Travel Health Australia

Australia has high standards of hygiene, and there are few exceptional health hazards – at least in terms of disease. No vaccination certificates are required unless you’ve come from a yellow-fever zone within the past week. Standards in Australia’s hospitals are also very high, and medical costs are reasonable in comparison to Europe and the US.

The national healthcare scheme, Medicare, offers a reciprocal arrangement – free essential health care – for New Zealanders, the British and Irish, and some Europeans. If you are a resident of a country without a reciprocal healthcare agreement, such as South Africa, the US or Canada, among others, ensure that you have adequate health insurance coverage before you travel. Similarly, you will need extended cover for adventure activities such as diving and climbing. Most policies cover bushwalking and surfing, though it pays to check before you travel.

Nationals of the UK, Ireland, New Zealand, Italy, Belgium, Malta, Finland, the Netherlands, Norway, Slovenia and Sweden have, under their country’s reciprocal health agreement, access to medically necessary treatment in hospitals and at GPs. Each country’s specific arrangement varies; consult humanservices.gov.au for full details. In general this arrangement allows for medically necessary treatment in public hospitals and casualty departments (though the ambulance ride to get you there isn’t covered). For most under the scheme, but not New Zealand or Ireland, visits to the GP are also included. You pay upfront (about Aus$50 minimum), with two-thirds of your fee reimbursed by Medicare, or fill in a bulk bill form and the doctor bills Medicare directly (so you don’t pay anything).

Reimbursements are collected from a Medicare Centre by presenting your doctor’s bill together with a Medicare Card, available from any Medicare Centre. It’s advisable to obtain one if you are eligible and staying in Australia for a while, particularly if on extended working holidays. Applicants need to bring a passport and their home country National Health documents.

Dental treatment is not included in the reciprocal health agreements. If you find yourself in need of dental treatment in one of the larger cities, try the dental hospital, where dental students may be able to treat you at a reasonable price.

The sun

Australia’s biggest health issue is one of its chief attractions: sunshine. You’d think by now every visitor would be aware that a sunny day in London, Toronto or even Miami is not the same as one in Cairns, and that Australian ultraviolet rays are so damaging. Apparently not – most visitors still get burned at some point, so special care is essential.

Two out of three Australians are likely to develop skin cancer in their lifetime, the world’s highest incidence rate. Around 95–99 per cent of this is caused by exposure to the sun and about five percent of these cancers will develop into fatal melanomas; in 2011, over 2000 Australians died from skin cancer. Looking at the ravaged complexions of some older Australians (who had prolonged exposure before there was an awareness of skin cancer) should be enough to make you use lashings of the highest-factor sun block (SPF 35+).

Sunscreen should not be used on babies less than six months old: instead, keep them out of direct sunlight. The war paint on the noses of surfers and small children is actually zinc cream; the thick, sticky, waterproof cream provides a total blockout and is particularly useful when applied to protruding parts of the body, such as noses and shoulders.

Australians are now fully aware of the sun’s dangers, and you’re constantly reminded to “Slip, Slop, Slap”, an old government catchphrase to remind Aussies to slip on a T-shirt, slop on some sun block and slap on a hat – still sound advice. Pay attention to any moles on your body: if you notice any changes, either during or after your trip, see a doctor; cancerous melanomas are generally easily removed if caught early. To prevent headaches – and cataracts in the long term – wear sunglasses; look for “UV block” ratings when you buy a pair.

The sun can also cause heat exhaustion and sunstroke, so as well as covering up, stay in the shade if you can. Drink plenty of liquids: on hot days when walking, experts advise drinking a litre of water an hour. Alcohol and sun don’t mix well; remember that more than one cold beer will dehydrate you.

Other health hazards

In the hot and humid north, tropical ear, a painful fungal infection of the ear canal, is an issue. Treatment is with ear drops, and if you think you might be susceptible, use them after getting wet regardless.

Water purity is a potential issue when bushwalking – gone are the days when you could guarantee that every creek and borehole in the bush was safe. E coli and giardia are the main concerns – dehydration from gastroenteritis is a real danger in the bush – so boil, filter or treat water supplies to guarantee their purity. Better still, seek local knowledge before you walk.

Wildlife dangers

The danger from wildlife is much over-rated. Snake and spider bites are central to the perilous Outback myth, and crocodile and shark attacks are widely publicized, but all are extremely rare. The widest-spread threat is disease passed on by mosquitoes. Jellyfish can be venomous and the stings are extremely painful. Reefs have their own minor hazards to keep in mind.

Mosquitoes

Mozzies are spread countrywide, and, while malaria has been eradicated, in the tropical north there are outbreaks of Ross River fever and dengue fever, both chronically debilitating viruses transmitted by mosquito bite that are potentially fatal to children and the elderly. Outbreaks of Ross River fever are most common in coastal marshy areas of the Northern Territory, Queensland and north Western Australia but can occur as far south as South Australia – reason enough not to be too blasé about mozzie bites.

Crocodiles

To minimize danger from saltwater crocodiles (which actually range far inland), keep your distance. If you’re camping in the bush within 100km of the northern coast between Broome (WA) and Rockhampton (QLD), make sure your tent is at least 50m from waterholes or creeks, don’t collect water at the same spot every day or leave any rubbish out, and always seek local advice before pitching camp. Four-wheel drivers should take extra care when walking creeks prior to driving across.

Snakes

Snakes almost always try to avoid people – you’ll probably never even see one. They’re more likely to be active in hot weather, when you should be more careful, and keep an eye out in open patches of woodland or scrub in the morning, when they often sunbathe. Treat snakes with respect and you’re unlikely to be bitten: most bites occur when people try to catch or kill them. Wear boots and long trousers when hiking through undergrowth, collect firewood carefully, and, in the event of a confrontation, back off. Sea snakes sometimes find divers intriguing, even wrapping themselves around limbs, but they’re seldom aggressive. If bitten by a snake, use a crepe bandage to bind the entire limb firmly and splint it as if for a sprain; this slows the distribution of venom into the lymphatic system. Don’t clean the bite area (venom around the bite can identify the species, making treatment easier), and don’t slash the bite or apply a tourniquet. Treat all bites as serious and always seek immediate medical attention, but remember: not all snakes are venomous, not all venomous snakes inject a lethal dose of venom every time they bite, and death from snakebite is rare.

Spiders

Two spiders whose bites could be fatal are the funnel-web, a black, stocky creature found in the Sydney area, and the small redback usually found in dark, dry locations all over Australia (ie outdoor toilets, among shrubs, under rocks and timber logs), although they are less common in colder regions like Tasmania. Both are prolific in January and February, when there is the greatest danger of bites – that said there hasn’t been a fatality from either species since antivenoms were developed in 1981 and 1956 respectively. Treat funnel-web bites as for snakebites, and apply ice to redback wounds to relieve pain; if bitten by either, get to a hospital immediately. Other spiders, centipedes, scorpions and ants can deliver painful wounds but only cause health problems if you have allergies.

Ticks, mites and leeches

The bane of bushwalkers, ticks, mites and leeches can be kept off of legs and out of socks with gaiters or repellent sprayed over shoes and leggings. Ticks are venomous – they produce the most toxins during feeding in spring – and can transmit disease. They attach themselves to long grass and bushes, latching on to passing animals that brush past. The most common complaint is discomfort and allergic reactions. However, the paralysis tick, a native of Australia, can be found from Cairns to Lakes Entrance, east Victoria, and is life-threatening. This tick causes more problems to humans because the tick can feed undiscovered over several days, thereby passing on toxins.

Check yourself over after a hike: look for local stinging and swelling (usually just inside the hairline) and you’ll find either a tiny black dot or a pea-sized animal attached, depending on which species has bitten you. Use fine-pointed tweezers and grasp it as close to the skin as possible, and gently pull the tick out, trying to avoid squeezing the animal’s body, which will inject more venom. Seek medical attention if you are not successful – a medic will need to cut out the tick’s mouthparts with a scalpel. Ouch. Incidentally, old bushwalker tales about dabbing kerosene, alcohol or insect repellent on the ticks before pulling them out are ill-advised – medical advice suggests this causes the ticks to inject more toxins into the host.

Mites cause an infuriating rash known as “scrub itch” wherever your clothes are tightest, such as around the hips and ankles. Unfortunately, there’s not much you can do except take antihistamines and wait a day or two for the itching to stop. Leeches are gruesome but harmless: insect repellent, fire or salt gets them off the skin, or twirl them gently with a fingertip until they let go, then flick them off. Bites may bleed heavily for some time.

Jellyfish

The threat from various jellyfish (aka “stingers”) in coastal tropical waters in summer needs to be taken seriously. Unfortunately, both the tiny irukandji and saucer-sized box jellyfish are virtually invisible in water. Irukandji have initially painless stings, but their venom causes “irukandji syndrome”, which can be fatal. Its symptoms are somewhat similar to those of decompression illness: elevated heart rate and increased blood pressure and, in addition, excruciating pain, anxiety and an overwhelming sense of dread. Box jellyfish stings leave permanent red weals, and the venom can cause rapid unconsciousness and even kill by paralyzing the heart muscles. Treat stinger victims by dousing the sting area (front and back) with liberal amounts of vinegar – which you may find in small stands on affected beaches, such as North Queensland. Never rub with sand or towels, or attempt to remove tentacles from the skin – both could trigger the release of more venom; apply mouth-to-mouth resuscitation if needed, and get the victim to hospital for treatment. Whatever the locals are doing, don’t risk swimming anywhere on tropical beaches during stinger season (roughly Oct–May) – tiny irukandji can pass through the nets designed to stop box jellyfish.

Better known as a Portugese Man o’War, bluebottle jellyfish (or “bluies”) are widespread. They deliver a searing sting and a rash for an hour or so, but are only dangerous if you are allergic to the venom. Quickly wash off any tentacles stuck to the skin.

Bushfires

The sheer devastation of bushfires in the last decade has led Australia to take its fire-hazard more seriously than ever. Although you’re highly unlikely to find yourself in the path of a raging bushfire – government warnings are now excellent – it doesn’t hurt to know survival basics. Government advice is to take shelter if you cannot escape a fire front: stay in the house when the fire front is passing – usually five to fifteen minutes – and take shelter furthest from the front, albeit while maintaining an easy escape route from the building. A room with two exits and a water supply such as a laundry or a kitchen are advised; people have died sheltering in bathrooms and single-entry rooms. If you must evacuate do so into an area that has already been burnt and go as far from the approaching fire as possible – toxic smoke and fumes from houses are a danger. And wear long sleeves, long trousers and strong leather boots against radiant heat.

Reef hazards

Stories of shark attacks, savage octopuses and giant clams all make good press, but are mostly the stuff of fiction. However, there are a few things at the Reef capable of putting a dampener on your holiday, and it makes sense to be careful. The best protection is simply to look and not touch, as nothing is actively out to harm you.

Seasickness and sunburn are the two most common problems to afflict visitors to the Reef, so take precautions. Coral and shell cuts become badly infected if not treated immediately by removing any fragments and dousing with antiseptic. Some corals can also give you a nasty sting, but this is more a warning to keep away in future than something to worry about seriously. Animals to avoid tend to be small. Some dangerous jellyfish are found at the Reef during summer – wear a protective Lycra “stinger suit” or full wet suit with hood. Conical cone shells are home to a fish-eating snail armed with a venomous barb that has caused fatalities. Don’t pick them up: there is no “safe” end to hold them. Similarly, the shy, small, blue-ringed octopus has a fatal bite and should never be handled. Stonefish are camouflaged so that they’re almost impossible to distinguish from a rock or lump of coral. They spend their days immobile, protected from attack by a series of venomous spines along their back. If you tread on one, you’ll end up in hospital – an excellent argument against reef-walking. Of the larger animals, rays are flattened fish with a sharp tail-spine capable of causing deep wounds – don’t swim close over sandy floors where they hide. At the Reef, the most commonly encountered sharks are the black-tip and white-tip varieties, and the bottom-dwelling, aptly named carpet shark, or wobbegong – all of these are inoffensive unless hassled.