g logo ipb green

Health advice for travellers

  • Travellers are exposed to many hazards while abroad; only a small percentage of these can be prevented by vaccines
  • Advice should be given on how to minimise the risk by taking preventative measures
  • A risk assessment should be performed to obtain details of the planned trip and traveller’s medical history. Pre-travel advice can then be tailored to each journey
  • Those who are pregnant, or planning a pregnancy should always seek medical advice well in advance prior to any planned foreign travel. Pregnancy presents special risks while travelling abroad, including being at a greater risk of malaria
  • Some vaccinations require a 2 or 3 dose course over a period of weeks to be fully effective, travellers should factor time into account when making appointments

Avoiding contaminated food and water

  • Vaccinations against hepatitis A, typhoid, cholera and polio may be recommended. Currently some countries are asking for a certification of polio vaccination
  • Advice on treating/managing travellers’ diarrhoea is important
  • To prevent diarrhoea the traveller should:
    • always wash hands before preparing and eating food
    • peel/wash all fruit and vegetables to be eaten raw; avoid in restaurants
    • avoid food left out for long periods of time; food served piping hot is much safer
    • not eat undercooked or raw meat, fish or shellfish
    • ensure milk is pasteurised (if in doubt bring almost to the boil first) and avoid dairy products e.g. cheese, butter, ice-cream from an uncertain source
    • avoid ice in drinks unless it is known to be made with safe water
    • drink bottled water (ensure seal is intact), hot drinks such as tea and coffee (ensure milk is pasteurised) and bottled sodas/beers or boil/purify water
    • only clean teeth in water considered safe to drink
    • avoid swimming in fresh water lakes and rivers

Insect bites

  • Specific advice on malaria prevention is often required:
    • this should include:
      • A wareness of the problem
      • B ite prevention
      • C hemoprophylaxis
      • D iagnosis
    • see Guidelines for malaria prevention in travellers from the United Kingdom at www.malaria-reference.co.uk
  • Other insect borne disease risks should be highlighted, e.g. dengue fever, Zika virus, chikungunya, Japanese encephalitis, tick borne encephalitis, yellow fever:
    • vaccination may be appropriate in some cases. Personal protection against insect bites is an important precaution
    • yellow fever vaccination and certification of this is mandatory for some countries
  • Give the following advice:
    • insect repellent should be applied to exposed areas of the skin day and night
    • use repellents containing N-diethylmetatoluamide (DEET), 50% ideally or a lemon eucalyptus based product
    • some types of clothing may be sprayed or impregnated with insecticide, e.g. permethrin, or purchased pre-treated to prevent biting through the clothing
    • mosquito nets for each bed are especially important when the room to be slept is in not air conditioned or screened
    • insecticide impregnated bed nets improve protection
    • bed nets should be free of tears and tucked in under the mattress
    • rooms can be sprayed with a knockdown insecticide to kill any mosquitoes which may have entered during the day
    • DEET is not recommended for infants below the age of 2 months

Diseases of close association

  • Diseases such as tuberculosis, meningitis, hepatitis B, diphtheria and polio pose a risk to certain travellers; specific advice for each may be necessary
  • Blood borne and sexually transmitted disease:
    • the incidence in other countries of hepatitis B, HIV/AIDs and STDs is often higher
    • people sometimes behave differently when travelling abroad
    • condoms reduce but don’t eliminate the risk; travellers should be aware that condoms purchased overseas may be of inferior quality and not afford adequate protection

Animal bites, accidents and insurance

  • Rabies should be discussed for travel to risk areas
  • A pre exposure vaccination course is appropriate for some
  • All travellers should know what to do if bitten i.e. clean wound thoroughly and seek post exposure advice and vaccines as a matter of urgency
  • Insurance should cover any current medical condition, high risk activities if planned, and repatriation. Travellers should be aware that alcohol-related injuries may negate travel insurance policies
  • Advice on first aid packs and sterile medical equipment packs is important for some travellers, as medical facilities are often poor in less developed countries

Environmental hazards

  • Advice should be given on coping with extreme temperatures, hot and cold
  • Advice on altitude illness, which may take several different forms should be given to travellers who are going to areas of altitude usually higher than 2500 metres. Travellers are more at risk if they undertake a rapid ascent to altitude without acclimatisation
  • Some travellers are more at risk of sun damage including babies, young children and those on certain medications
  • Advise travellers of the following:
    • the sun is at its strongest from 11am to 3pm, so it is best to avoid being outside in bright sunlight during this period
    • babies under the age of 6 months should not be exposed to direct sunlight
    • wearing of hats with wide brims of at least 3 inches will protect both the head and provide shade for the face and neck
    • sunscreen which blocks UVA and UVA rays with a sun protection factor (SPF) ≥15, with 4 or 5 stars should be used. This is to be applied liberally in even thickness to clean dry, skin before going outside, it should be reapplied every 3 hours or more often if sweating and after swimming
    • when both sunscreen and insecticide/DEET are required, sunscreen should be applied first with insecticide/DEET applied on top

Travellers can search for MASTA clinics close to their location plus obtain a free health brief for their journey from
www.masta-travel-health.com

 

full guidelines available from…
MASTA Ltd, City Exchange, Floor 7, 11 Albion Street, Leeds, LS1 5ES
(Tel: 0113 238 7500)

MASTA. Health Advice for Travellers.
First included: January 2015.