Whilst volunteering abroad your own personal health and safety are paramount and it is important you are more likely to be exposed to conditions and illnesses than in your home country. It is, therefore, essential that you take the necessary preparations such as having the necessary vaccinations before your trip to reduce the chances of becoming ill. Below we have compiled a list some of the illnesses, which are common in the developing world but are preventable by vaccination. This list is not definitive and it is essential that you contact your local doctor to discuss your own medical history and what vaccinations you will need for your trip.
Cholera
Cholera epidemic typically happen in areas where there are lots of people with very poor hygiene facilities (particularly slums and refugee camps) and areas affected by floods and the rainy seasons. Most travellers should experience minimal risk of exposure to Cholera but the risk is far greater for emergency relief and health workers in refugee camps. There is an effective vaccine available for Cholera administered orally in two doses one to six weeks apart.
Diphtheria
Diphtheria is a bacterial disease spread mainly by exhaled water droplets and occasionally through infected skin lesions. It can be fatal if left untreated. Travellers are at risk when mixing closely with the local population in most developing countries. If they are likely to be at risk, travellers should ensure they have had a diphtheria vaccine within the last 10 years.
Hepatitis A
This disease affects the liver and is usually spread through contaminated food and water or close physical contact with an infected person. It is common in developing countries where sanitary conditions are poor and the safety of drinking water is not adequately controlled. The disease can incubate for 3-5 weeks before illness develops. Adults can take many months to recover from infection. Hepatitus A is prevented by eating ‘safe’ food, drinking ‘safe’ water and pre-travel vaccination. A single vaccine is valid for a minimum of 1 year with one booster vaccine valid for 20+ years.
Hepatitis B
Hepatitis B is a disease, which affects the liver. It is associated with chronic liver problems leading to increased risk of liver cancer or cirrhosis. Approximately 350 million people are carriers worldwide and the general infection rate is far higher in Asia, Africa and China than elsewhere where it can exceed 8% of the population. Many infections cause mild symptoms and may not be recognised, however, infected individuals may develop into life long carriers. hepatitis B is generally spread through unprotected sex and blood (e.g. blood transfusions, dirty needles, piercings and tattoos etc) but may also be transmitted through bodily fluids. All travellers should consider a course of hepatitis B vaccines especially if travelling long term or those working with children. It is a three day course, given over a three week to six month period.
Malaria
Malaria is a common and life threatening disease in the tropics and affects many international travellers each year. It is caused by a parasite introduced by the bite of an infected mosquito that normally feed from sunset to sunrise. Symptoms will develop eight days or more after the infected bite. Severe illness or death may occur within a few hours of the first symptom. Early symptoms include high temperature with shivering, headache, muscle ache and weakness, vomiting and diarrhea. Prompt medical treatment can be life saving. Anti-malarial tablets are recommended for at risk area and the choice of drug will depend on your destination and medical history. Avoiding insect bites using repellents, covering up with treated clothes and sleeping under a mosquito net are also essential protection against malaria.
Meningitis
Sub-Saharan Africa has frequent epidemics of meningitis particularly in the zone stretching from Senegal to Ethiopia during the dry season. Outbreaks have also been known during religious pilgrimages to Saudi Arabia. Meningitis is an inflammation of the surface of the brain. Transmission occurs from direct person to person contact and through inhaling infected droplets. A vaccine for strains A, C, W135 and Y are available and should be considered for extended trips or if mixing closely with the local population.
Polio
Polio is a disease of the central nervous system usually spread through contaminated food and water. Many countries have eradicated Polio through vaccination although it still exists in some African and Asian countries and cases continue to occur worldwide. Boosters are recommended at 10 year intervals if travelling to an endemic country.
Rabies
Rabies is endemic throughout most of the world and causes 60,000 human deaths per year. The virus is carried in the saliva of infected mammals (which may appear normal) and is usually spread by a bite but licks on open wounds and scratches have been enough to transmit the virus to humans. In the event of a possible exposure the area should be washed thoroughly using soap and water, irrigated with iodine based antiseptic or a high percent alcohol and medical attention sought as soon as possible, ideally within 24 hours. The virus affects the nervous system and once symptoms develop death is inevitable – even with good medical care. A pre-exposure course of three vaccines is available and should be administered over a 3-4 week period.
Tetanus
The bacteria that causes Tetanus is present in soil worldwide and disease occurs when the bacteria gets into a would or small cut. The disease leads to uncontrollable muscle spasms and possibly death. Travellers should ensure they have had a Tetanus vaccine within the last 10 years before they travel.
Tuberculosis
TB is mainly spread trough infected respiratory droplets but also through unpasteurised milk. The BCG vaccine provides limited protection and is advised for healthcare workers and those under the age of 16 travelling for more than three months to high-risk countries.
Typhoid
Typhoid is spread through fecal contaminated food and water. The disease is common in areas with poor standards in food hygiene and preparation and where suitable treatment of sewage is lacking. It is possible to contract typhoid from shellfish, raw fruit or vegetables fertilised by ‘night soil’ (human waste). A feverish illness will develop 1-3 weeks after infection and without correct diagnosis and treatment. The disease can spread through the gut wall and cause a serious infection throughout the body. It is also possible to become a carrier of this disease when bacteria remain in the gut after symptoms have resolved but you can continue to be able to infect others. This disease can be prevented by healthy eating and drinking and pre-travel vaccination that will last up to 3 years.
Yellow Fever
This disease is spread by infected mosquitoes normally from sunrise to sunset and is endemic in parts of Sub-Saharan Africa and South America. During outbreaks it has up to a 50% mortality rate and therefore the World Health Organisation (W.H.O.) recommends vaccination against Yellow Fever if travelling to affected regions. In addition, some countries now require a certificate proving vaccination before allowing entry. A single vaccine certificate lasts for ten years and is available only at registered Yellow Fever Vaccination Centres. Insect bite avoidance using repellents, mosquito nets and covering up in clothing treated with Bugproof Clothing Treatment is essential.
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