Tropical health threats

The threat of serious diseases is a major consideration for staff travelling abroad on business, and employers should ensure that they are adequately covered against them, says Sam Barrett

Sending employees overseas is a good way to win, and conduct, international business but, if the right health precautions aren’t taken, staff could come back with something much less desirable.

A whole host of tropical diseases lie in wait for unsuspecting travellers. Malaria, which is found in Africa, Asia, Latin America, the Middle East and parts of Europe, can cause fever and vomiting and result in death if left untreated. Cholera, lurking predominantly in the tropics, is an intestinal infection that causes diarrhoea, dehydration and, potentially, death. And, if staff travel to Africa or South America they could contract yellow fever, resulting in fever, vomiting, jaundice and, in some cases, death.

While the list of symptoms makes for unpleasant reading, the risk of contracting many of these diseases can be greatly reduced by being immunised or taking a course of tablets before setting off. Mark Coleman, director of international sales at healthcare provider Cigna International, says: “Most employers wouldn’t think twice about picking up the cost of these treatments. They tend to feel morally obliged not to put their employees at risk of contracting what can be fatal diseases.”

It can also be relatively inexpensive to get all the necessary jabs and tablets. Some of the most frequently-requested vaccinations, according to Bupa, for example, are a hepatitis A and typhoid jab, priced at £95, a combined tetanus, polio and diphtheria vaccination at £46, an innoculation for yellow fever, which costs £51, and a course of anti-malarial drug Marlarone at £40 for 12 tablets.

Some healthcare providers in the corporate market will be able to supply staff with vaccinations. Bupa, for example, can give these onsite for larger organisations that accomodate one of its Wellness centres. Other employers, meanwhile, can send staff to its City-based Austin Friars Wellness centre.

International medical insurance can help, with some corporate schemes covering the cost of pre-travel immunisations. Cigna International, for example, covers immunisations for 10 tropical diseases, including hepatitis A and B, cholera and rabies, as well as the cost of malaria tablets for employees and any dependants travelling with them.

Likewise, Goodhealth Worldwide includes immunisations in some of its corporate schemes. Andrew Apps, global sales and business development director, adds: “Many insurers will include it, sometimes as a standard benefit under the wellbeing section, or as an optional add-on.”

But whether an insurer or the employer picks up the tab, relying on immunisations alone isn’t necessarily enough to safeguard employee health. Dr Trevor Smith, clinical director at employee health specialist PMI Health Group, explains: “Immunisations and tablets don’t give 100% protection from tropical diseases. For example, with the anti-malarial tablets, their efficacy will vary according to where you’re going, with some strains resistant to some tablets.” He recommends any immunisation programme is supplemented by education on how staff can avoid risks in the first place. If someone is travelling to an area where typhoid is a problem, for example, then it is wise to advise them they should not drink the water or eat raw products, which may have been washed in it. “It’s also sensible to educate staff about what they need to do if they get some of the more common health problems, such as diarrhoea, as without the right treatment this can be very debilitating,” adds Smith.

Apps agrees this is important but believes it is often overlooked by employers. “Large companies and those that are regularly sending employees overseas tend to have the resources to do this but where it’s more unusual to send employees abroad, or they’re sent at the last minute, they won’t receive this sort of advice,” he says.

Sign up to our newsletters

Receive news and guidance on a range of HR issues direct to your inbox

This field is for validation purposes and should be left unchanged.

It can be relatively straightforward, however, to provide relevant information as there are plenty of free sources available, especially online. The Foreign & Commonwealth Office, for example, has details of the immunisations it recommends for every country and many of the international medical insurance companies can also provide this. Smith also recommends the Fit for Travel website, which is run by the Scottish NHS, for advice to keep employees healthy wherever they are posted.

If you read nothing else read this…

  • The risk of contracting many tropical diseases, including malaria, typhoid, cholera and yellow fever, can be greatly reduced through vaccination or by taking a course of tablets before employees travel.
  • Although international medical insurance will cover the cost of treatment if an employee contracts a tropical disease not all policies will pick up the relatively inexpensive cost of pre-travel jabs and tablets.
  • Websites such as those run by the Foreign & Commonwealth Office ( and the Scottish NHS ( can provide information about health risks in different countries around the world.