holiday health: countdown to take-off
by Jenny Bryan
No one wants to fill their suitcases with medicines when they go on holiday. There's little enough room for all the beach and party gear. But a few essentials could mean the difference between lazy days on the beach and a frantic search for an all-night pharmacy or an English-speaking doctor.
when you book
© stockbyte
Travel agents are getting better at warning clients about health hazards in some of their more exotic destinations, but it may just be small-print advice to go to your doctor or local travel clinic. As courses of some vaccines need to be started well in advance of your holiday, it's as well to check what you need when you book, especially if it's a last-minute deal (see which jabs do I need?).
If you are pregnant or are trying to become pregnant, be sure to tell your doctor or nurse when you discuss what injections and other drugs you might need, as some treatments should not be used in pregnancy.
two to four weeks before you go
With your vaccines up to date, now's the time to:
- check that you have enough of any medicines you need to take regularly for high blood pressure, asthma, diabetes or other long term conditions. This may mean a trip to the doctor for a repeat prescription – allowing for delays in appointments/administration.
- be sure you have a supply of prescription or pharmacy medicines for any infrequent health problems, such as thrush, gastric reflux, constipation or piles, which are sure to flare up as soon as you are away from home.
- if you're going somewhere exotic buy your anti-malarial medication (chloroquine, proguanil) or get a prescription from your doctor (mefloquine, doxycycline). (See malaria alert.)
- if taking mefloquine as anti-malarial, start treatment two to three weeks before departure.
- ask your doctor whether it's worth taking a small supply of a broad spectrum antibiotic, especially if you're going somewhere exotic. You'll need a prescription and instructions on how to take it.
Now's also a good time to stock up on:
- sunscreens: the higher the sun protection factor (SPA) number, the greater protection you will get. Use sunblocks for the face and other sensitive skin, high factor sunscreens for the rest of your body. Consider hypo-allergenic brands for children and those with skin allergies.
- painkillers: everyone has their favourite brand of paracetamol, aspirin, ibuprofen or other combination. You may want to take a soluble brand as well as a capsule, for those mornings when swallowing anything is a trial.
- insect repellent: if you are visiting a country where malaria is endemic or you seem to be a favourite target for biting things, get advice from your travel clinic about the most effective brands. Used carefully, roll-on and gel formulations will give you better skin coverage than sprays. Consider wrist and ankle bands impregnated with repellent. If you are travelling to a non-malarial area or rarely get bitten, you may get away with a milder brand of insect repellent.
- insect bite cream: for the millimetre of skin you missed with the repellent and was a direct hit for the mosquitoes, buy an anti-histamine or itch-reliever, such as hydrocortisone cream, from your pharmacy.
- upset stomach remedies: mild bouts of diarrhoea and vomiting are best treated by a 24-hour fast and plenty of clean fluids, so that the bug can quickly work its way through your system. But, if you're travelling and that's impractical take loperamide (eg: Arret, Imodium) to stop the diarrhoea and rehydration powders (eg: Dioralyte).
- travel sickness: anti-cholinergic agents, such as hyoscine (eg: Kwells) work fast, so you can take them after the journey has started. Anti-histamines, such as cinnarizine (Stugeron), need to be taken two hours before travelling and may cause drowsiness.
- a simple antiseptic cream for cuts and scrapes.
- plasters for the inevitable blisters after a day in the hills or a night on the town.
one week to go
- Start anti-malarial drugs that need to begin one week before travelling to an endemic area.
time to pack
- it sounds so obvious, but make sure you pack any medicines you need for the journey in your hand luggage. Include painkillers, travel sickness tablets and treatment for diarrhoea and vomiting.
- don't put your entire first-aid kit in one suitcase. If it goes astray, you'll be hitting the local pharmacies. Spread the medicines between your bags.
two hours to go
- If you're using anti-histamine for travel sickness, now's the time to take it!
Bon voyage!
which jabs do I need?
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| Type | Dose | What about the kids? | Special requirements | |||||
| Basic jabs | ||||||||
| Typhoid | single injection or |
not fully effective under 18 months | booster every 2 years | |||||
| course of 3 capsules over 5 days |
not recommended for children under 6 |
booster every 5 years (annually, if regular traveller) | ||||||
| Tetanus | course of injections | part of infant vaccine schedule | booster lasts 10 years | |||||
| For exotic climes | ||||||||
| Yellow fever | single injection lasts for 10 years | not recommended for children under 9 months | some countries require vaccination certificate; not recommended in pregnancy | |||||
| Polio | course of oral drops | part of infant vaccine schedule | single booster for adults every 10 years | |||||
| Hepatitis A | Single injection, followed by booster after 6-12 months, protects for 10 years | not recommended under 12 months, low dose for children under 16 | ||||||
| You might need | ||||||||
| Hepatitis B | course of 3 injections over 7 months | recommended for those at high risk of infection – transmitted through sexual contact, or contaminated needles or blood | ||||||
| Cholera | vaccines no longer available in the UK because of low effectiveness | as some countries require a certificate, contact your travel clinic before leaving | ||||||
| TB | single injection, no booster needed | part of childhood vaccination programme | non-immunised adults should be immunised if spending some time in a country where the disease is endemic | |||||
| Rabies | course of 3 injections over 28 days, with boosters every 2-3 years | discuss with doctor | not fully effective. If bitten by a rabid animal, get further, prompt treatment | |||||
| Tick borne encephalitis | discuss with doctor | recommended if staying for long periods in affected European countries | ||||||
| Japanese encephalitis | discuss with doctor | only needed by those staying for 1 month+ in rural parts of India and Asia | ||||||
| Diphtheria | low dose booster lasts 10 years | part of infant vaccine schedule | boosters only needed by those spending long periods in developing countries or travelling to former USSR countries. Can be combined with tetanus booster | |||||
| Meningococcal meningitis | single dose vaccine against A and C strains | not recommended for children under 2 months | advisable for those travelling to countries with outbreaks or northern, sub-Saharan Africa in the dry season |
help and info
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organisations
Hospital for Tropical Diseases – Department of Travel Medicine
Mortimer Market
Capper Street
London WC1E 6JD
Switchboard: 020 7387 9300
Travel clinic: 020 7388 9600
Website: www.uclh.org/services/htd/index.shtml
Travellers Healthline Advisory Service: 09061 33 77 33 (calls are charged at 50p per minute and should last on average 7-8 minutes.)
Fax-Back Information Service: 09061 991 992 (calls are charged at £1.50 per minute and on average should last no longer than 2 minutes)
Provides pre-travel advice, including up-to-date information on anti-malarials and prophylatic drugs, consultant led clinics and post-tropical screening.
MASTA (Medical Advisory Services for Travellers Abroad)
Moorfield Road
Yeadon
Leeds LS19 7BN
Tel: 0113 238 7575 (note: MASTA do not accept personal travel enquiries by phone)
Travellers' Health Line (for MASTA Health Brief): 0906 550 1402 (calls are charged at £1 per min, calls from mobiles may be higher)
E-mail: enquiries@masta.org
Website: www.masta.org
Aims to raise the awareness of health issues associated with travel. Services include up-to-date information about immunisations and anti-malarials, an online search facility to find your nearest MASTA associated travel clinic, a health library with travel advice, factsheets and news, and a chat room. Also produce a Health Brief, which gives personalised immunisation and anti-malaria advice for a specific journey. The website includes advice on staying well when you're away from home, including info on immunisation and antimalarials.
HPA Malaria Reference Laboratory (formerly PHLS)
London School of Hygiene and Tropical Medicine
Keppel Street
London WC1E 7HT
Malaria Prevention Advice Line: 09065 508 908 (24 hours, £1 per minute at all time)
Website: www.lshtm.ac.uk
Malaria prevention guidelines: www.hpa.org.uk/infections/topics_az/malaria/guidelines.htm
Provides in-depth information and advice to travellers on malaria prevention.
websites
Fit for Travel
www.fitfortravel.scot.nhs.uk
NHS (Scotland) public access website providing travel health information for people travelling abroad from the UK. Features information on vaccine and malaria recommendations, jet lag, traveller's diarrhoea and sun exposure, plus information for special travellers such as children, pregnant women and the elderly.
Foreign and Commonwealth Office
www.fco.gov.uk/travel
Extensive website containing the FCO's travel advice and dos & don'ts, arranged by country. Offers a range of information material aimed at helping British travellers avoid trouble, especially threats to their personal safety arising from political unrest, lawlessness, violence, natural disasters, epidemics, anti-British demonstrations and aircraft safety.
International Travel and Health
www.who.int/ith
World Health Organisation site which contains information on health risks, protective measures, infectious diseases, vaccinations and emergency treatment. Includes a section on malaria.
Lonely Planet
www.lonelyplanet.com/health
Covers how to plan for healthy travelling, including health insurance and immunisations, plus diseases and ailments and preventative measures.
National Center for Infectious Diseases – Traveler's Health
www.cdc.gov/travel/index.htm
Part of the US Department of Health and Social Services, this website features information on specific diseases that can affect travellers, advice on how to avoid illness from food or water, and on travelling with children.
NetDoctor.co.uk
www.netdoctor.co.uk/medicines/menu.asp
Contains extensive information on medicines to prevent and treat infections, including information on malaria, what it is, how to treat it and how to prevent it.
Safety Regulation Group (SRG): Travelling Safely
www.caa.co.uk/docs/3/PAS_travelsafely.pdf
Civil Aviation Authority leaflet on travelling safely containing simple safeguards to protect all aircraft passengers.
TravelHealth.co.uk
www.travelhealth.co.uk
Health advice and useful resources for travellers on topics such as malaria, DVT, travelling with children, insurance, sun safety and other health related subjects.
World Wise Directory
www.brookes.ac.uk/worldwise
Provides information on each country to help you prepare and plan for safe travelling. Gives an overview of security conditions and tells you about basic health, safety, visa and currency requirements as well as things you should know about local codes of dress and behaviour.
reading
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The Backpacker's Handbook by Hugh McManners (Dorling Kindersley, 1995) |
Health Advice for Travellers Department of Health |
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The Traveller's Healthbook by Jonathan Lorie and Nicholas Beeching (WEXAS, 2000) |
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Travelling Woman: Great Tips for Safe & Healthy Trips by Catherine Comer and Lavon Swaim (Impact Publications, 2001) |
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(July 2001, resources updated January 2005)
