Australians are travelling overseas in ever-increasing numbers. Whatever your age or destination, properly preparing before you leave and staying in good health while travelling can help you to have a happy and enjoyable trip.
When you travel abroad, you leave behind Australia's support systems, emergency service capabilities and medical facilities. The Australian Government will do what it can to help Australians in difficulty overseas, but there are legal and practical limits to what can be done to assist travellers in other countries. You should have realistic expectations about this and read the Consular Services Charter, before you go.
If you can't afford travel insurance, you can't afford to travel. Overseas medical costs are not covered by Medicare. We strongly advise you to take out comprehensive travel insurance.
Make sure it covers all medical expenses for injury or illness, as well as theft of valuables, damage to baggage, and cancellations or interruptions to flight plans. Fully disclose any pre-existing medical conditions in writing. It will save you worry and possible financial hardship. Medical costs overseas can be in the tens of thousands of dollars and many families have been burdened financially in paying these costs when things go wrong.
If you plan to rely on the travel insurance provided by your credit card, before travelling you should obtain written confirmation that you're covered and ensure that you have the details of the policy clearly outlined in writing.
You may be able to obtain travel insurance for yourself and your immediate family or travelling partner under the one policy. However, cover varies from policy to policy so check the fine print. Make sure you confirm all details with your insurance provider and receive written confirmation of your policy.
If you extend your overseas travel, make sure you also extend your travel insurance policy — it could save you and your family thousands.
More information on travel insurance, including tips for choosing a policy that's right for you, is available on our travel insurance page.
Insurance for cruise passengers
Cruise passengers are strongly encouraged to take out travel insurance appropriate to their circumstances.
Medicare benefits are only payable to cruise passengers if you are travelling between two Australian ports, with no intermediate stops outside Australia, and services are provided by a Medicare-eligible doctor. Before departure, contact your cruise operator to find out whether a Medicare-eligible doctor will be available. Some passengers have been charged expensive fees for medical services while travelling between Australian ports because a Medicare-eligible doctor has not been available.
Medicare benefits are not payable for journeys between an Australian port and a foreign port or between two foreign ports.
Staying healthy overseas
Health checks and vaccinations
Every year Australian travellers become ill, or even die, while travelling overseas. Make an appointment with your doctor or travel clinic for a basic health check-up at least eight weeks before you depart.
Infectious diseases that cause some of the overseas illnesses are often preventable through vaccinations. It's important that you discuss your personal travel plans with a health professional to ensure you have the correct vaccinations for your trip and any booster doses of childhood vaccinations you may need.
Vaccines can prevent you from contracting some diseases, but remember:
- New vaccines are constantly being released but diseases continue to evolve.
- Vaccinations may be an entry requirement of some countries so check with the embassy or consulate of the countries you are intending to visit or transit. In some countries you may be refused entry or required to have the vaccination at the border. We recommend you seek medical advice from your GP or travel clinic doctor and have any vaccinations prior to leaving Australia.
- It's never too late to vaccinate; however, some vaccines require a long period to take effect and more than one dose may be needed.
- You may need boosters for childhood vaccines.
- Health risks within a country can vary from one region to another and local authorities may be slow to announce outbreaks of disease.
To find out more about healthy travel and vaccinations, contact your nearest travel clinic doctor or visit:
- World Health Organization
- Immunise Australia
- U.S. Centers for Disease Control and Prevention
- UK National Health Service
If you plan to take medicines overseas, we recommend that you:
- discuss with your doctor the medication you'll need to take
- carry a letter from your doctor detailing what the medication is, how much you'll be taking with you, and stating that it's for your own personal use
- leave the medication in its original packaging so it's clearly labelled with your name and dosage instructions.
If you're travelling with medication, make sure it's legal in the countries you're visiting by contacting the relevant embassy or consulate in Australia.
If you need to travel with large quantities of medication, it's good practice to divide portions among different pieces of your luggage in case bags go missing. Keep all medication in the original, labelled container to avoid customs problems.
If you have to inject your medication, it may be preferable to carry your own needles and syringes if permissible in the countries you're visiting. If you buy needles and syringes overseas, ensure they are sealed and sterile.
Take enough medication to cover the length of your trip. If you need to purchase medication at your destination, be careful to avoid imitation or counterfeit medications and prescription drugs, and always check the strength of a medication with a doctor. Be aware that packaging and labelling may be similar to those available in Australia, but the strength and active ingredients can vary from country to country.
It's an offence to carry or send Pharmaceutical Benefits Scheme (PBS) medication overseas unless it's for your own personal use, or for the use of someone travelling with you. You could be fined $5,000 and spend two years in prison if you break the law.
More information on travelling with medicines and medical devices:
- Taking and sending PBS medicines overseas – Department of Human Services (Medicare)
- Travelling with medicines and medical devices – Therapeutic Goods Administration
- 1800 500 147 – Department of Human Services PBS medicine enquiry line
If you wear glasses, take along a spare pair and/or a copy of the prescription so that they can be replaced more easily if lost or broken.
Additional health tips
- If you're currently taking prescription medication, continue to take it as directed by your doctor.
- Make up a small medical kit, including items such as headache tablets, antacids, antiseptic lotion, cotton wool, band-aids, latex gloves, safety pins, SPF 30+ sunscreen and an appropriate insect repellent.
- If your trip will involve an increase to your usual physical activity, such as a lot of walking, gradually build up your fitness (after receiving clearance from your doctor) weeks, or preferably months, before you depart.
- If you plan to travel to locations or undertake activities at high altitudes (>2,500 m) you should see your doctor prior to travel and get advice specific to your situation. Altitude sickness can affect anyone, even the physically fit.
- Find out whether essentials are readily available at your destination. In some countries supplies of feminine hygiene products, nappies and contraceptives, including condoms, can be unreliable or unavailable, so it may be best to stock up before you leave.
- Don't try to save luggage space by combining medications into one container. Keep all medication in the original container to avoid problems with customs officials.
In the air
- Keep a supply of important medication in your hand luggage in case your check-in luggage goes missing.
- Continue taking your prescribed medication.
- Factor the effects of jet lag into your itinerary.
- If you've been scuba diving, don't travel in an aircraft for at least 24 hours after your final dive.
To help avoid deep vein thrombosis (DVT):
- drink plenty of fluids (but avoid alcohol and caffeine)
- stretch your feet and lower legs while seated
- walk around the cabin at regular intervals.
On the ground
- Exercise within your limits — especially in hot climates.
- Include rest time in your travel itinerary to recover from any fatigue.
- Wear comfortable shoes, a hat and sunscreen for sightseeing.
- Wear a pair of thongs when showering.
- Always take spare medication when going on excursions.
- Practice safe sex as HIV/AIDS and other sexually transmissible infections are widespread in many countries
Where local tap water is not safe:
- only use bottled water to drink and brush your teeth and always check the seal
- don't put ice in drinks — freezing preserves germs, it doesn't kill them
- avoid uncooked food, including salads and fruit that you cannot peel
Potential health risks
New diseases can appear and spread suddenly, as happened with the outbreak of the pandemic influenza (H1N1) in 2009. Check the latest travel advice and travel bulletins for your destination before you depart and while travelling so you can ensure you have the latest information.
Common illnesses that travellers can pick up include those that result from eating or drinking contaminated food or water. Water-borne, food-borne, parasitic and other infectious diseases (including cholera, hepatitis, tuberculosis, typhoid and rabies) are common, with more serious outbreaks occurring from time to time. You should consider having vaccinations before travelling. In some destinations, you should boil all drinking water or drink only bottled water; avoid ice cubes and raw and undercooked food. Beware of swimming in fresh water as it could mean exposure to parasitic diseases such as schistosomiasis (bilharzia).
Bear in mind that standards of food handling and preparation may be different from those in Australia. Illness caused by poor food handling is common in some locations. You should ensure that food is fresh and make enquiries of relevant staff about food handling standards. Naturally occurring seafood toxins such as ciguatera (which can affect reef fish in tropical locations), as well as scombroid (histamine fish poisoning) and toxins in shellfish can also be a hazard. Seek urgent medical attention if you suspect poisoning. For more information, including on symptoms and treatment, see Queensland Health's fact sheet [PDF].
Alcoholic drinks can be mixed with harmful substances, particularly methanol, which can cause serious illness, blindness, brain injury or death. If you suspect that you or a companion may have been poisoned, you need to act quickly and get urgent medical attention. Symptoms of methanol poisoning can include fatigue, headaches and nausea, similar to the effects as excessive drinking, but with pronounced vision problems that may include blurred or snowfield vision, flashes of light, tunnel vision, changes in colour perception, dilated pupils, difficulty looking at bright lights, or blindness. If you suspect that you, or anyone you are travelling with, have been affected by methanol or other poisoning, it is imperative that you seek immediate medical attention, which could be vital in avoiding permanent disability or death. All suspected cases of methanol poisoning should be reported to local police.
There are a number of mosquito-borne diseases that affect travellers visiting warm climates (including malaria, dengue fever, chikengunya and Japanese encephalitis). Consider taking prophylaxis against malaria. Take measures to avoid insect bites, including using an insect repellent at all times, wearing long, loose fitting, light coloured clothing and ensuring your accommodation is mosquito proof.
If you're travelling to Africa, South/Central America or the Caribbean you may be exposed to yellow fever. Yellow fever is a potentially fatal viral disease transmitted by mosquitoes. You should check with the foreign missions of the countries you intend visiting for any vaccination entry or exit requirements and discuss vaccination for yellow fever with your GP or travel clinic doctor. For more information, visit the Department of Health website.
If you have visited certain yellow fever declared countries in the last six days prior to your date of return to Australia, Australian Customs officials will ask you to present a valid yellow fever vaccination certificate upon entry into Australia.
For more information on the spread of HIV/AIDS, visit the World Health Organization website.
Influenza is a viral infection that affects mainly the nose, throat, bronchi and, occasionally, lungs. The virus is transmitted easily from person to person via droplets and small particles produced when infected people cough or sneeze. Occasionally the virus can also be transmitted from animals to humans. Annual epidemics of influenza usually occur during the winter months in temperate regions.
Most infected people recover within one to two weeks without requiring medical treatment. However, severe disease is more likely to occur in children, the elderly, pregnant women and those with chronic medical conditions.
The viruses that cause influenza generally undergo frequent changes in their composition. There are three general categories of influenza to be aware of: seasonal, animal-origin (avian and swine) and pandemic. You should familiarise yourself with the advice regarding personal protective and infection-control measures provided on the Department of Health's Influenza website.
Infection with seasonal influenza viruses is common. In temperate climates, most cases occur during the winter months. The influenza season in the Southern Hemisphere may begin in April and last through September and in the Northern Hemisphere may begin as early as October and can extend until May. In tropical and subtropical areas, infection with influenza virus may occur throughout the year.
According to the World Health Organization, worldwide seasonal influenza epidemics result in about three to five million cases of severe illness, and about 250,000 to 500,000 deaths. Most deaths associated with influenza in industrialised countries occur among people aged 65 or older.
An influenza vaccine is available and is particularly relevant if influenza epidemics are occurring in the areas that you are planning travel to. Make sure you consult with your doctor in Australia about receiving the influenza vaccination either before you depart Australia or upon arrival at your destination. Following vaccination, most adults develop antibody levels that are likely to protect against the strains of the virus represented in the vaccine for about a year.
Animal-origin influenza viruses (avian or swine)
Influenza viruses circulating in animals can pose a threat to human health. Humans can become ill when infected with viruses from animal sources, however most animal-origin influenza viruses do not cause disease in humans. The primary risk factor for human infection appears to be direct or indirect exposure to infected live or dead animals or contaminated environments.
The most common sources of human infections with animal-origin influenza are from avian (bird) or swine (pig) sources.
The best-known example of avian influenza is the avian influenza subtype H5N1 virus. This virus subtype first infected humans in 1997, and following widespread re-emergence of the virus in 2003 is currently entrenched in poultry in parts of Asia and northeast Africa. Since 2003 there have been more than 600 cases reported globally. This virus subtype continues to cause serious infections in humans, with the case fatality rate associated with this disease around 60%, much higher than seasonal influenza infections. Thus far, transmission of the avian influenza H5N1 subtype from birds to humans has only resulted in sporadic human cases or small clusters among close contacts, with no evidence of sustained person to person spread.
In April 2013, the World Health Organization was notified of human infection caused by the avian influenza A (H7N9) virus by Chinese authorities. Avian influenza A (H7N9) is one of a subgroup of influenza viruses that normally circulate among birds. For the latest updates on A (H7N9), visit the Department of Health and the World Health Organization websites.
If you intend to travel to an area affected by avian influenza, you should discuss the risk of avian influenza with your doctor as part of your routine pre-travel health check. The Department of Health advises anyone who resides in an avian influenza affected area for an extended period to consider, as a precautionary measure, having access to influenza antiviral medicine. Medical advice should be sought before antiviral medicines are taken.
Swine influenza viruses are endemic among pig populations globally and do not usually infect humans. Most human infections with swine influenza viruses are mild, with the virus not spreading further to other people. The (H1N1) 2009 virus that caused the global pandemic in 2009-2010 was thought to have originated in swine and is an example of a swine-origin virus that was able to spread among people and cause disease. In August 2010 the World Health Organization announced that the H1N1 virus had run its course as a pandemic and had started to take on the behaviour of the seasonal influenza virus. Since 2010 the H1N1 virus strain has been incorporated in the annual seasonal influenza vaccine for both northern and southern hemispheres.
The word pandemic is used to describe an epidemic that affects the whole population across every continent. An influenza pandemic occurs when a new influenza virus emerges in humans to which most people do not have immunity and who are therefore highly susceptible to infection with the new virus.
For both seasonal and pandemic influenza, the total number of people who become severely ill can vary. However, the impact of the disease tends to be higher in pandemics due to a larger portion of the population being susceptible, making the total number of persons affected quite large.
In 2009 the World Health Organization declared a pandemic associated with a novel influenza virus, pandemic (H1N1) 2009. Between 2009 and late 2010 more than 214 countries and overseas territories or communities reported laboratory-confirmed cases of this pandemic influenza virus, including more than 18,000 deaths.
Rabies is a potentially fatal viral disease that is almost always spread by an animal bite but can also be spread when a rabid animal's saliva gets directly into the eyes, nose, mouth, or broken skin. You can minimise the risk of exposure by avoiding contact with wild and domestic animals, such as dogs, monkeys, bats and other mammals. The availability of post-exposure rabies treatment in some locations overseas may be limited, which may require bite victims to return to Australia or travel to a third country for immediate treatment. Rabies immunoglobulin (RIG) is one component of the treatment of people who may have been exposed to rabies or other lyssaviruses. The treatment is painful, with large volumes of liquid injected into the wound. Treatment is expensive and RIG is in short supply around the world.
Roughly 97 per cent of confirmed human rabies cases worldwide are caused by contact with infected dogs. However, in recent years an increasing number of Australians returning from overseas have required RIG treatment following contact with monkeys that may carry rabies, particularly following travel in locations such as Bali and Thailand. To avoid potential exposure travellers should not feed or pat monkeys, even in popular markets, tourist destinations and sanctuaries where tourists may be encouraged to interact with monkeys. Be aware that monkeys may bite or scratch you without warning to look for food. If bitten or scratched by an animal that may carry rabies, you should immediately use soap and water to wash the wound thoroughly and seek urgent medical attention. If you are planning to stay in a location with high levels of rabies for a prolonged period or to work with animals, you should consult your doctor or travel clinic about obtaining a pre-exposure rabies vaccination. For further information on rabies see the WHO website.
Deep vein thrombosis
Deep vein thrombosis (DVT) can occur on long flights but simple actions can reduce the danger. For more information, visit the Civil Aviation Safety Authority website.
Before travelling overseas, it is important to consider your physical and mental health. If you have a current medical condition it is recommended that you consult with your doctor about the implications of travel such as the availability of subscription medicines overseas, the interactive effects of additional medications, such as anti-malarial medication, on your health and wellbeing. If you have a mental health condition, you, your family and any travelling companions should also assess the possible consequences of the challenges and stressors that can arise whilst travelling overseas.
The experience of different environments, unfamiliar customs, language barriers, social isolation, and general uncertainty are examples of risk factors that may increase stress and anxiety. Increased stress may exacerbate existing mental health conditions and possibly trigger unfamiliar mental health issues. Mental health facilities and treatment approaches in other countries may be very different to those in Australia. Australians with mental health concerns should carefully consider the possible consequences of travelling on their wellbeing.
Medical tourism refers to travelling to another country for the purpose of obtaining medical care. Many people who undertake medical tourism do so because treatment is much cheaper in another country. The most common procedures that people undergo on medical tourism trips include cosmetic surgery, dentistry, and heart surgery.
If you plan to travel overseas to receive medical care, including a cosmetic procedure, keep in mind that the quality of care you will receive may be different from that of medical care in Australia.
Remember that you are financially responsible for costs incurred during and after treatment. Standard travel insurance is unlikely to cover any extra costs as a result of planned medical treatment abroad. Be honest with your insurance company about your plans and declare any pre-existing medical conditions.
Reciprocal health agreements
Australia has reciprocal health care agreements with Belgium, Finland, Ireland, Italy, Malta, the Netherlands, New Zealand, Norway, Slovenia, Sweden and the United Kingdom.
These agreements allow Australians to access urgent or emergency treatment overseas. However, medical services are only provided when it would be unreasonable to delay treatment until the person returns to Australia.
It's important to remember:
- Healthcare agreements are no substitute for travel insurance. They won't cover you if a doctor recommends medical evacuation back to Australia.
- You'll only be covered by these healthcare agreements once you're in the specific country. Health problems that occur during travel to and from an agreement country are not covered.
If you wish to be treated under the relevant reciprocal healthcare agreement, you must advise the medical staff in the country you're visiting. You'll need to provide the local authorities with:
- Either your Australian passport or other passport that shows you are a permanent Australian resident
- A valid Medicare card. If you don't have a valid Medicare card, or your card will expire while you're away, visit a Medicare office and arrange for a new card before travelling overseas.
Further information about health care when travelling overseas and international health agreements is available on the Department of Human Services website, or by calling 13 20 11.
Department of Veterans' Affairs
If you receive a pension from the Department of Veterans' Affairs (DVA), it's your responsibility to advise DVA of your intention to travel overseas before you leave. Ask about the possible implications your overseas travel may have on your pension and healthcare entitlements. A DVA 'gold card' or DVA healthcare card does not guarantee that DVA will cover your medical costs while you're overseas. Further information is available on the DVA website or by calling DVA on 13 32 54.
Getting help overseas
DFAT provides assistance to Australians who find themselves in trouble overseas. This support is referred to as consular services; however, there are legal and practical limits to what can be done.
The Consular Services Charter sets out the standard of services all Australians can expect to receive from consular staff, including what they can and cannot do.
Australia has an agreement with Canada to provide consular assistance to Australians in some countries.
The 24-hour Consular Emergency Centre in Canberra can also be contacted for assistance from anywhere in the world on +61 2 6261 3305 or 1300 555 135 (local call cost within Australia).
Contact your travel insurance provider
Travel insurance companies often have 24-hour assistance centres that you can contact from anywhere in the world. If you get sick overseas or are involved in a medical emergency, you should contact your travel insurance provider as soon as possible. Make sure you take your travel insurance policy information and contact numbers with you so you can easily contact your insurer from overseas. Consider leaving details of your travel insurance policy with family or friends back home.