Travel guide

TRAVEL GUIDE

Some information which will help you stay healthy on holiday.
WATER
Diseases can be caught from drinking contaminated water. In order to avoid illness, unless
you know definitely that the water supply where you are staying is safe, use only
1. Bottled water (make sure the seal on the lid has not been tampered with).
2. Boiled water
3. Canned drinks
4. Water treated with a sterilising agent

Avoid ice cubes (they will have been made with local water) and do use bottled water for
cleaning your teeth.
FOOD
Travellers’ diarrhoea is the most common cause of illness in travellers. Eating contaminated
food and, less commonly, drinking contaminated water are the main ways of acquiring
travellers’ diarrhoea. Consider the following guidelines to prevent becoming ill.

1. Avoid salads if possible
2. Only eat well cooked fresh food, avoid re-heated food
3. Avoid buying food from street vendors
4. Do not drink unpasteurised milk
5. Avoid ice cream, shellfish, and raw meat
6. Only eat fruit which you can peel

“Boil it, cook it, peel it or forget it”
Be aware that gastro-intestinal illnesses that lead to vomiting and / or diarrhoea can result in
the reduction of effectiveness of some medication including oral contraception. In this case
additional precautions should be considered.

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SWIMMING
If you are swimming in the sea check local information regarding tides and weather
conditions. Consider swimming only in designated safe areas. When using swimming pools
try to ensure that the water is well chlorinated.
Swimming in freshwater lakes, streams or rivers in countries such as Africa, China,
Cambodia (Mekong River), Laos, and in South America is not advisable as a disease called
Schistosomiasis can be caught from these places.
PERSONAL HYGIENE
Travellers’ diarrhoea (TD) is acquired by ingesting faecally contaminated water or food. To
help prevent transmission of disease always wash your hands with soap and water before (and
after) going to the toilet, before handling food and before eating.
TRAVELLERS’ DIARRHOEA
Travellers’ diarrhoea (TD) is the most common cause of illness in travellers abroad. All
travellers are at risk. Exposure to poor sanitary conditions, incorrectly cooked and stored
food, fruit which cannot be peeled and ground-grown leafy vegetables are all causes of TD.
The risk of infection is higher in some countries that in others.
High risk Developing countries of South America, Africa, The Middle East, and Asia.
Low risk Western Europe, North America and Australia.
Prevention Follow advice under food, water and personal hygiene sections.
Symptoms Incubation period varies from a few hours to a few days.
Watery diarrhoea (usually 3 or more stools in 24 hours). Diarrhoea is sometimes
accompanied by stomach pain / cramps, vomiting. Most sufferers will not have a raised
temperature. Blood in the stools is less common.
Often the disease is self-limiting lasting only 3 - 6 days though a very small number of people
will have diarrhoea for longer. The illness often disrupts holiday plans.
Treatment
Rehydration is very important and is the mainstay of treatment. Parents who travel to high
risk areas with children should take rehydration preparations with them (available in most
pharmacies). The elderly are also at higher risk from dehydration. Anti-diarrhoeal tablets
can also be taken by adults but never by children under the age of 4 years old. These tablets
should NOT be used if the person has a temperature or blood in the stool. Only very
occasionally are antibiotics administered but then only under medical supervision.
Medical help should be sought if
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1. The person has a temperature
2. There is blood in the stools
3. The diarrhoea persists for more than 48 hours (24 hours in children)
4. The person becomes confused

HEPATITIS B AND HIV
Hepatitis B has global distribution. HIV is present throughout the world the highest
prevalence being in sub-Sahara Africa. Both diseases can be transmitted by

1. Infected blood transfusions
2. During exchange of body fluids during unprotected sex
3. Via contaminated needles shared by injecting drug users
4. Via medical / dental procedures with non-sterile equipment
5. Via contaminated needles used during body piercing, tattooing, acupuncture

Preventative Measures
Avoid having casual sex, and use condoms at every opportunity (locally made condoms may
not be of adequate quality, use those with a Kitemark
). Do not share needles or any other
medical equipment. Try to avoid having tattoos or piercings done. Avoid having a blood
transfusion. Carry a sterile medical kit.
ANIMAL BITES
Rabies is present in many countries world-wide and is an acute, invariably fatal illness. Dogs
are most commonly associated with transmission.
Considerations

1. Avoid the risk. Avoid contact with dogs, cats, bats (wild or domestic)
2. If you are bitten or licked on an area of broken skin in a country that has rabies, wash
the area thoroughly in water / soap and water vigorously for 5 minutes.
3. Seek medical help immediately in order to receive post-exposure treatment even if you
were vaccinated before travelling.
1. Bite avoidance. Use insect repellent spray containing DEED (diethyltoluamide) at
appropriate strength (50% in malarious areas). Caution in young children and
pregnant ladies. Re-apply after swimming or sweating.
2. Use mosquito nets, impregnate clothing with insecticide e.g. permethrin.
3. Be aware of the risk and time of risk e.g. dusk until dawn.
4. Wear long sleeves, trousers, socks and shoes.
5. Use air conditioning, mosquito coils, “Bug Bands”

There are other diseases caused by mosquito bites, these include:

1. Yellow fever (daytime biting) vaccination is available
2. Dengue fever (daytime biting) no vaccination is available
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3. Japanese Encephalitis (dusk until dawn) vaccination is available

ACCIDENTS
Road traffic accidents are the leading cause of death of children overseas, with drowning
being the second most common cause of death. When hiring a car try to make sure it is from
a reputable source. Child seats should be brought over from the U.K. as they may not be
available at the holiday destination. Avoid alcohol when driving and familiarise yourself with
local regulations.
Avoid hitch-hiking.
Avoiding eating a large meal or drinking alcohol before swimming.
Take note of any safety restrictions on beaches e.g. the current, safe swimming areas, tide
times.
INSURANCE
Make sure you have adequate insurance cover for your trip.

 Inform the insurance company of any pre-existing medical conditions.
Check the details of your medical insurance before travelling
 Obtain an EHIC before travelling to an EU country (available at Post Offices). This
will give you some basic cover so make sure you have secondary insurance too.

AIR TRAVEL
Especially on long-haul flights

 Try to ensure enough leg room. This may entail special pre-booking with the airline or
booking a more expensive seat.
 Move around as much as possible. Exercise your legs and feet every 30 minutes. Do
some deep-breathing exercises.
 Drink plenty of fluids (water). Excess alcohol intake can lead to dehydration.

NOTE: Those travellers with a previous history of DVT (deep vein thrombosis), PE
(pulmonary embolism) must see their G.P. as soon as their flight is booked as they may need
specialised medication whilst travelling.
HEAT AND SUN
Sunburn and heat related illnesses can cause serious skin problems in travellers and can
curtail holiday plans. Sunburn can cause skin cancer in the long term. Just taking a few
precautions could help prevent a painful holiday !

1. Limit yourself to 20 minutes of sun exposure daily, initially
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2. Use sunblock, reapply regularly especially after swimming. Children aged under 3
should wear sunblock. Children aged 6 months or younger should be kept out of the
sun
3. Try to keep out of the sun between 10a.m. and 3p.m. when the sun is at its hottest.
4. Wear hats and protective clothing when possible.
5. Keep well hydrated with water (alcohol can make you dehydrated).

WEBSITES

(Department of Health)
(National Travel Health Network ad Centre)
(Foreign and Commonwealth Office)
MOST OF ALL HAVE A VERY ENJOYABLE AND SAFE
TRIP
With reference to:
Health Information for Overseas Travel (The Yellow Book) Nathnac 2010
Travel Medicine Pollard, A J and Murdoch, DR 2001
Grieve, S Independent Nurse 21 February – 06 March 2011

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Source: http://www.stannstreetsurgery.co.uk/website/J83020/files/Travel_Guide_(VH).pdf