Tetanus is caused by a toxin released from Clostridium tetani and occurs worldwide.  Tetanus bacteria are present in soil and manure and may be introduced through open wounds such as a puncture wound, burn or scratch.

Prevention

Travellers should thoroughly clean all wounds and seek appropriate medical attention.

Tetanus vaccination

• Travellers should have completed a primary vaccination course according to the UK schedule.
• If travelling to a country where medical facilities may be limited, a booster dose of a tetanus-containing vaccine is recommended if the last dose was more than ten years ago even if five doses of vaccine have been given previously.

Country specific information on medical facilities may be found in the ‘health’ section of the FCO foreign travel advice website.

Tetanus in brief

Typhoid is a bacterial infection transmitted through contaminated food and water. Previous typhoid illness may only partially protect against re-infection.

Those at increased risk include travellers visiting friends and relatives, those in contact with an infected person, young children, long-stay travellers, and those visiting areas of poor sanitation.

Prevention

All travellers should take care with personal, food and water hygiene.

Typhoid vaccination

• Both oral and injectable typhoid vaccinations are available and are recommended for those at increased risk.
• Vaccination could be considered for other travellers.

Typhoid in brief

Hepatitis A is a viral infection transmitted through contaminated food and water or by direct contact with an infectious person. Symptoms are often mild or absent in young children, but the disease becomes more serious with advancing age. Recovery can vary from weeks to months. Following hepatitis A illness immunity is lifelong.

Those at increased risk include travellers visiting friends and relatives, long-stay travellers, and those visiting areas of poor sanitation.

Prevention

All travellers should take care with personal, food and water hygiene.

Hepatitis A vaccination

Vaccination is recommended for those whose activities put them at increased risk. This includes:

• those who are staying with or visiting the local population
• frequent and/or long-stay travellers to areas where sanitation and food hygiene are likely to be poor
• adventure travellers visiting rural areas and staying in basic accommodation such as backpackers
• those with existing medical conditions such as liver disease or haemophilia
• men who have sex with men
• injecting drug users
• those who may be exposed to the virus through their work
• those going to areas of hepatitis A outbreaks who have limited access to safe water and medical care
  
  

Hepatitis A in brief

Hepatitis B is a viral infection; it is transmitted by exposure to infected blood or body fluids. This mostly occurs during sexual contact or as a result of blood-to-blood contact (for example from contaminated equipment during medical and dental procedures, tattooing or body piercing procedures, and sharing of intravenous needles). Mothers with the virus can also transmit the infection to their baby during childbirth.

Hepatitis B in Reunion

2% or more of the population are known or thought to be persistently infected with the hepatitis B virus (intermediate/high prevalence).

Prevention

Travellers should avoid contact with blood or body fluids. This includes:

• avoiding unprotected sexual intercourse.
• avoiding tattooing, piercing, public shaving, and acupuncture (unless sterile equipment is used).
• not sharing needles or other injection equipment.
• following universal precautions if working in a medical/dental/high risk setting.

A sterile medical equipment kit may be helpful when travelling to resource poor areas.

Hepatitis B vaccination

Vaccination could be considered for all travellers, and is recommended for those whose activities or medical history put them at increased risk including:

• those who may have unprotected sex.
• those who may be exposed to contaminated needles through injecting drug use.
• those who may be exposed to blood or body fluids through their work (e.g. health workers).
• those who may be exposed to contaminated needles as a result of having medical or dental care e.g. those with pre-existing medical conditions and those travelling for medical care abroad including those intending to receive renal dialysis overseas.
• long-stay travellers
• those who are participating in contact sports.
• families adopting children from this country.

Hepatitis B in brief

Although rare, bat lyssaviruses (bat rabies) can be transmitted to humans or other animals following contact with the saliva of an infected bat most often by a bite. The disease can also be transmitted if the saliva of an infected bat gets into open wounds or mucous membranes (such as on the eye, nose or mouth). Bat lyssaviruses can cause disease in humans that is indistinguishable from rabies.

Symptoms can take some time to develop, but when they do the condition is almost always fatal.

The risk to most travellers is low. However, it is increased for certain occupations for example bat handlers and veterinarians, or certain activities such as caving.

Bat Lyssavirus in Reunion

Rabies has not been reported in domestic or wild animals in this country; therefore most travellers are considered to be at low risk. However, bats may carry bat lyssavirus (bat rabies).

Prevention

Travellers should avoid contact with bats. Bites from bats are frequently unrecognised. Bat lyssaviruses are preventable with prompt post-exposure rabies treatment.

Following a possible exposure, wounds should be thoroughly cleansed and an urgent local medical assessment sought, even if the wound appears trivial. Although rabies has not been reported in other animals in this country, it is sensible to seek prompt medical advice if bitten or scratched. It is possible, although very rare for bats to pass rabies like viruses to other animals including pets.

Post-exposure treatment and advice should be in accordance with national guidelines.

Rabies vaccination

• Pre-exposure rabies vaccinations are recommended for those who are at increased risk due to their work (e.g. laboratory staff working with the virus and those working with bats).
• Pre exposure vaccines could be considered for those whose activities put them at increased risk of exposure to bats.

A full course of pre-exposure vaccines simplifies and shortens the course of post-exposure treatment and removes the need for rabies immunoglobulin which is in short supply world-wide.

Rabies in brief