It has famously been said that travel broadens the mind but loosens the bowels. And it is true that a bout of ill health can ruin a trip.
So avoiding ill health is a key factor when travelling. But how do you do that? Traveller’s diarrhoea for example, is estimated to affect 20-60% of people going to high risk destinations (which includes most of Asia, and much of Africa and Central and South America).
While some people may have cast iron guts and can travel with impunity, others lose several days from their trip as they cannot venture too far from a toilet.
And there are lots of exotic diseases that occur in some of our favourite destinations that you may or may not know about.
Does this mean that travel is not worth the trouble? While you can never be certain that you can avoid all health problems while travelling (you can’t in this country either), there are some things that can help reduce your risk of getting a bout of illness.
I have listed some top tips that can help you remain healthy when travelling to maximise your chances of enjoying every minute without having to deal with any illnesses.
We do not leave our current health behind when we leave home. If you have any health conditions, make sure they are stable and well managed before you leave home. You may need to consult your Doctor to make sure that you are fit to travel, especially if you are contemplating long haul flights and/or a significant length of time away.
For some conditions, you may wish to wear a Medic Alert bracelet or carry an ID card that will inform medical staff of your condition. Know what medication you take and ensure you have enough to cover your time away and preferably, a spare prescription in case your medicines are lost or stolen.
Find comprehensive travel health insurance that will cover any pre-existing illness and repatriation and remember that any existing health problems have to be declared in advance.
Then you need to consider what the health risks are in your destination.
Some illnesses that occur in your destination country may not occur in the UK and will therefore be unfamiliar to you.
There may also be new health threats emerging, or disease threats we had considered to be fading, re-emerging.
Most people will be aware of the Ebola outbreak in West Africa in 2014 but is Middle East respiratory syndrome coronavirus (MERS-CoV) on your radar?
Can you recall the scare stories about Avian Influenza? Cases of Avian influenza are still reported regularly in a number of Asian countries.
Did you know that currently the Yellow fever disease risk areas in Brazil are extending and that cases of the disease are being reported in unvaccinated travellers?
Once you know what illnesses occur in the area you are visiting, how do you then make an assessment of the risk to you? You need to know how the infection is spread, how easy it would be to get it and how you might prevent it.
Could your activities increase your risk of being exposed to an infection? For example, a safari trip will have the potential for disease risks that differ from those you may find on a beach holiday or a backpacking.
The type of accommodation will also have an impact on exposure to disease risks. For example, staying an air conditioned hotel will minimise the risk of biting insects, especially the evening and night biters that transmit malaria and Japanese encephalitis.
What about taking a cruise? Norovirus outbreaks are a known risk for cruise holidays; a flu jab is also usually recommended before a cruise.
Some of the diseases that occur in a destination may be prevented by vaccination. Modern vaccines are pretty safe and effective but may require several doses. Some may be provided without cost at your GP but others will not.
Some vaccinations are required to get into a country; others are recommended for all travellers to the area, while others may be considered because of the activities you are planning to do.
Get advice about travel immunisations by visiting a travel clinic.
On average, 1-2,000 people a year from the UK pick up malaria on their travels. This potentially fatal infection is spread by night-time biting mosquitoes.
If you are going to a malaria risk area it is really important to get the right advice and take medicine if advised. The correct tablets, taken correctly will provide 90% protection against malaria, but insect bite avoidance is the most important preventive measure.
You must be Aware what the malarial situation is in the places you are going to, avoid mosquito Bites on all your travels, take malarial tablets (Chemoprophylaxis) if advised to do so, and know what symptoms you might experience if you have malaria so that you can be Diagnosed and treated.
For example, a simple diarrhoeal illness may settle but it is important to treat feverish illnesses as an emergency if you have been in a malarial area.
Simple as ABCD.
Food and Water
We get Traveller’s Diarrhoea from eating and drinking and it is really common. Food that is freshly cooked and piping hot is safest. Sparkling bottled water is safer than still.
Hand washing, especially before eating is essential.
Anything else that is served at the ambient temperature or cold (including ice) is a bit of a lottery. You can’t see if it is safe or not.
Tummy upsets, if you get them, should settle within a few days; if they do not or if they get worse, you will need to see a doctor.
Make sure you keep hydrated and remember that water alone, does not hydrate you; you need something with salts and sugar in it for hydration.
A variety of creatures may bite us on our travels. It is important to try and avoid mammal bites or licks or scratches as they may carry rabies. A vaccination course before you travel gives a lot of protection but ensure that any injuries from mammals are washed very thoroughly and that you see a reliable doctor as soon as you can.
Insects are big problems as many can carry infections. Data from the World Health Organisation suggests that case numbers reported worldwide has grown significantly in recent years.
Chikungunya is another unpleasant illness that is similar to Dengue and spread by the same mosquito but would you know how to prevent it?
It is spread by a daytime biting mosquito and currently the only way of preventing it is to prevent, or at least minimise the number of bites you get
Drinking too much alcohol can have serious consequences such as increasing your chances of having accidents, increasing your chances of being mugged (or worse), or even just falling asleep in the sun and getting burnt.
Poisonous alcohol, such as methanol, can be sold as ‘safe’ local drinks and can have devastating, permanent, health consequences.
Accidents are actually the most common cause of death in young travellers and alcohol contributes to many of them.
And while your insurance company does not expect you to be teetotal, many will not pay for treatment for accidents if you were overly drunk when you had them.
So it is important to be Drink Aware.
Yes we all want a tan but we need to protect our skin (a tan will build gradually even with sun creams).
You know many skin cancers are related to sun exposure but lots of annoying ‘age-related’ things like liver spots, and wrinkles are also linked to sun exposure.
Remember your UVA and UVB protection.
Many travellers leave home with no intention of having sex with a new partner and do not think of packing any precautions like condoms. But research shows that having unprotected sex with a new partner is more common when travelling than when you are at home.
A number of factors may influence this but because we don’t plan on meeting a new sexual partner on our travels, we don’t take precautions with us and may end up having unprotected sex. Risky.
If we have new sexual encounters we need to take precautions (against infection and pregnancy).
Another risk for some infections is having tattoos or piercings done on our travels. If you are tempted, think about how you can be sure sterile equipment is being used.
It is important to read your insurance exclusions to know what you are not covered for as the health infrastructure in countries varies widely. If you are travelling to an EU country you should have got your European Health Insurance card (EHIC) which is free and can be obtained from https://www.gov.uk/european-health-insurance-card
There are many helpful websites for advice. The Foreign and Commonwealth Office https://www.gov.uk/foreign-travel-advice provide safety and security advice for countries. Maybe consider subscribing to the FCO free email notification or social media feeds for alerts to travel advice changes for the countries you are visiting?
If you are travelling to multiple countries you may wish to get a multi destination Travel Health Brief and advice from MASTA. https://www.masta-travel-health.com/
However you may also find it helpful to discuss all the advice you have found online to help you decide what vaccines and medicines you may require or get further advice for other specific risks such as preventing Deep Vein Thrombosis (DVT) when you travel, or if you are travelling to altitude. For this you will need to see your GP or a private travel health clinic.
And if all this seems like a lot of effort it is worth remembering that with a little preparation, and taking a few simple measures your chances of getting a travel-related illness becomes very low meaning you can just concentrate on enjoying your travels.
Article by: Gael Somerville RGN, BSc (Hons), MSc, PgDip
Gael is a registered nurse with occupational health and travel health qualifications. She Joined MASTA in 2007 after working for many years in the BBC Occupational Health Department.