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TRAVEL ADVICE
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This leaflet is designed to remind you of some of the information the nurse gave you when you visited for your travel appointment. PLEASE READ IT! The information will help you to stay healthy on your trip
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WATER
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Diseases can be caught from drinking contaminated water, or swimming in it. Unless you KNOW the water supply is safe where you are staying, ONLY USE (in order of preference)
1. Boiled water
2. Bottled water or canned drinks
3. Water treated by a sterilising agent.
This includes ICE CUBES in drinks and water for CLEANING YOUR TEETH.
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SWIMMING
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It is safer to swim in water that is well chlorinated. If you are travelling to Africa, South America or some parts of the Caribbean, AVOID SWIMMING in fresh water LAKES and STREAMS. You can catch a parasitic disease called SCHISTOSOMIASIS from such places. This disease is also known as BILHARZIA. It is wise NEVER TO GO BAREFOOT, but to wear protective footwear when out, even on the beach. Other diseases can be caught from sand and soil, particularly wet soil.
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FOOD
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Contaminated food is the commonest source of many diseases abroad. You can help prevent it by following these guidelines :
• ONLY EAT WELL COOKED FRESH FOOD
• AVOID LEFTOVERS and REHEATED FOODS
• ENSURE MEAT IS THOROUGHLY COOKED
• EAT COOKED VEGETABLES, AVOID SALADS
• ONLY EAT FRUIT YOU CAN PEEL
• NEVER DRINK UNPASTEURISED MILK
• AVOID ICE-CREAM and SHELLFISH
• AVOID BUYING FOOD FROM STREET VENDOR’S STALLS
Another source of calories is ALCOHOL ! If you drink to excess, alcohol could lead you to become carefree and ignore these precautions.
Two phrases to help you remember
1. COOK IT, PEEL IT, OR LEAVE IT!
2. WHEN IN DOUBT, LEAVE IT OUT!
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PERSONAL HYGIENE
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Many diseases are transmitted by what is known as the ‘faecal-oral’ route. To help prevent this, always wash your hands with soap and clean water after going to the toilet, before eating and before handling food.
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TRAVELLERS’ DIARRHOEA
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This is the MOST COMMON ILLNESS that you will be exposed to abroad and there is NO VACCINE AGAINST IT ! Travellers’ diarrhoea is caused by eating and/or drinking food and water contaminated by bacteria, viruses or parasites. Risk of illness is higher in some countries than others.
High risk areas include North Africa, sub-Saharan Africa, the Indian Subcontinent, S.E. Asia, South America, Mexico and the Middle East.
Medium risk areas include the northern Mediterranean, Canary Islands and the Caribbean Islands.
Low risk areas include North America, Western Europe and Australia
You can certainly help PREVENT travellers’ diarrhoea in the way you BEHAVE - make sure you follow the food, water and personal hygiene guidelines already given.
Travellers’ diarrhoea is 4 or more loose stools in a 24 hour period often accompanied by stomach pain, cramps and vomiting. It usually lasts 2-4 days and whilst it is not a life threatening illness, it can disrupt your trip for several days. The main danger if the illness is DEHYDRATION, and this, if very severe, can kill if it is not treated. TREATMENT is therefore REHYDRATION. In severe cases and particularly in young children and the elderly, commercially prepared rehydration solution is extremely useful. This can be bought in tablet or sachet form at a chemist shop e.g. DIORALYTE® or ELECTROLADE®. (Dioralyte Relief® is a new formula containing rice powder which also helps to relieve the diarrhoea, particularly useful in children). Prepare according to instructions.
ANTI DIARRHOEAL TABLETS can be used for adults but should NEVER be USED in children under 4 years of age, and only on prescription for children aged 4 to 12 years. Commonly used tablets are IMODIUM® and LOMOTIL®.
None of these tablets should ever be used if the person has a temperature or blood in the stool.
DO CONTACT MEDICAL HELP IF THE AFFECTED PERSON HAS:-
• A temperature
• Blood in the diarrhoea
• Diarrhoea for more than 48 hours (or 24 hours in children)
• Becomes confused
In very special circumstances, antibiotics are used for diarrhoea, but this decision should only be made by a doctor.
(A woman taking the oral contraceptive pill may not have full contraceptive protection if she has had diarrhoea and vomiting. Extra precautions must be used - refer to your ‘pill’ information leaflet. If using condoms, use products with the British Kite Mark.
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HEPATITIS B and HIV INFECTION
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These diseases can be transmitted by
1. Blood transfusion
2. Medical procedures with non sterile equipment
3. Sharing of needles (e.g. tattooing, body piercing, acupuncture and drug abuse)
4. Sexual contact. Sexually transmitted diseases are also transmitted by no. 4)
WAYS TO PROTECT YOURSELF
• Only accept a blood transfusion when essential
• If travelling to a developing country, take a sterile medical kit
• Avoid procedures e.g. ear, body piercing, tattooing and acupuncture
• Avoid casual sex, especially without using condoms
REMEMBER - excessive alcohol can make you carefree and lead you to take risks you otherwise would not consider.
INSECT BITES - Mosquitoes, certain types of flies, ticks and bugs can cause many different diseases. e.g. malaria, dengue fever, yellow fever. Some bite at night, but some during daytime.
AVOID BEING BITTEN BY:
• Covering up skin as much as possible if going out at night, (mosquitoes that transmit malaria bite from dusk until dawn). Wear light coloured clothes, long sleeves, trousers or long skirts.
• Use insect repellents on exposed skin. (Choose those containing DEET or eucalyptus oil base. A content of approximately 35% DEET is recommended for tropical destinations.) Clothes can be sprayed with repellents too. Impregnated wrist and ankle bands are also available. Check suitability for children on the individual products.
• If room is not air conditioned, but screened, close shutters early evening and spray room with knockdown insecticide spray. In malarious regions, if camping, or sleeping in unprotected accommodation, always sleep under a mosquito net (impregnated with permethrin). Avoid camping near areas of stagnant water, these are common breeding areas for mosquitoes etc.
• Electric insecticide vaporisers are very effective as long as there are no power failures!
• Electric buzzers, garlic and vitamin B are ineffective
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MALARIA
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If you are travelling to a malarious country, the travel nurse will have given you a separate leaflet with more details, please read it.
REMEMBER, malaria is a serious and sometimes fatal disease.
ANIMAL BITES
Rabies is present in many parts of the world. If a person develops rabies, death is 100% certain.
There are 3 RULES REGARDING RABIES
1. Do not touch any animal, even dogs and cats
2. If you are licked on broken skin or bitten in a country which has rabies, wash the wound thoroughly with soap and running water for 5 minutes.
3. Seek medical advice IMMEDIATELY, even if you have been previously immunised
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ACCIDENTS
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Major leading causes of death in travellers are due to swimming and traffic accidents. You can help prevent them by taking the following.
Precautionary Guidlines:
- Avoid alcohol and food before swimming
- Never dive into water where the depth is uncertain
- Only swim in safe water, check currents, sharks, jellyfish etc.
- Avoid alcohol when driving, especially at night
- Avoid hiring motorcycles and mopeds
- If hiring a car, rent a large one if possible, ensure the tyres,
- brakes and seat belts are in good condition
- Use reliable taxi firms, know where emergency facilities are
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INSURANCE COVER
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Take out adequate insurance cover for your trip. This should possibly include medical repatriation as without it, this service if needed is extremely expensive.
• If you have any pre existing medical conditions, make sure you inform the insurance company of these details and check the small print of the policy thoroughly.
• If you travel to a European Union country, make sure you have obtained an E111 form before you travel (including a photocopy of the original form). The E111 form is in the T6 leaflet, and after completion, should be stamped at the Post Office. Additional travel insurance is still advised.
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AIR TRAVEL
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t is sensible on any long haul flight to :
• Be comfortable in your seat
• Exercise your legs, feet and toes while sitting every half an hour or so and take short walks whenever feasible. Upper body and breathing exercises can further improve circulation
• Drink plenty of water and be sensible about alcohol intake which in excess leads to dehydration
Further information can be obtained from the Department of Health website detailed below with more specific advice and information on travel-related deep vein thrombosis.
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SUN AND HEAT
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Sunburn and heat-stroke cause serious problems in travellers, but in the long term can be a serious cause of skin cancer. Long term damage to the skin due to sun exposure can lead to skin cancer. There is no such thing as a safe suntan but the following advice should be taken.
Precautions & Guidlines
• Increase sun exposure gradually, 20 minutes limit initially.
• Use sun blocks of appropriate adequate ‘SPF’ strength but a minimum of SPF 15. Children under 3 years should have a minimum SPF 25 and babies under 6 months should be kept out of the sun at all times. Reapply often and always after swimming and washing. Read manufacturer instructions
• Wear protective clothing – sunhats, T shirts and sunglasses etc.
• Avoid going out between 11am - 3pm, when the sun’s rays are strongest.
• TAKE SPECIAL CARE of CHILDREN and those with pale skin/red hair.
• Drink extra fluids in a hot climate.
• Be aware that alcohol can make you dehydrated
Boots the Chemist have a useful sun factor calculator where individual details can be entered & the appropriate SPF then calculated Boots
sun smart is also very good
Interesting web site addresses and further information: Scottish NHS public travel site
National Travel Health Network and Centre
Department of Health
Foreign and Commonwealth Office
Immunisation issues
Malaria for the general public
The Foreign Office provide a travel advice information service on CEEFAX page 470 (BBC 2).
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HAVE A VERY HAPPY AND HEALTHY TRIP!
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