(American Samoa, Cook Islands, Easter Island, Fiji, French Polynesia (Tahiti), Guam, Kiribati, Marshall Islands, Micronesia (Federated States of), Nauru, New Caledonia, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Trust Territory of the Pacific Islands, Tuvalu, Vanuatu and the Wallis and Futuna Islands)

3.11.1  Disease risks

Food and water-borne diseases:

Diarrhoeal diseases, typhoid fever, helminth infections and hepatitis A. Biointoxication may occur from raw or cooked fish or shellfish.

Malaria - endemic in Papua New Guinea, the Solomon Islands, and Vanuatu. Not in fiji nor in islands to the north, to French Polynesia and Easter Island in the east and to New Caledonia in the south (ie present in Melanesia, but absent from Polynesia and Micronesia due to absence of the vector mosquito).

Other arthropod-borne diseases (see Chapter 7):

•   Filariasis - widespread but variable prevalence

•   Dengue and dengue haemorrhagic fever - epidemics can occur in most islands

•   Japanese encephalitis reported in the past from some islands including Guam, Saipan and recently from Papua New Guinea.

•   Ross River fever

•   Scrub typhus, mainly Papua New Guinea.

Diseases of close association:

•   Poliomyelitis - poliomyelitis cases have not been reported from any of these areas for more than five years.

•   Tuberculosis - variable incidence throughout the region - higher in Papua New Guinea.

Sexually transmitted and blood-borne infections:

Hepatitis B of intermediate to high prevalence and HIV reported.

Other hazards could include:

For sea bathers, corals, jellyfish, poisonous fish and sea snakes.

3.11.2  Recommendations for immunisations and malaria chemoprophylaxis (see later chapters for general health precautions)

FOR ALL COUNTRIES Check routine immunisations including tetanus. Immunisation against poliomyelitis, hepatitis A and typhoid. For long term travellers, consider immunisation against diphtheria and hepatitis B and check BCG status.

3.11.3  Country by country variations and malaria chemoprophylaxis:

Fiji

Yellow fever vaccination certificate required from travellers over one year of age entering Fiji within ten days of having stayed overnight or longer in infected areas.

French Polynesia (Tahiti)

Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas.

Kiribati

Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas.

Nauru

Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas.

New Caledonia and dependencies

Yellow fever vaccination certificate required from travellers over one year old coming from infected areas.

Cholera - vaccination against cholera is not required. Travellers coming from an infected area are not given chemoprophylaxis, but are required to complete a form for use by the Health Service.

Niue

Yellow fever vaccination certificate required from travellers over one year old coming from an infected area.

Palau

Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas or from countries in any part of which yellow fever is endemic.

Papua New Guinea

Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas.

Malaria - high risk, predominantly P.falciparum, throughout the year in the whole country below 1,800m. P.falciparum highly resistant to chloroquine and resistant to sulphadoxine-pyrimethamine reported.

Recommended prophylaxis: mefloquine or doxycycline or atovaquone/proguanil, or if these contra-indicated, maloprim plus chloroquine.

Japanese encephalitis - probably year-round risk. Consider immunisation for visits over one month to rural areas.

Samoa

Yellow fever vaccination certificate required from travellers over one year old coming from infected areas.

Solomon Islands

Yellow fever vaccination certificate required from travellers coming from infected areas.

Malaria - high risk throughout the year except in some eastern and southern outlying islets. Chloroquine resistant P.falciparum reported.

Recommended prophylaxis: mefloquine or doxycycline or atovaquone/proguanil, or if these contra-indicated, maloprim plus chloroquine.

Tonga

Yellow fever vaccination certificate required from travellers over one year of age coming from infected areas.

Vanuatu

Malaria - low to moderate risk, predominantly P.falciparum, throughout the year in the whole country. P.falciparum highly resistant to chloroquine and resistant to sulphadoxine-pyrimethamine reported.

Recommended prophylaxis: mefloquine or doxycycline or atovaquone/proguanil, or if these contra-indicated, maloprim plus chloroquine.