Author: Dr. De Frey

Source: Travel Doctor

The Olympic Games in Beijing and other cities in China are expected to attract 600 000 foreign visitors and athletes and up to 2.5 million domestic visitors and volunteers.

In a study published in the American Journal of Tropical Medicine and Hygiene it is pointed out that respiratory illness and physical injuries were the most common complaints amongst travellers to China in the recent past. Traveller’s Diarrhoea was – not unexpectedly – fairly common and the importance of avoiding animal contact is noteworthy in the light of the fact that Beijing recorded a staggering 140 000 animal bites in 2006 and the most common cause of reportable infectious disease deaths in China was rabies, killing more than 3 000 people in the same year.

We look at some of the disease risks in China and what you can do to prevent them.

A pre-travel consultation is vital to ensure you have taken the proper precautions. Make an appointment with Travel Doctor today by clicking here.


Get the kit

Travel Doctor offers a comprehensive personal medical kit. These kits are stocked with a range of products, such as a set of sterile needles, eye pads, plasters, bandages and “Respi-aids” (for hygienic mouth to mouth resuscitation). They also include a variety of over the counter medicines and several prescription only items. This is the ideal kit to take on any trip where reading a script may be problematic if you do not understand Mandarin!


Disease risks in China

Japanese Encephalitis

Japanese Encephalitis (JE) is an exotic disease found in the Far East, spread by mosquitoes. The risk of getting JE is very low in cities but greater in rural, farming areas. The virus normally circulates between pigs and wading birds in rice paddies. The most common symptoms include fever, headache, weakness and behavioural changes. It is potentially life threatening and up to 30% of survivors suffer from some form of permanent neurological disability. It is extremely rare in travellers, but contact Travel Doctor if you are going to be in China for more than 30 days or are planning to spend night time in rural areas.

ALWAYS prevent mosquito bites: Use an insect repellent containing DEET and wear long-sleeved shirts and long pants. If you are sleeping outdoors or in a room with no insect screens, use an insecticide-treated bed net available from The Travel Doctor.

Although the disease is vaccine preventable, JE vaccine was NOT available in South Africa at the time of publication of this newsletter.


Hepatitis A (Yellow Jaundice/Geelsug)

Hepatitis A (Hep A) is a very common vaccine preventable disease of the liver that you contract from contaminated food and water. It can cause fever, tiredness, loss of appetite, upset stomach, stomach pain, dark urine and yellowing of the skin and eyes.

To get lasting protection against Hep A, you should receive a series of two vaccines. If you have time to get only the first Hep A shot before you go to China, we recommend you do: The first dose will help protect you during this trip and the booster dose can be administered six to 12 months after the first, once you are back home. This will afford you decades of protection against a disease that is common not only in China, but all over the developing world, including in South Africa.

Only eat foods that are cooked through and served hot, and drink beverages that have been bottled and sealed (water, carbonated drinks, or sports drinks). Fruit that you personally peel avoiding contamination of the flesh is also safe for those who have had enough of rice and noodles…


Hepatitis B

Hepatitis B is another viral disease of the liver that you contract when coming in contact with blood and other body fluids of infected persons. Signs of Hep B include fever, tiredness, loss of appetite, upset stomach, stomach pain, and yellowing of the skin and eyes.

Avoiding contact with blood in any form – including sharing needles and having tattoos! and unprotected casual sexual encounters – will keep you safe from this scourge that causes permanent liver damage in up to 30% of victims.

Permanent protection against Hep B is assured after a series of three injections. This is highly recommended for people taking part in contact sports and health care workers.


Influenza (Flu)

Bird flu (or Avian Influenza) usually affects birds and rarely affects people. It attracted much attention when the first human cases were recorded in the Far East. People catch bird flu from touching sick or dead birds or from eating undercooked poultry or poultry blood. Bird flu causes a range of symptoms in people, including eye infections, fever, aches, chills, coughing, difficulty breathing, diarrhoea, and vomiting.

Seasonal flu is much more common and usually causes fever, cough, body aches and other respiratory symptoms. There is no vaccine against bird flu, but there is a vaccine to prevent seasonal flu.

Get a flu vaccine to avoid seasonal flu – travellers to the tropics are at risk all year round and crowding predisposes to the spread of this common but potentially deadly disease. Click here to make an appointment at Travel Doctor.

To minimise your risk of contracting bird flu, do not touch birds (alive or dead), do not visit poultry farms or live bird markets, only eat poultry which has been fully cooked, and wash your hands and utensils after handling raw poultry.



Rabies is a universally deadly disease spread through infected animal bites or scratches and is highly prevalent in China, which currently has the second highest number of cases of human rabies in the world.

In 2006, 140 000 animal bites were reported in Beijing and since May 2006, rabies has become China’s leading cause of reportable infectious disease mortality, killing 3 293 people in 2006, 27% more than in 2005.

To prevent rabies, do not touch animals – even pets – as dogs in China are often not properly vaccinated, especially in rural areas. If you get an animal bite or scratch, wash the wound with copious amounts of water and ordinary soap (do NOT scrub the wound), then disinfect the wound with iodine from your medical kit, and go to a hospital or doctor’s office immediately and insist on rabies vaccination if there is ANY suspicion that the animal might have been rabid. Contact your travel clinic or travel medical insurance company to assist with this very serious matter. There is, however, a lower risk of rabies in urban areas, especially in Beijing.

Note: There is currently no World Health Organisation-approved imported rabies immune globulin vaccine available in China. For updates on the rabies vaccine supply, please check the CDC’s Rabies News and Highlights page regularly.


Traveller’s Diarrhoea

Traveller’s Diarrhoea (TD) is one of the most common traveller ailments, and China is a high risk area for TD.

TD can be caused by many different germs. People who get TD have loose stools and stomach cramps. Some people also have gas, nausea, vomiting, bloating, and fever.

To prevent TD eat only piping hot food or fruits and vegetables you can wash and peel yourself. Drink beverages that have been bottled and sealed (water, carbonated drinks, or sports drinks). Wash your hands with soap and water or use an alcohol-based hand gel before you eat or prepare a meal. Remember: ice is often made from tap water!


Breathing problems

If you suffer from asthma or any lung problem, you might have more trouble breathing in areas with severely polluted air than other people. Air pollution can cause symptoms like coughing, wheezing, and trouble breathing.

China has reported that it is taking steps to reduce the levels of air pollution during the Olympic Games by closing factories and limiting the number of cars on the roads. Recent newspaper reports signal that they may not have been as successful in doing so as was planned…

Visit your doctor before you go to China. You may need to take additional medication to control your symptoms. If you cough, wheeze, or have trouble breathing while you are in China, see a health-care provider right away. If possible, plan outdoor activities early in the day in areas with no traffic.



The Olympic venues are NOT in malaria risk areas. Malaria is a risk in some rural parts of China, but not in cities.

Signs of malaria include fever, chills, headache, body aches, and tiredness. If you are travelling to rural parts of China, you may need to consider malaria prophylaxis. It is always a good idea to prevent mosquito bites, even if you are not going to a malaria risk area.


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