Cool article Dr Joel.

I caught Dengue fever when I lived in the tropics for awhile. I was living in Port Douglas and when not working spent a lot of time fishing in and around the mangrove creeks that surround the area. I thought my biggest worry was crocs.

But I suspect it was the little freshwater stream that ran behind my place that harboured my little winged mate that got me.

One night my colleague said I didn't look too good and it was about that time I started feeling shitty. Went home to bed and was rolling around shivering uncontrollably. At about that time the white light headache kicked in and my bowels spontaneously let go, in my bed mind mind you. It couldn't get any worse, I have never felt so ill in my life.. I managed to get up, clean my bed and myself up and opted to phone a friend. She got me to hospital in Mossman and I was diagnosed with suspected Dengue as there were a few clusters reported in various streets in Port. A couple of days later and the blood test confirmed it.

Suffice to say, I spent the next two weeks stumbling from my bed to the couch, passing out and then back to bed to pass out again.

As I'm probably one of the only few on the planet who'd never seen Star Wars, I did manage to watch the Star Wars trilogy over the course of about 6 days though;)

As a footnote, I can't stress how important travel insurance is. It makes me mad when I read that families and friends are desperately trying to raise funds to cover the medical expenses of some Wombat who's come off the bike when, for the cost of a couple of slabs, they would have been covered.

Which travel ins policys cover you if riding a motor bike ? any.
sorry going off topic again.

+1 travel insurance again!

I've met far too many tossers (mostly in Bali) who save $200 by not getting travel insurance, even though they are spending at least that on booze/accommodation every couple of days.

I'm sure many here read that Tracks article from Sparkesy about 5 or 6 years ago; bloke goes to G-Land, snaps his leg in half on his first or second day, has to get private chopper out of Java to Bali and then business class flight to Sydney for surgery. Total costs was something close to $100K, but thanks to his insurance he was only $99 out of pocket. No-one goes to Indo planning to get sick, hit reef or crash a bike. You're a fool not to take out insurance.

Ok I am reposting this here on stunets good advice, I read this article after I posted on the other thread. Good article but a little dengue specific. And apologies in advance for my Aussie docs comment, it should have read 'most Aussie docs' and as I mention, I realise you are binded by Australia's oppressive systems (in my opinion), but anonymously, surely you can tell us some looser advice.

Regarding travel insurance, definitely get it, it really is not that much considering the costs of the rest of your trip. But I hate to say it, but I would guess 80-90% of Aussies on scooters in Bali would not be covered in a crash anyway because you must have an international license and a bike license at home (in OZ). My cousin fell from a bike in Thailand, had insurance but not covered because no license in Oz. It cost his Family $65 000 to get him home accompanied on a plane by a nurse and a doctor, massive brain injuries, family had to mortgage the house to get him home, He still doesn't know how much it cost, but he is much better now.

I just went to the doctor for malaria advice for a trip to Indo, Dr. khan, so I'm guessing he was Indian or Pakistan. Which is good I thought because Aussie docs don't seem to have a clue. I basically had a good conversation about some of the things in this thread like bombing a heap after you get sick, He said it was not a good idea, but did not rule it out, saying in Oz doctors wont tell you about this stuff because they may be held responsible. He said that Doxy is the best thing they can recommend "in Australia" which lead me to believe there are better things overseas, but he would not confirm.

I told him about sunburn and how most people stop the medication because of the side effects, and he said "Isn't it better to get sunburn than die or get cerebral malaria? I kind of agreed while telling him I had also stopped with the medication in the past. I took a bottle of doxy to Mentawais last time and brought it back without opening it. I did get quite sick just before coming home and thought I had got malaria but it just turned out to be a really nasty throat infection. I am wondering, if I was taking doxy as a prophylactic would it have prevented this infection too? because my understanding is that doxy is not specifically for malaria, it is just an antibiotic to prevent many infections.

Come on there must be a doctor out there in swellnet land that can tell us about this stuff anonymously?

I just wanted to share my personal experience with mosquito born viruses and Vitamin C. Early in January this year I started to feel very unwell. Fevers, aching muscles and joints, heart palpitations, short of breath and extreme fatigue. I was off work for about 6 weeks unable to get out of bed. After many visits to my local medical centre, dozens of blood tests and echo cardiographs I was finally diagnosed with Kokobera virus. I had picked the virus up from a mossie bite at home in Brisbane. It took almost 3 months before this was diagnosed and I left the doctor’s surgery very despondent as there was no treatment other than rest. One doctor had never even heard of Kokobera virus before.
Thanks to my wife I had the opportunity to watch a great documentary called Food Matters. In the doco there was mention of how high dose vitamin C had been used for decades by a few doctors in the US to treat viral infections amongst other illnesses. After much research and reading I decided to give it a go. I was taking 24000mg (4 grams 8 times a day orally). I also was taking a multi vitamin, zinc, B complex as well as vegetable juices and I gave up all forms of sugar. After 7 days I started to notice a marked improvement in my energy levels. Within a fortnight I was feeling almost fully recovered and after 4 weeks I had energy levels that I haven’t had since my twenties (I am 48). I was feeling so good that I even managed to get a few surfs in over the past 2 weeks. My research has also revealed that high dose vitamin C has been used to cure, yes you read it right, cure dengue fever. Vitamin C is an effective anti viral.
I went back to my doctor recently and she was amazed at my recovery. I am gradually tapering my Vitamin C dose down to about 6 – 10 grams per day as a protective but I am now an orthomolecular convert.
Here’s some links with the information I used by Dr, F. R. Klenner MD who was treating his patients with high dose vitamin C for a variety of illnesses back in the 1950’s.

http://www.doctoryourself.com/klennerpaper.html

http://www.doctoryourself.com/titration.html

Hope this helps someone.

WB

WB, how was your kokobera diagnosed ?

I'm glad there is consensus on travel insurance, it is an absolute must! Sypkan, you seem pretty keen on learning, check the link below. It will answer your questions and there is more than enough info to keep you reading all night! Did you go to a Doc that has an interest, or specialises in travel health? A quick web search reveals there are many practices now tailored towards this. I would suggest making an appointment with one of them, hopefully you will leave the consultation more satisfied than your last. Remember prevention is better than cure, hope you score some epic waves on your trip!!!

http://www.cdc.gov/malaria/

Excellent advice and timely delivery too. I just booked a last minute Ments trip with a few weeks in Bali afterward. Thanks.

I have been told a cholera vaccination is also good against many common gastro bugs. It seems to have worked for me. Anyone know for sure?

BB, short answer is yes.
Longer answer. The cholera vaccine is not 100% effective against cholera, (more in the 50-65% range) and shows some cross reactivity with other bugs that cause travellers diarrhoea. So across a cohort of people taking the vaccine there will be a reduction in the rates of travellers diarrhoea, but having taken the vaccine individually is no guarantee of avoiding it.
It's always the simple things that give the most protection against any infections. Clean food/water and good hand hygiene will keep you the healthiest.

If you want to read more, below is some of the evidence base behind the cholera vaccine and its protection across a few gut bugs.

http://www.ncbi.nlm.nih.gov/pubmed/23324573
http://www.ncbi.nlm.nih.gov/pubmed/17131234
http://www.ncbi.nlm.nih.gov/pubmed/23653448

Good info DR Joel, congrats on becoming swellnets new surf G.P. with your weekly column.
whats your view on long term taking of doxy .

Thanks for the info and good wishes JoelM, yeh I'm keen on learning, just not keen on reading, have you got any video links? just joking, I will have a bit of a read, well a lot of a read.

No I didn't go to a travel doc, I have in the past, they tend to be expensive especially all the stuff they try and sell you, but yeh I know, how much is your health worth? I need a surfing doctor who can appreciate what feralling your way around Indonesia involves. Most doctors have no idea, and surfing ones go with flash resorts and boat trips, fair enough they have earned it, but I would like to know what they would do/take if they were to spend a month or two in the jungle roughing it. I was actually pretty happy with Dr. Khan, he was much freer with information than some I have visited in the past, I find doctors are always cagey with information whatever the topic. it seems they don't like to put ideas in your head, maybe they learn about the power of the mind when studying about placebos etc. I bought a big batch of doxy anyway, I will probably take them if I go back to Mentawais. It seems most crew don't take them though, plenty of tough guys out there, it is hard to know if your being paranoid or not, but I gotta say I saw the biggest mosquitoes in my life at HTs, they were like an inch long, no exaggeration, scary!

Just a warning to those crew planning on South Sumatra, no one even considers malaria there, and neither did I the few times I went there, but a friend of mine got malaria there, so I guess it can happen anywhere in the tropics.

youes guys is ignorantz. cure all manner of stuff >>>>>>>>>>>>>>
http://electrocleansing.com/stories.php

Geez WG.
I've been nearly killed by electricity. Not nice.
Not sure what's better, although never had the latter, malaria etc.
From all the aforementioned posts of peoples near deaf experiences, not my game at all.

Great article Dr Joel, thank you.
Better than Dr Karl, ran into him once, he took me and mate on a good ride, which ended up disheartening :)

wellymon ran into Dr. Karl once. Dr Karl then took wellymon ,[and a mate] riding. it was a good one AND disheartening...
to0 many hold downs ??????????????

Haha, nah I don't think doctor Karl Kusoinksi....... Surfs
Interesting link to the electric shocks tho WG
DR JOEL have you heard before of this remedy before???

WG, probably not the same ride and hold downs that you like.

could electrical stimuli revive a wilted cashew

Dr Joel Menzies wrote:

The timing is bad. The Indonesian swell season has just begun with surfers filtering into the archipelago, while on Bali, the embarkation point for many of those surfers, an outbreak of Dengue fever has struck. Dr Joel Menzies provides sound advice to all surfers intending to make the trip.

I startled awake, rain pelting my face, wind lashing my body, incoherent ramblings being muttered by my brother. My last memory was drifting off to sleep, lingering images of clear turquoise barrels on my mind with the sun setting over our isolated Pacific paradise. Completely disoriented I stumbled up, only to be struck by flying debris. “What the f@#K is going on?!”

As I gathered myself, the situation slowly crystallised in front of me. The whole bloody roof had been torn off our hut. We were in the middle of a cyclone. The beast responsible for the beautiful waves we had surfed the day before. The rest of the night was spent huddling with the locals and other surfers in the only cement building for a long way.

The next morning we found trees had fallen on our boards and detritus laying everywhere. Torrential rain followed for a couple of days combined with average onshore waves, it was dull. Finally the rain cleared, the water was glassy, the surf was pumping. We were frothing! Almost predictably, before we could even manage the paddle out, our sphincters collectively started to quiver…..Satan’s gastro had found us!

The runoff from the hills had contaminated our drinking water with cow, pig, horse, and human filth. I will never forget the image later that night of finding one of our New Zealand brethren having crawled delirious and dehydrated from his hut, laying in ankle deep water, in spasms of gastro whilst fish surrounded him in a feeding frenzy. He looked up and asked me to drop a rock on his head…it was heavy (The situation, not the rock).

Until this trip it was only reef and assorted ocean hazards that had gained my attention. But the vicious cyclone and its resultant unexpected health consequences really opened my eyes to the vast array of health issues we face whilst travelling to the exotic locations we love to surf. The following is just a brief overview of things to consider. Hopefully it will help you avoid finding yourself in ankle deep water surrounded by fish with a stranger holding a rock above your head!

What do I need to watch out for?

With the southern hemisphere swell season ramped up, and hordes of wave hungry surfers embarking on their annual pilgrimage to wave drenched destinations it’s worth having a quick glimpse at a few viruses that are causing grief at some of our favourite destinations. Covering every virus/parasite/bacteria/bug that could cause trouble whilst overseas is beyond the scope of this article, but if you are left hungry for more info – the Centre for Disease Control is a great place to start.

Is that yoouur mate, Dengue?

He is a real douche, no one wants him around. Dengue fever is a nasty virus that involves delights such as high fevers lasting three to seven days, severe headaches (often behind the eyes), and muscle and joint pain. Some people will develop a rash a few days after the fever. Skin bruising and mild bleeding of the gums can occur. It is spread by the bite of an infected female mosquito of the Aedes family. Typically the symptoms of the infection start four to seven days after the mosquito bite and last up to ten days. There are four strains of the Dengue virus, once you have recovered from the infection you will be immune but only to the strain you contracted.

I’m pumped for my surf trip, but is Dengue a local where I am heading?

Dengue is one of the leading causes of illness and death in the tropics and subtropics. It is endemic to the Caribbean, South America, and South and Southeast Asia, and the Pacific Islands. Not many good surf spots there hey?

These mozzies typically inhabit domestic areas in small bodies of water around dwellings. They are most active during the day, and rarely fly more than 200m from their breeding site.

Unfortunately if you've already copped it once, if infected a second time (with a different strain) the illness is often much more severe and you are at risk of developing dengue hemorrhagic fever. It’s like getting caught inside 20 foot chopes - you don’t want to be there! This can be a life threatening condition. It can involve severe dehydration through fluid shifts in your body, internal bleeding and multi-organ dysfunction leading to death. Yeah, heavy.

What do I do if I think Dengue has found me? Read below for some hot tips on managing it and other viruses. But first let's pay a quick visit to some of Dengue's mates.

Chikungunya

Sounds like a mysterious spicy chicken dish or a funky voodoo spell. Unfortunately it’s another virus spread by the Aedes Mosquito – remember her, she has been spreading youuur mate dengue around. There has been a recent outbreak reported in the Caribbean, and islands in the Indian Ocean and Western Pacific are known to harbor this spicy burrito! Chikungunya is a viral illness that causes fever, muscle aches, joint inflammation, and other flu like symptoms. It presents itself 3-12 days after you are bitten. Only specialised labs can diagnose this infection and treatment is largely supportive with fluid replacement and analgesia for the muscle and joint pain.

ZIKA!

Zika fever! Until recently it was mostly found in Africa and Asia. In April 2007 an outbreak of Zika occurred on Yap Island in Micronesia. Since then it has emerged increasingly in the places we love to visit. In particular this year outbreaks have been reported in French Polynesia (Tahiti and its neighbours), New Caledonia, and Easter Island. Zika fever is closely related to Dengue fever. Think of Zika fever as Dengue’s little brother, still a douche but doesn’t inflict as much pain. Symptoms of Zika fever may include fever, headache, red eyes, rash, muscle aches, and joint pains. The illness is usually mild and lasts 4-7 days.

I’m sweating like a fat kid on a jumping castle!

If you or one of your mates start displaying any of the symptoms mentioned above your best course of action is to rest, stay hydrated, and take paracetamol for fevers and pain (avoid aspirin as this can make it worse). Drink any fluids you can get your hands on, just make sure if its water that it’s clean water. Soft drinks are great to keep some sugar in the system. It’s a good idea to throw some electrolyte powder you can mix with clean water in your board bag as well. Any powder is good: Powerade, Gatorade, Gastrolyte, just something that can replace salts and sugar if you are losing it to sweat, or if a diabolical gastro finds you!

Should you feel really ill or start to develop any of the following symptoms after the temperature declines you should immediately seek emergency medical treatment:

Severe abdominal pain or persistent vomiting Red spots or patches on the skin Bleeding from nose or gums Vomiting blood Black, tarry stools (faeces, excrement) Drowsiness or irritability Pale, cold, or clammy skin Difficulty breathing

Prevention

There are no vaccines currently available to protect against Dengue, Zika or Chikungunya. The only way to avoid infection is to dodge the mozzies. Here are some tips to avoid mosquito exposure:

Wear long sleeved, loose fitting shirts and long pants. Use insect repellent with 20-30% DEET on exposed skin and clothing. If your mate is on an Arak attack and has passed out on the sand, drag him inside, and spray some repellent on him! Where possible sleep indoors with fly screen and use a mozzie net over your bed.

Camping and adventure stores sell permethrin treated clothing and gear, which will keep mozzies at bay. If you see items collecting rain water (old bottles, cans, or tyres) lying around, empty them and dispose of them. This will help eradicate mosquito breeding areas within your immediate vicinity. If they are water storage containers, ensure they are covered.

It is the people living in endemic areas (areas where dengue and these over infectious diseases are common) that are most at risk of infection. As surfers we are at more risk than other travelers as we tend to gravitate towards these areas, and away from ready access to medical help.

Scared?

Well fortunately taking these simple precautions goes a very long way in keeping you protected from illness. Keep in mind that the riskiest thing you’re going to be involved in is getting to the breaks. Jumping on the back of that ute, truck, or scooter screaming to exotic barrels is the most dangerous thing you will do on your epic adventure. Often we are only presented with one means to get to the waves, but stack the odds in your favor where you can. If you can sit inside, instead of hanging out the back then do it! If there is a belt use it! If you’re going to party, work out a way to get yourself home that doesn’t involve you being in charge of a vehicle.

Things you need before you travel

Travel Insurance Vaccinations: Visit your local Doctor, they’ll jab you with the required vaccinations for your destination. See them as early as possible before travel (like months, if possible) as some vaccines are given over a course of time. If you’re flying out next week it’s not too late, you may not have protection this trip, but you’re sorting yourself for the next one! Medications: While chatting with your Doc about vaccinations, ask if you need malarial prophylaxis for your destination, and if other meds (like some antibiotics for traveler’s diarrhea) could be useful. First Aid kit: You may need more or less in your kit depending on where you are heading. Chat with your doc about this. Surfboards: YEEEEEEWW!!

There are a couple of great, reliable websites that have loads of information on how to make the memories of your trip epic barrels and not hallucinations through a dehydrated fit of dengue fever! 

Smart Traveller
Centre for Disease Control and Prevention

Dr Joel Menzies is an avid surfer with a keen interest in health issues that affect the surfing community. He's had placements at Margaret River Hospital and spent the last couple of years working at Mona Vale and Manly Hospitals. Currently he works in Critical Care at Royal North Shore Hospital and surfs at Curl Curl.

Dr Joel Menzies wrote:

The timing is bad. The Indonesian swell season has just begun with surfers filtering into the archipelago, while on Bali, the embarkation point for many of those surfers, an outbreak of Dengue fever has struck. Dr Joel Menzies provides sound advice to all surfers intending to make the trip.

I startled awake, rain pelting my face, wind lashing my body, incoherent ramblings being muttered by my brother. My last memory was drifting off to sleep, lingering images of clear turquoise barrels on my mind with the sun setting over our isolated Pacific paradise. Completely disoriented I stumbled up, only to be struck by flying debris. “What the f@#K is going on?!”

As I gathered myself, the situation slowly crystallised in front of me. The whole bloody roof had been torn off our hut. We were in the middle of a cyclone. The beast responsible for the beautiful waves we had surfed the day before. The rest of the night was spent huddling with the locals and other surfers in the only cement building for a long way.

The next morning we found trees had fallen on our boards and detritus laying everywhere. Torrential rain followed for a couple of days combined with average onshore waves, it was dull. Finally the rain cleared, the water was glassy, the surf was pumping. We were frothing! Almost predictably, before we could even manage the paddle out, our sphincters collectively started to quiver…..Satan’s gastro had found us!

The runoff from the hills had contaminated our drinking water with cow, pig, horse, and human filth. I will never forget the image later that night of finding one of our New Zealand brethren having crawled delirious and dehydrated from his hut, laying in ankle deep water, in spasms of gastro whilst fish surrounded him in a feeding frenzy. He looked up and asked me to drop a rock on his head…it was heavy (The situation, not the rock).

Until this trip it was only reef and assorted ocean hazards that had gained my attention. But the vicious cyclone and its resultant unexpected health consequences really opened my eyes to the vast array of health issues we face whilst travelling to the exotic locations we love to surf. The following is just a brief overview of things to consider. Hopefully it will help you avoid finding yourself in ankle deep water surrounded by fish with a stranger holding a rock above your head!

What do I need to watch out for?

With the southern hemisphere swell season ramped up, and hordes of wave hungry surfers embarking on their annual pilgrimage to wave drenched destinations it’s worth having a quick glimpse at a few viruses that are causing grief at some of our favourite destinations. Covering every virus/parasite/bacteria/bug that could cause trouble whilst overseas is beyond the scope of this article, but if you are left hungry for more info – the Centre for Disease Control is a great place to start.

Is that yoouur mate, Dengue?

He is a real douche, no one wants him around. Dengue fever is a nasty virus that involves delights such as high fevers lasting three to seven days, severe headaches (often behind the eyes), and muscle and joint pain. Some people will develop a rash a few days after the fever. Skin bruising and mild bleeding of the gums can occur. It is spread by the bite of an infected female mosquito of the Aedes family. Typically the symptoms of the infection start four to seven days after the mosquito bite and last up to ten days. There are four strains of the Dengue virus, once you have recovered from the infection you will be immune but only to the strain you contracted.

I’m pumped for my surf trip, but is Dengue a local where I am heading?

Dengue is one of the leading causes of illness and death in the tropics and subtropics. It is endemic to the Caribbean, South America, and South and Southeast Asia, and the Pacific Islands. Not many good surf spots there hey?

These mozzies typically inhabit domestic areas in small bodies of water around dwellings. They are most active during the day, and rarely fly more than 200m from their breeding site.

Unfortunately if you've already copped it once, if infected a second time (with a different strain) the illness is often much more severe and you are at risk of developing dengue hemorrhagic fever. It’s like getting caught inside 20 foot chopes - you don’t want to be there! This can be a life threatening condition. It can involve severe dehydration through fluid shifts in your body, internal bleeding and multi-organ dysfunction leading to death. Yeah, heavy.

What do I do if I think Dengue has found me? Read below for some hot tips on managing it and other viruses. But first let's pay a quick visit to some of Dengue's mates.

Chikungunya

Sounds like a mysterious spicy chicken dish or a funky voodoo spell. Unfortunately it’s another virus spread by the Aedes Mosquito – remember her, she has been spreading youuur mate dengue around. There has been a recent outbreak reported in the Caribbean, and islands in the Indian Ocean and Western Pacific are known to harbor this spicy burrito! Chikungunya is a viral illness that causes fever, muscle aches, joint inflammation, and other flu like symptoms. It presents itself 3-12 days after you are bitten. Only specialised labs can diagnose this infection and treatment is largely supportive with fluid replacement and analgesia for the muscle and joint pain.

ZIKA!

Zika fever! Until recently it was mostly found in Africa and Asia. In April 2007 an outbreak of Zika occurred on Yap Island in Micronesia. Since then it has emerged increasingly in the places we love to visit. In particular this year outbreaks have been reported in French Polynesia (Tahiti and its neighbours), New Caledonia, and Easter Island. Zika fever is closely related to Dengue fever. Think of Zika fever as Dengue’s little brother, still a douche but doesn’t inflict as much pain. Symptoms of Zika fever may include fever, headache, red eyes, rash, muscle aches, and joint pains. The illness is usually mild and lasts 4-7 days.

I’m sweating like a fat kid on a jumping castle!

If you or one of your mates start displaying any of the symptoms mentioned above your best course of action is to rest, stay hydrated, and take paracetamol for fevers and pain (avoid aspirin as this can make it worse). Drink any fluids you can get your hands on, just make sure if its water that it’s clean water. Soft drinks are great to keep some sugar in the system. It’s a good idea to throw some electrolyte powder you can mix with clean water in your board bag as well. Any powder is good: Powerade, Gatorade, Gastrolyte, just something that can replace salts and sugar if you are losing it to sweat, or if a diabolical gastro finds you!

Should you feel really ill or start to develop any of the following symptoms after the temperature declines you should immediately seek emergency medical treatment:

Severe abdominal pain or persistent vomiting Red spots or patches on the skin Bleeding from nose or gums Vomiting blood Black, tarry stools (faeces, excrement) Drowsiness or irritability Pale, cold, or clammy skin Difficulty breathing

Prevention

There are no vaccines currently available to protect against Dengue, Zika or Chikungunya. The only way to avoid infection is to dodge the mozzies. Here are some tips to avoid mosquito exposure:

Wear long sleeved, loose fitting shirts and long pants. Use insect repellent with 20-30% DEET on exposed skin and clothing. If your mate is on an Arak attack and has passed out on the sand, drag him inside, and spray some repellent on him! Where possible sleep indoors with fly screen and use a mozzie net over your bed.

Camping and adventure stores sell permethrin treated clothing and gear, which will keep mozzies at bay. If you see items collecting rain water (old bottles, cans, or tyres) lying around, empty them and dispose of them. This will help eradicate mosquito breeding areas within your immediate vicinity. If they are water storage containers, ensure they are covered.

It is the people living in endemic areas (areas where dengue and these over infectious diseases are common) that are most at risk of infection. As surfers we are at more risk than other travelers as we tend to gravitate towards these areas, and away from ready access to medical help.

Scared?

Well fortunately taking these simple precautions goes a very long way in keeping you protected from illness. Keep in mind that the riskiest thing you’re going to be involved in is getting to the breaks. Jumping on the back of that ute, truck, or scooter screaming to exotic barrels is the most dangerous thing you will do on your epic adventure. Often we are only presented with one means to get to the waves, but stack the odds in your favor where you can. If you can sit inside, instead of hanging out the back then do it! If there is a belt use it! If you’re going to party, work out a way to get yourself home that doesn’t involve you being in charge of a vehicle.

Things you need before you travel

Travel Insurance Vaccinations: Visit your local Doctor, they’ll jab you with the required vaccinations for your destination. See them as early as possible before travel (like months, if possible) as some vaccines are given over a course of time. If you’re flying out next week it’s not too late, you may not have protection this trip, but you’re sorting yourself for the next one! Medications: While chatting with your Doc about vaccinations, ask if you need malarial prophylaxis for your destination, and if other meds (like some antibiotics for traveler’s diarrhea) could be useful. First Aid kit: You may need more or less in your kit depending on where you are heading. Chat with your doc about this. Surfboards: YEEEEEEWW!!

There are a couple of great, reliable websites that have loads of information on how to make the memories of your trip epic barrels and not hallucinations through a dehydrated fit of dengue fever! 

Smart Traveller
Centre for Disease Control and Prevention

Dr Joel Menzies is an avid surfer with a keen interest in health issues that affect the surfing community. He's had placements at Margaret River Hospital and spent the last couple of years working at Mona Vale and Manly Hospitals. Currently he works in Critical Care at Royal North Shore Hospital and surfs at Curl Curl.

Guys,
the one thing you NEVER have to experience again is diaorrhea. There is just no need to cop that on top of everything else. Travelan is a legend of a product. it works everytime and is safe and natural. i think you can get it on the website now.
cheers

The author of the above article, Dr Joel Menzies, just got back from a trip to Indonesia. Here's a few photos of him taken during the trip:

Viral: noun,
an image, that is circulated rapidly on the Internet:

Nice waves Dr Joel ;)