife professionals, and researchers).
• People who are taking long trips or moving to remote areas

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.

Japanese encephalitis vaccine

Japanese encephalitis is found in many part of Asia, the Indian subcontinent, Southeast Asia and China, especially in the wet season

You may need this vaccine if:

• Your trip will last more than a month, depending on where in the country you are going and what time of year you are traveling.
• You plan to spend extended periods in rural areas or will be spending a lot of time outdoors

Melioidosis

Melioidosis is an infectious disease caused by a bacterium (Burkholderia pseudomallei) which lives in soil and water. It is an important public health issue in parts of Vietnam and northern Australia.

In endemic areas, people (rice-paddy farmers in particular) are warned to avoid contact with soil, mud, and surface water where possible

Schistosomiasis

Bilharzia (schistosomiasis) is a common, serious infection caused by a parasite found in rivers, streams and lakes in sub-Saharan Africa, Asia and South America. The parasite infects people by penetrating their skin then developing in the person’s blood stream.

No vaccine is available. To avoid bilharzia:

• avoid paddling, swimming and washing in fresh water – only swim in the sea or chlorinated swimming pools
• take waterproof trousers and boots with you if there’s a chance you’ll need to cross a stream or river
• boil or filter water before drinking – as the parasites could burrow into your lips or mouth if you drink contaminated water
• avoid medicines sold locally that are advertised to treat or prevent schistosomiasis – these are often either fake, substandard, ineffective or not given at the correct dosage
• don’t rely on assurances from hotels, tourist boards or similar that a particular stretch of water is safe – there have been reports of some organisations downplaying the risks

Tick-borne encephalitis (Rickettsia)

Tickborne encephalitis is a viral infection of the central nervous system transmitted by tick bites. It most commonly affects people who visit or work in forests or fields. Infection also can be acquired by consuming unpasteurised dairy products from infected cows, goats or sheep.

An effective vaccine is available but can only be obtained via a Special Access Scheme. It is only recommended for travellers who plan to spend extended periods in affected areas, especially if extensive rural exposure is planned during warmer months

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.

Tuberculosis

Tuberculosis is a disease caused by infection with the bacteria Mycobacterium tuberculosis. Tuberculosis can damage a person’s lungs or other parts of the body and cause serious illness.

• Avoid exposure to people who have active tuberculosis.
• Only consume pasteurized milk products.
• Travellers at higher risk should be tested for tuberculosis upon their return home.
• There is a vaccine available which confers partial protection. Speak to your doctor to determine if this is recommended.