Your plane tickets in hand and travel insurance purchased. You have organised enough foreign exchange and your mobile phone coverage will be adequate. Is there anything else you need to consider before heading overseas?
The answer is YES! It shouldn’t be up to mum, a friend or a work colleague to remind you about your health.
Over 40% travellers will experience a health issue when travelling. Thankfully most are minor and can easily be sorted out. All will cause inconvenience and loss of enjoyment and, for some, it will be the end of their holiday or business trip.
Many health issues can be prevented with better pre-travel preparation. Here are 5 tips on how to stay healthy when travelling.
1. Start out fit and healthy
Consider a Health Check Before Leaving.
If you are on specific medication, make sure you have enough for the trip and know the generic names of the medication in case of loss. Carry a letter which notes the dose and frequency. This is also a good time to consider any routine screening tests which may be due: (PAP smear, mammogram, bowel cancer). It might also be sensible to have a blood pressure check if taking medication and seek blood sugar screening if at risk of diabetes.
Some trips require considerable training (walking Kokoda, climbing Kilimanjaro, Everest base camp trek). Have you done enough? Seek advice from those who have undertaken similar trips in the past. Join a group which is training for the same trip. Fitness may also require a dietary adjustment. Do a calorie count. Reduce alcohol consumption to 3 days a week.
Some trips are about pampering one-self (European cruises, game park tours). Avoid feeling guilty about a bulging waistline while on the trip. Lose a few kgs before heading off. You never know, you may even gain a desire to maintain the new you!
Consider your current level of physical activity. If it is low and the trip requires a great deal of walking then organise a daily walk of at least an hour. Wear a pedometer and aim for at least 10,000 steps a day. Time a specific walking route and try for a PB (personal best) at least once a week.
2. Research your destination or type of trip. Are there any specific concerns?
Low risk group tours staying in high end accommodation can be very different from locally organised adventurous stays in backpacker guest houses or tents. Bottled water would be easily available in the first scenario while packing sterilising tablets or carrying a filter might be sensible in the other.
Weather Conditions & Climate
Check out weather conditions for the time of year. What will the day time temperatures be like? Is rain a concern? Packing for Mongolia and northern China in January (-35C) would be vastly different to the monsoon period in the middle of the year. Travelling comfortably in cold climates requires a knowledge of how to layer clothing – visit an adventure shop for advice. For hot humid environments choose clothing that breathes and is loose fitting. It’s important for moisture to be transferred away from the skin to avoid chaffing and skin rashes. Frequent showering helps with temperature control in hot conditions but might cause skin conditions through loss of skin oil in cold conditions.
Is altitude a particular concern for your trip? Have you had problems in the past? Has the travel operator considered this aspect when preparing the itinerary. Travelling from Lima to Cuzco via Arequipa in Peru might be better for some than going straight to Cuzco. Not stopping in Cuzco but continuing to the Urubamba valley may be just as good. Is your particular trip at higher risk for altitude sickness. It is always sensible to seek advice on altitude sickness if travelling to destinations like Lhasa (Tibet) and La Paz (Bolivia).
Motion sickness can be very debilitating for some travellers. It is much more likely for an Antarctic cruise (Drake passage) than the Galapagos Is or a mid-year Pacific cruise. However, it is possible on any cruise. Having medication available may avoid an expensive visit to sick bay. Trial the medication before you leave to check for any potential side effects such as excessive sedation and dry mouth.
3. Avoid infectious disease
Vaccine preventable (recommended for the destination and those perhaps required by law) as well as non-vaccine preventable.
Vaccine-Preventable Infectious Disease
Find out whether any vaccines are recommended for your trip. Do this at least 4-6 weeks before leaving. Some require a bit of time to start working.
Vaccination levels are very good in Australia. Herd immunity helps protect us from infectious disease still common in many overseas destinations. Children undergo a series of routine immunisations from birth to year 8/9. Unfortunately not all children receive these routine vaccines.
Many of our measles cases are in unvaccinated travellers returning from overseas. Travel provides a good opportunity to review all routine immunisations.
Travel vaccines are specific to the destination and length of stay. Hepatitis A is a childhood disease in many developing countries. Children acquire it naturally in the first few years of life and are then immune for ever. This is not the case in countries like Australia. Hepatitis A can be fatal in older people and it is preventable through vaccination. Hepatitis A is a real risk in all less developed regions of the world. There are a number of travel vaccines.
Yellow fever vaccination is the only vaccine subject to international health regulations. Travellers to South America or Africa may be at risk of the disease and might be required to carry a certificate. Globe Medical is a WHO approved Yellow Fever Vaccination Clinic in Adelaide.
A certificate for Meningococcal vaccination is required by Saudi Arabia authorities for pilgrims attending the Haj or Umra.
Non-Vaccine Preventable Infectious Disease.
Many holidays and work trips are spoilt by infectious diseases which cannot be prevented by vaccination. Cruising, bus and train travel all have an increased risk of respiratory tract infections, particularly if part of a group tour. Many travellers will have experienced an unwell tour member spreading a bug to other people within the group. Other common health issues include traveller’s diarrhoea and diseases carried by mosquitoes eg Dengue, Zika and Malaria.
Those who have undertaken cruises will know of the attention paid to hand hygiene. Bannisters and railings are constantly wiped down with sanitising agents. Staff with extra hand gel stand guard over the entry to dining rooms and beside the smorgasbord. Proper use of utensils is demonstrated. Some cruise operators will only allow patrons to self-serve after an initial period of training.
In airports and railway stations this doesn't happen even though the risk of transmission is the same. Attention to hand hygiene is important at all times, whether cruising or passing through an airport. Carry hand gel in a plastic bag through airport security and then put it in your pocket before boarding.
Mosquito-borne disease is common in tropical regions. The memories of a great holiday can be quickly erased by discomfort associated with a bout of dengue fever. Mosquito avoidance measures are always important whether you are camped by the Murray during the summer months in Australia or travelling in tropical regions. All travellers should carry DEET or Picaridin containing repellents and those more at risk might consider impregnating clothes with permethrin. If you are a “mosquito magnet”, take extra care!
4. Assemble or update a medical kit. Check that it is appropriate for the destination.
Medical kits are an essential part of healthy travel. Kits should be tailored to the specific trip. Health problems differ according to the destination and some individuals seem to have a greater risk of illness (eg. women who know they frequently suffer from bladder infections would be tempting fate to travel without a suitable antibiotic treatment).
Easy access to medication to terminate vomiting can help you restore your fluids and get on with your holiday or business trip. A visit to the doctor or hospital admission may be avoided. Information on when and how to use medication and understanding generic names for medication gives you some control over the management of common health issues related to travel.
Pharmacy shelves can seem very different away from home. A good knowledge of the generic names of medication is essential. Many medications in less developed countries can be fake or damaged. Consider putting together a general kit for your first overseas trip and modify it according to your destination and proposed activities.
5. Plan B. What can go wrong?
Think about the concept of “double failure”. In other words, “if something can go wrong it will go wrong” …. and at an inopportune time.
Where have you packed your medication? Is it essential that you take it at the same time every day? Bags commonly go astray. It is always sensible to carry essential medication in your hand luggage with perhaps extra medication in another place. Do you have enough for the entire trip?
Do you have a doctor’s letter with information on the generic name and dosage in the event of loss or damage. Do you have the contact details of your specialist should you be hospitalised or have to see a doctor for a related issue.
Where do you store all your important information. Is it in your phone? Phones do get lost or stolen! Do you have accessible back up paper copies at home?Who is your main contact at home?
Chronic Health Conditions
Have you built into your trip extra capacity should there be a problem?
If you have a chronic health issue make sure you brush up on your standard management program. Areas of concern include asthma, diabetes and acute allergy. Make sure you have any required extra medication should you have a complication. An asthmatic on preventive puffers might carry a short course of steroids. An insulin dependant diabetic would always have some sweets and injectable glucagon available in case of a hypo! Check any medical equipment before leaving and make sure you know what to do if it fails.
While health issues in travel are common, serious issues are not. Being prepared is a big part of travelling well.
10 Step Pre-Travel Checklist - We advise our patients to observe the following 10 step checklist to reduce their chances of getting sick while abroad.
Book a Travel Medicine Appointment - Book an initial pre-travel consult at Globe Medical (Adelaide CBD) with one of our expert travel doctors.
Image Credit: Nicolas Raymond, Flickr