Travelling Seniors – what you don’t know CAN hurt you.
February 20th, 2018
Of the gladdest moments in human life, methinks, is the departure on a distant journey to unknown lands. Sir Richard Burton explorer
Look at the bucket list of most seniors, and you will see some form of travel. Money and time means the world is your oyster…Unfortunately, what the glossy brochures don’t tell you, is that sometimes travellers get sick. The fancy internet sites don’t mention illness, or that some hospitals overseas will make a patient worse not better. Many travel health problems are preventable with the right pre-travel preparation: Like the motto of the boy scouts, travellers need to “Be Prepared”.
Senior travellers are at higher risk of illness during travel than their younger counterparts. Unfortunately with increasing age, one’s immune system – like one’s eyesight – is not what it used to be. Seniors may travel with some form of pre-existing illness or require regular medication. Increasing age is not necessarily a barrier to travel – one just needs to plan in advance. Of course, not all seniors are the same: A fit 70-year-old will cope better than a overweight, 55-year-old who has diabetes, heart and kidney disease.
Of all the travel vaccines, the Yellow Fever vaccine merits special mention. This vaccine is mandatory for travel to certain parts of Africa and South America. Senior travellers frequently come to our clinic for a yellow fever vaccine. Seniors think that getting a yellow fever vaccine is akin to getting a tetanus vaccine. They often bemoan the fact that they must visit a special clinic in the city to get the vaccine. When they get here, they may be quite shocked to learn that the Yellow Fever vaccine can cause some very serious side effects when given for the first time to persons over 60 years of age – the vaccine can even be fatal. That would definitely spoil your holiday.
For example individuals over 75 years of age, having a Yellow Fever vaccine means 18 times the risk of serious reactions and 9 times the rates of hospitalization or death compared to those 25 to 44 years of age. Sometimes a medical exemption certificate must be given instead of the vaccine.
That is why Yellow Fever vaccine has to be given at a properly resourced travel medicine clinic, and is best discussed with doctors who have completed formal qualifications in travel medicine. Visit www.travelmedicine.com.au or phone 1300 42 11 42 to find your nearest travel medicine provider.
For those seniors who will be visiting countries where traveller’s diarrhoea is more common, it is worth knowing that they are also more susceptible to complications of bacterial gut infection. Sadly, as we age, we make less stomach acid, and it is our stomach acid that kills invading gut bacteria. Some drugs can decrease the stomach acid production even further, so for some travellers, it may be worth a discussion about stopping such medication temporarily. Diarrhoea may also worsen heart and kidney problems.
Packing an appropriate medical kit is as important as packing shoes. Medicines should ideally be carried in the aircraft cabin to minimise problems if the luggage goes astray.
As you get older, vaccines take longer to take effect, so it is recommended to seek travel medicine advice at least 6 – 8 weeks before departure. Information about simple tips to stay well can make all the difference to a trip: Some problems such as heat exhaustion, dehydration, chest infections and deep vein thrombosis may be worse in seniors. It’s not all bad though, happily, seniors generally suffer less altitude sickness and less motion sickness.
As part of the specialised consultation, travel medicine doctors will recommend appropriate vaccines, medical supplies and information on how to stay healthy while away. The book, Travelling Well is a useful source of travel health tips.
Senior travellers should always see their dentist before travel, as dental issues are much harder to sort out when overseas.
It is wise for senior travellers to ask their GP for a written medical history to carry in their documentation, in case something happens. This brings the locally treating doctor up-to-speed quickly. Travel insurance is critically important for all travellers, but for senior travellers it is even more so, especially the medical cover. Travellers should read the policy, and often need to provide their complete medical history to the insurance company even if not specifically required, so they can’t be refused later for not giving information. As the Australian smart traveller website says “If you can’t afford the travel insurance you can’t afford to travel”.
Last but definitely not least, most travel means more physical activity, so it pays to get fit before departure. Walk for an hour a day, at least for the 6 weeks before travel. Wear your travel shoes as an insurance policy against future blisters. Packing a trekking pole can be handy to enhance stability over rough terrain – especially around old ruins. These collapsible poles can fit in your suitcase and may also be useful to fend off stray dogs in countries where rabies is a risk.
In summary, overseas travel can be a source of great joy and good stories, but a little forward planning will make sure you have a holiday to remember, rather than one you would like to forget.
Dr Deb Mills is the Doctor with a passion for travel and health. She is the Medical Director of the Travel Medicine Alliance – a network of travel medicine doctors around Australia. She has been looking after Australians travelling overseas since 1988.
I have been diagnosed with hep A. Should i ggo to Bali in 2 weeks
HI if you are recovering and feeling well, then prior Hepatitis A is not a contraindication to travel or reason not to go
I am a fit 75 year old having just hiked Tiger’s Nest in Bhutan within the last year and traveled to Israel, Jordan and Egypt for 23 days last month. Traveling is my hobby and I have a safari to Kenya and Tanzania planned for August of 2019. The Yellow Fever vaccination is causing me some concern. I have no medical issues other than mild psoriasis and minor high blood pressure for which I take medication daily. I exercise (walk)at least 4 times a week for 1 hour and a half each time.
Should I risk the Yellow Fever shot or cancel my trip? I have an appointment with my general physician in January to discuss this but I would like your opinion. Thank you.
Hi, thanks for your question. There is no easy answer to this question and I cannot answer to your personal situation on a blog, but here are my more detailed thoughts
It really depends on how much risk you feel personally comfortable accepting. We all take a risk by getting out of bed in the morning and travellers – especially those to remote parts of the world – frequently take risks. There could be a car accident, one could have a heart attack remote from medical care and defibrillators, one could pick up a dreadful disease, be mugged, have a plane crash etc etc – you get the idea.
The risk of yellow fever vaccine has to be balanced with the risk of the disease. Tanzania for example (below) has not had any cases for a while so it maybe recommended to just carry an exemption certificate to solve the paperwork requirement.
You really need to see a yellow fever provider who has the most up to date information about the size of the risk on your trip and can help you decide about the balance of risk-benefit. No disrespect to general physicians but many do not know enough about yellow fever to give you the detailed advice you need.
Health recommendation: CDC does not recommend yellow fever vaccine for most travelers to Tanzania. However, you might consider this vaccine if you are staying a long time or will be heavily exposed to mosquitoes.
Hi,
I am trying to decide how to advise my 22 year old who will be accompanying me to Iguazu Falls in Argentina. I have been vaccinated for yellow fever, but she has not. She has a history of asthma but is otherwise healthy. I can’t see a chart showing me risk by age group for the vaccine and the current risk for yellow fever in that area of Argentina. Argentina does not require it. Brazil does. Of course, it is a lifelong vaccine, so if she gets it now, she will be covered for future travel she might do.
Do you know where I can see some statistics on vaccine reactions as they relate to younger age groups?
Thanks,
Barb
HI
Really your friend should discuss this with a travel doctor but
Side effects in young persons are very low
https://www.cdc.gov/vaccines/hcp/vis/vis-statements/yf.html#whoshould
regards Dr Deb
I am going to Brazil in two weeks and in April to Uganda. Both countries need yellow fever. I am very healthy 79 year old woman, no medical history at all should I worry?
HI – once again the need for Yellow Fever Vaccination really depends on the balance of risk and benefit – ie where you are going and how much risk that entails for getting the disease vs risk factors for side effects. The Yellow fever providers can discuss this with you. Regards Dr Deb
I am 63years old. I need to travel to Ghana, Zambia and Liberia for a period of maximum 10 days in all these countries for business from India. Should Yellow Fever Vaccination be compulsory for me. I have no Blood Pressure, Diabetes and I am not allergies at present. I may have some lung infection for which results are awaited.
HI – Whether to have the vaccine depends on balance of risk versus benefit – ie where they are going and how much risk that entails for getting the disease. The Yellow fever providers can discuss this but west africa is high risk. Regards Dr Deb
Hi hubby and I had yellow fever vaccine 2 days ago. No side effects. Could we still get side effects up to 10 days or are we ok now? We’re in our 50s. Karen
Hi – you can get side effects up to 10 days after yellow fever vaccine, regards Dr Deb
My 80 year old parents who are very fit are going to South America for 3 weeks. Would you advise them to have the yellow fever jab or is it too dangerous at that age??
HI – it is not a black and white question – it really depends on balance of risk and benefit – ie where they are going and how much risk that entails for getting the disease. The Yellow fever providers can discuss this and give an exemption certificate if relevant. Regards Dr Deb
Hello,
My 10y Yellow Vaccination expires on 26th of April 2019. I’m a fit 68y old woman going to travel around the world. I’m planning to go first for a Safari week in South Africa and then a week in Madagascar. I understand that I must travel at the latest 10th of April to reach the dead line. Am I stretching too much the efficiency of my immunisation? Thanks for your reply. Kind Regards, Chantal
The Yellow fever vaccine lasts for life Regards Dr Deb
Hi,
I have had two full knee replacements this past year and just turned 65, healthy. Going on a Amazon river cruise in November. Is the yellow fever vaccine safe for me?
Thanks in advance for your response.
Kathleen
I am thinking of traveling to Ghana, I am 67 years old in good health but do not want to take the yellow fever shot.
No-one likes to get unnecessary things but YEllow fever disease is really bad
I am 63 and my husband is 65, we are going to Tanzania, have a layover in Ethiopia. I am hearing there is risk to the Yellow Fever vaccine for those of us over 60. I have high blood pressure, my husband has no markers for any disease. The chances we would leave the airport in Ethiopia are very small, do we get the vaccine or not?
You really need to speak to a travel doctor to assist you balance the risk-benefit equation and get some sort of certificate – what if the plane is delayed?. YF is transmitted by mosquitoes.
Hi, I am 61 and will go to Brazil in April in an excursion including Iguazu falls. I am very frightened to get yellow fever vaccine because of the side effects. I already have fibromialgia and back pains and I don’t want to get it worse. I read the high incidence Yellow Fever months are mostly January and February
I am 67 years old and still healthy. I need proof of YF vaccination to board an around-the-world cruise. I am 100% sure that had a yellow fever vaccination when I was around 20 years old, but I no longer have the Yellow Card to prove it.
So, I will need to get another vaccination and new Yellow Card. When I get the 2nd vaccination, are there any precautions I or the clinic should take? Should the 2nd shot be different from the first? I am concerned about getting a YF vaccination at my age, but it’s just easier to travel with a Yellow Card rather than a Letter of Exemption.
Any advice would be appreciated.
HI
It is extremely rare to react to the second yellow fever vaccine, as the body already has antibodies from the first dose, so it is safe to have it again. There are no special precautions.
regards Dr Deb
Dear Dr. Debb,
Thanks so much for your kind reply and service to the traveling community.
I am glad to hear the valuable information you provided.
I plan to have the YF vaccination later this year, based on your advice.
If when I am on a cruise ship traveling to Ghana, and I do not get off the ship (I would be quarantined)does my risk factor for contracting Yellow Fever decrease?
Hi
Basically yes ..As Yellow feer disease is carried by mosquitoes, if you stay on the ship behind the doors and air conditioning, it is very unlikely a mosquito would be able to get to you
Regards Dr Deb
Thank you!!! I have one last question… I am traveling with students and faculty that will be getting off the ship in Ghana. Can someone who was vaccinated bring it back onto the ship? We are a floating University, with almost 450 students and faculty.
Thanks again so much!
Karen
HI Karen
No the disease is spread by mosquitoes and not like the flu
regards Dr Deb