and Blood Borne Infections
(including HIV& Hepatitis B)

Sexually transmitted diseases (STD's) including HIV and hepatitis B are endemic world wide but are more prevalent in certain overseas destinations.

If a traveller indulges in casual sex, the risk of infection with a sexually transmitted disease is high. Gonorrhoea and syphilis may cause serious long-term disability, especially if treatment is delayed. Chlamydia is widespread throughout many countries including European countries and the UK and is often symptomless and goes unnoticed for some time. If untreated it can result in sterility. Hepatitis B and HIV are both also spread sexually and there is currently no cure for either infection.

It is difficult to be sure about the risk of HIV infection in different parts of the world. However, it is clear that the infection is widespread and although the risk is high amongst homosexual and intravenous drug using groups, on a global scale, it is primarily a heterosexually spread disease. Large numbers of the population in many parts of Africa are infected and AIDS is common. Infection is also widespread in other countries in Asia and South America. High proportions of prostitutes are infected.

The greatest increase in the number of HIV cases in the UK are heterosexually acquired and about 75% of this figure can be attributed to sex with a partner abroad.

Travellers should be aware that a person infected with an STD, HIV or Hepatitis B may appear perfectly healthy and may not even know that they are infected.

Casual sexual intercourse is risky. Unprotected sexual intercourse should avoided with anyone other than a regular partner. Always use good quality condoms and carry them rather than try to obtain them at the last minute. Remember, condoms provide good but not complete protection.

Alcohol weakens inhibitions and makes it easier to forget about taking precautions.

Any person who on return has any reason to believe that they may have picked up an infection should get a thorough check up at their local VD clinic.

Intravenous Drug Abuse and Tattoos

Drug-taking might put the traveller in contact with people who are HIV positive and should be avoided. Needle sharing is very dangerous.

Unless you are absolutely certain that the equipment being used is sterile, skin-damaging procedures such as ear piercing, tattooing and acupuncture should be avoided.

Medical Care

In many developing countries standards of infection control may be inadequate to prevent the spread of blood borne infections. Instruments may not be sterilised between patients and re-use of medical supplies, including needles and syringes is common. Travel packs are available from chemists and travel clinics, containing sterile equipment for use in an emergency. These kits should be supplied with a certificate showing contents and the reason for its purchase, useful for customs clearance.

Blood transfusion: In most of Western Europe, North America, Japan and Australasia all donated blood is now screened for HIV antibodies.

However, in many developing countries there may be only the most basic blood transfusion services and much of the blood donated is unscreened. The risks from blood transfusion in such circumstances are high. Thus, points to consider are:

• accidents are the commonest reason for needing a blood transfusion so they should be avoided where possible, e.g. driving carefully.
• blood transfusion should only be accepted when essential.
• pregnancy or any medical condition which may lead to heavy blood loss, should be taken into account before travelling to destinations where good medical facilities will not be available.
• knowing your blood group in advance may make it easier to find a blood donor in an emergency.

 
Hepatitis B Vaccine

Hepatitis B is a serious illness which is spread as described above. Symptoms include chronic fatigue, loss of appetite, fever and jaundice. In a small percentage of individuals the disease may cause permanent damage or liver cancer.

Fortunately there is a vaccine available which gives good protection against the disease. However, it can take up to six months to become effective.

Vaccination is recommended for those travelling to areas of high prevalence who plan to remain there for lengthy periods such as voluntary workers, who may be at risk from medical or dental procedures carried out in those countries.

Short term travellers are not generally at risk but may place themselves at risk by their sexual behaviour. It is given as a course of three 1ml intra-muscular injections, the second 28 days after the first and the third 6 months after the second.