Vaccination and Travel Information for East Timor

EAST TIMOR - TIMOR LESTE

 Information current as at:  February 2009 by The D2 Medical centre No 1 Fitzwilliam street upper Dublin 2 ph 6314500. The experts in travel vaccines Dublin 2.

Climate: The dry season is from May to November. With a temperature of between 20 to 33 ° Celsius, there is virtually no rain at all. The weather is pleasant and dry, the mountains cool to very cold. The vegetation is dry and brown and the creeks and rivers dry up. Around October to November monsoon cloud activity builds up. The wet season is from December to April, with temperatures between 29 to 35 ° Celsius. Roads may be washed away, landslides occur. Travel is difficult. The country turns vivid green.
Capital City: Dili
Altitude: 210 metres above sea level
Population: 522,433
Land Area (sq km): 18,989
Currency: United States Dollar
Languages: Tetun, Javanese, Portuguese Creole
Religions: Roman Catholic, Animist, the East Timorese are 90% Catholic
Economy: War has devastated this nation, no economy to speak of at this time.



The D2 Medical advises all travellers to be 'up-to-date' for:

CHOLERA Immunisation is neither required nor recommended.
DIPHTHERIA We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

HEPATITIS 'A' Immunisation is strongly recommended but not compulsory.


HEPATITIS 'B' Immunisation is strongly recommended for travellers who will be in the area for 1 month or more.
Transmission of Hepatitis B is through sex or contact with contaminated blood, needles and syringes.


JAP.B.ENCEPHALITIS Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.

POLIO Adults who are travelling to areas where poliomyelitis cases are occurring, or where the contracting the disease is possible, and who have received a primary series with either IPV or OPV should receive another dose of IPV before departure. For adults, available data do not indicate the need for more than a single lifetime booster dose with IPV.



RABIES Immunisation is recommended for travellers who will be in rural or remote areas for 1 month or more at a time.


TUBERCULOSIS (TB) Immunisation is not compulsory, and is not recommended for adults.
Children should be immunised at any age.
A skin test is available if immune status is in doubt.


TETANUS We recommend the initial childhood series of vaccinations in the first five years of life, with booster doses at ages 11 years, 45 years, and 65 years. Travellers are recommended to have the vaccine 10 yearly esp. if travelling to developing countries, or where there may be a risk of contracting the disease.

TYPHOID FEVER Immunisation is recommended for travellers to remote or rural areas for a month or more at a time.


YELLOW FEVER No vaccination requirements, for any international traveller.




Malarial prophylaxis is extremely important for travel to this area. Plasmodium falciparum is the prevalent malarial parasite, so Mefloquine or Doxycycline are the preferred medications. Malaria risk exists throughout the year in East Timor. Rainfall and temperature are both favourable for the transmission of malaria throughout the year. Due to the population movements within the country and the destruction of social services brought about by the war with Indonesia, mosquito breeding habitats are on the increase. There is Increased malaria transmission linked to the ‘wet season’, which goes from November to March/April.

Plasmodium species: 60-80% Plasmodium falciparum ( P. falciparum ) with remainder P.vivax and occasional P.ovale. In vitro resistance has been found to chloroquine, amodiaquine and sulfadoxine/pyrimethamine

There are five common medications for malaria prevention available in Ireland. They are: chloroquine, doxycycline, malarone, mefloquine, paludrine. To determine the appropriate antimalarial, it is advised that the traveller discuss this with a globewise Travellers Health Specialist or other Travel Health Professional. None of the medicines are 100% effective against the disease at all times, and each has its own side effects. These need to be discussed with the intending traveller.

 

Warnings:

  • All travellers are advised to ask their health professional about the side-effects of the various medications, as problems may occur with balance/fine skills, heart disease, blood pressure pills, epilepsy, mental illness and pregnancy.
  • Not all medications are suitable for everybody, neither are any of the recommended medications 100%effective. Other mosquito preventative measures are recommended in association with any recommended medication (see below).

 

Self Treatment Regimes:

  • Travellers who develop fever should seek immediate medical help. If Malaria is confirmed then self-treatment regimes are available. Travellers may wish to discuss these with their health professional BEFORE they travel. They are best used in association with a firm diagnosis of malaria (which may be done either by a laboratory of with the aid of a ‘rapid diagnostic kit’).

 

General Advice on Mosquito Prevention.
Malaria is transmitted by mosquito bite, so recommend all travellers to the country to:

  • cover exposed skin after dusk when they are at most risk for getting bitten
  • use insect repellent with DEET in it.
  • return before dusk from country areas where malarial mosquitoes are the most active
  • sleep in screened room or use a bed net, remembering to tuck in the edges & spray inside.
  • sleep in air conditioned rooms or rooms with fans. Vapour pads and smoke coils also help. Insect buzzers are useless.

Malaria map of East Timor

 




 

HEALTH, ACCIDENTS AND INSURANCE
Accidents and injuries are the leading cause of death among travellers under the age of 55. Most are caused by motor vehicle and motorcycle crashes; and to a lesser degree, drowning, aircraft crashes, murders, and burns.

Heart attacks cause most fatalities in older travellers, but infections cause only 1% of fatalities in overseas travellers. Generally, infections are the most common cause of travel-related illness.

Travellers are advised to obtain, before departure, travel health insurance with specific overseas coverage. The policy should include a medical evacuation benefit. Check for any exclusions that are part of the policy, and keep in mind that many insurance policies have terrorism exclusion clauses. The D2 Medical  recommends that the policy also provide 24-hour access to an assistance centre that can help arrange and monitor delivery of medical care, and determine if air ambulance services are required.


                                                                                                                                                                 DR JOHN J RYAN MEDICAL DIRECTOR

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