Going to Japan: ‘The travel advice that nobody’s talking about’

Twenty years ago, travel between Japan and Australia was largely one-way, as Japanese tourists crowded Australian beaches to escape cold, snowy winters.
 
But that trend has now largely reversed, with a 170% rise in the number of Australians jetting to Japan over the last five years.
 
Dr Takako Kobayashi, a Japanese-trained GP who now practises in Brisbane, is not surprised so many Australians are keen to visit her home country, and she anticipates this to increase even further with the Tokyo Olympics in 2020.
 
‘Japan is thought of as very secure, safe and clean, easy to go to and a very enjoyable country,’ she told newsGP.
 
However, Dr Kobayashi warns that, due to communication gaps between countries, many tourists may be unaware of important health risks when travelling to Japan.
 
‘Maybe due to some language barriers, or because it is a geographically isolated island, medical information is not easily spread from Japan to other countries,’ she said.
 
There are also differences in health systems that may come as a surprise to many overseas travellers. For example, there is no general practice-based system in Japan.
 
‘There is a perception that some medical services are quite available, like they are in Australia and the United States. No problems, just go to the doctor, get some medication, easy to do,’ Dr Kobayashi said.
 
‘But actually, no … and Japanese doctors are not always happy to see [tourists] because of the language barrier.’


Dr Kobayashi wants to encourage more sharing of health information between Japan and other countries, including Japan, to help keep travellers safe.

Dr Kobayashi is especially concerned about sexual health, an issue that is often particularly relevant for travellers. One reason for her concern is a recent resurgence in cases of syphilis in Japan among people engaging in heterosexual encounters.
 
‘In Japan, syphilis has been significantly epidemic, with the number of cases now 10 times higher than 10 years ago,’ she said. ‘The majority of the patients are in their late teens to early 20s.
 
‘Last year, nearly 7000 people had syphilis and 13 cases of congenital syphilis were identified.
 
‘The cause is not known. Some say it is because of huge numbers of tourists bringing syphilis from overseas, others say more people are having [STI] checks which is revealing hidden syphilis.
 
‘Next year a lot of people will go to Japan for the Tokyo Olympics, and about 40% of syphilis patients were found in the Tokyo area.’
 
Dr Kobayashi also wants travellers to know that treatment for issues of sexual health may not be as easy to access in Japan as they might assume.
 
‘For example, it is very hard in Japan to get contraceptive pills,’ she said. ‘You cannot get the morning-after pill without a script, and it costs approximately ¥15,000, or $180 [AUD].
 
‘The best advice to patients who plan to go to Japan is use condoms all the time for sexual contact, and avoid it altogether if they are worried. Be aware there is no penicillin injection in Japan.
 
‘Also, [women should] consider LARC [long-acting reversible contraceptives] before they go, especially if they are staying for a few years.’
 
Dr Kobayashi is also particularly keen to warn Australian travellers about influenza, in part because the two countries experience peak flu season at different times of the year.
 
‘In Australia, we start to get influenza infection around May, June or maybe early April, and the peak of the season is August or September,’ Dr Kobayashi said.
 
‘If you go to Japan, the peak season time for influenza is around December, January and February.’
 
There are also issues relating to flu that are very specific to Japan, including an epidemic flu infection rate across the country, exacerbated by low rates of immunisation.
 
‘By mid-January this year, the number of cases reached approximately 300,000, and each health facility saw an average over 53 flu patients in one week,’ Dr Kobayashi said.
 
There are also strains of flu present in Japan that have not yet made it to Australia, another issue that concerns Dr Kobayashi. Additionally, accessing flu treatment for tourists in Japan is expensive and may be difficult to navigate without a good grasp of the language.
 
Dr Kobayashi offered the following advice for Australian doctors to pass on to any patients who are thinking of travelling to Japan.
 
‘Please check flu information in Japan before you go, and have your flu shot here in Australia,’ she said.
 
‘But also consider avoiding travel in Japan during flu season if your travel is not for skiing, you have any chronic disease such as COPD or uncontrolled asthma, low immunity status, are pregnant or are over 65 years old.
 
‘If you get flu in Japan and are sick for more than two days even after taking medicine, go to your GP when you get back, or see a doctor if you are still in Japan, to check the virus – you may need to have a throat swab done.’
 
Dr Kobayashi is pleased people enjoy travelling to her home country, and wants to see better communication and exchange of healthcare information between Japan and other countries to help keep their travel safe.
 
‘At the peak of globalisation, it’s easy to get information, but it’s also easy to get infections,’ she said.
 
‘We cannot maintain healthcare only for one country. We have to encourage health communication between neighbours, Australia, Japan, China, Taiwan and Indonesia, everywhere, just to keep in touch, to communicate, and to provide good care to ordinary people.’

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