SWADLINCOTE SURGERY
GUIDE TO HEALTHY TRAVEL
Accident Prevention
5.
6.
If a swimming pool smells of chlorine, the risk of
infection is probably slight.
Travellers to the tropics beware of water associated
diseases eg. Schistosomiasis. Seek local advice on the
presence of these diseases and water snakes.
Jet Lag
Road and swimming accidents are the most common cause of
death and injury to travellers.
Road Safety
1. Do not drink alcohol and drive.
2. Wear seat belts in cars.
3. Wear crash helmets when riding motor bikes and mopeds.
Ensure your clothes help protect your arms and legs.
4. Check that rented vehicles are in good condition and are
insured.
5. Find out about local traffic systems, regulations and road
conditions.
Usually only appreciable if crossing more than 5 time zones
(five hours’ time difference). Worse if the flight is eastwards
(ie. When the day of travel is shortened).
1. Do not book heavy commitments for the first 24 hours
after travel.
2. Sleep on the plane.
3. Avoid or limit your alcohol intake. Drink plenty of soft
drinks.
4. Keep regular medications on home time and meals during
the flight, when practicable, and adjust on arrival.
Diabetics need more detailed advice.
Sun and Hot Climates
Swimming Safety and Leisure Activities
1. Do not drink alcohol and swim. Wait at least an hour after
eating before swimming.
2. Think before you jump. Make sure you know the depth of
the water before diving.
3. Find out about local safe beaches and sea conditions.
Beware of water currents and inflatable airbeds or
dinghies.
4. Children need close supervision by water.
1.
2.
Prevent damage to the skin in the first place by careful
preparation. Initially limit exposure to the sun and increase
gradually. Fair skins are
most at risk.
Use high factor sunscreens with frequent top ups
especially after swimming.
3.
4.
5.
Wear hats and T-shirts and other loosely fitting clothing.
Encourage children and snorkellers to wear T-shirts over
swim suits.
Increased sweating means increased fluid loss, therefore
increase fluid intake and add extra table salt to meals.
Drink enough to keep your urine light coloured.
If you get sunburnt: avoid the sun, have cool showers,
drink plenty of fluids, and use calamine lotion. Painkillers
such as paracetamol and anti-histamines may help. Do not
burst any blisters as it encourages local infection.
Blood Borne Diseases, Sexually Transmitted
Diseases and AIDS
Blood Borne Diseases
Many countries do not have the standard of healthcare that you
are used to in the UK. Medical and dental equipment may not
be properly sterilised. Blood is not always screened for
infections.
1. Make sure you are fit to travel.
2. If you have a medical problem, try to find out where you
will receive a good standard of medical care at your
destination. If you become ill abroad seek advice from the
British Embassy or High Commission.
3. Any dental treatment should be completed before travel.
4. Ensure holiday insurance includes medical repatriation.
5. Reduce the risk of accidents abroad and attend a first aid
course.
6. Know your blood group and find out if any fellow
travellers have a compatible blood group.
7.
If you do need a blood transfusion ensure it is absolutely
necessary. Ask if alternatives such as plasma expanders
can be used or the availability of screened blood.
8. The charity the Blood Care Foundation will provide
screened blood for Emergencies worldwide. For
information write to the Blood Care Foundation, PO Box
7, Sevenoaks, Kent TN13 2 SZ. Tel. 01732 742427.
Sexually Transmitted Diseases and AIDS
1. Beware of casual sex. Do not take risks.
2. Always use a condom. Take adequate supplies of
condoms, which have the British Standard Kitemark.
3. Alcohol encourages sexual risk taking.
4. If in doubt visit the local STD or genitourinary clinic on
your return.
Sterile Needles and Syringes
1. Medical kits are available containing sterile needles and
syringes for emergency use.
Carry it at all times and keep it in its original case so that
it’s purpose is obvious.
Travellers Diarrhoea
1.
2.
Use only bottled water (preferably carbonated) or boiled
water and ensure the seal is intact. This includes water
used for brushing teeth, washing fruit and salads, and in
ice cubes. Beware of locally produced drinks; ice cubes
and ice cream. Water can also be purified by boiling for at
least 10 minutes, or using water sterilising tablets, or using
a water filter/purifier.
Peel fruit, including tomatoes and avoid those that cannot
be peeled. Eat only cooked vegetables and avoid salads.
3.
Cook meat, seafood and fish thoroughly. Ensure food is
served piping hot and avoid left overs and reheated food.
4. Boil unpasteurised milk.
5. Be wary of soft cheeses and other dairy products
particularly if made with unpasteurised milk and when
there is no refrigeration.
6. Wash your hands thoroughly with soap and clean water
before eating and always after going to the toilet. Use
paper towels or hot air for drying hands and whenever
possible avoid touching food with your hands.
What to do when diarrhoea strikes
Most episodes of diarrhoea will pass in three to four days
without treatment.
1. Assess the diarrhoea. Is it watery? Is there any blood or
mucous present?
2. Check your fluid balance. Make a rough guess about
whether you are losing more fluid through diarrhoea than
you are drinking.
3. Drink plenty of fluids – enough to keep your tongue moist
and your urine a pale yellow colour. Small amounts of
dark urine suggest you are at risk of dehydration. (See
“Travellers First Aid Kit” for oral rehydration mixture).
4. Seek medical attention if you develop a temperature above
38C, find blood in your stools, become dehydrated, or if
the diarrhoea persists for one week.
5. Introduce food gradually. Avoid solid food for the first day
or two.
6. Antidiarrhoeal tablets are recommended when the
diarrhoea will be an inconvenience. They are not
recommended for children.
7. Antibiotics are not routinely recommended.
Remember: boil it, cook it, peel it. When in doubt, miss it
out!
Animal Bites, Scratches and Licks
If you are going to a country where rabies is present, then all
bites, scratches and even licks should be considered as suspect.
Rabies is a virus infection carried by infected dogs, cats, foxes,
bats and other animals.
1. Always consider the possibility of rabies if you are bitten,
scratched or licked by an animal.
2. Clean the wound immediately and thoroughly with soap
and running water for at least 5 minutes. Apply tincture of
iodine or alcohol.
3. If the owner of the animal is present, find out if it has been
vaccinated against rabies and ask to see the last certificate.
Exchange each other’s details.
4. Make sure you seek local medical advice about rabies
vaccination as soon as possible, even if the animal has
been vaccinated or you have had the rabies vaccine.
5. Inform the local police in the country and then your GP on
returning home.
Prevention of Malaria
Malaria is the most serious disease that a traveller faces in
tropical climates and it can be fatal. It is transmitted by the bite
of a mosquito; these are most active between dusk and dawn.
Personal Protection
1. Avoid exposing areas of skin after sunset. Wear long
sleeved tops and trousers. Light colours are less attractive
to mosquitoes.
2.
Use insect repellents. Skin preparations should contain
DEET. Eucalyptus preparations are an alternative and
more user friendly. Apply to all exposed areas, especially
the wrists, ankles and feet. Wrist and ankle bands soaked
in DEET are available and last for several weeks.
Physical Protection
1. Always use a mosquito net treated with permethrin in
malarial areas in rooms that do not have air-conditioning.
Check the net for holes and tuck it firmly under the
mattress.
2. Use accommodation that has screens on windows and
doors and air conditioning that runs all night. Keep doors
and windows tightly shut.
3. Mosquitoes that have entered a room can be killed with
insecticide spray.
4. Mosquito coils that burn smouldering pyrethrum can be
useful in preventing mosquito bites at night or use
synthetic pyrethroid containing electric mats.
Antimalarial Tablets
Start your antimalarial tablets two to three weeks before you
travel, so that any reactions can be reported to your doctor.
Take them with a meal and regularly. It is important that you
continue taking the tablets for four weeks after you have
returned, to cover the incubation period.
When To Suspect Malaria
Some of the main signs and symptoms of malaria are a flu-like
illness with fever, chills, sweating, and headache.
Seek medical attention for any fever 1-week after arriving in
malaria zone.
On your return home, remember to suspect malaria if feverish
symptoms begin, especially in the first three months following
your return. The possibility of malaria persist for up to one
year. Always inform your doctor that you have visited a
malaria zone.
Taking Children to Malarial Areas
The advice for babies and children is the same as for adults.
1. Antimalarials should be started in babies from birth.
Breast-feeding does not provide protection. Some
antimalarials are available in syrup.
2. Insect repellents containing DEET should be used
sparingly avoiding the mouth and eyes.
3. The onset of malaria can be very rapid in babies and
children, therefore seek medical attention promptly if the
signs or symptoms of malaria appear.
The Travellers First Aid Kit
Remember to take enough of your usual medication.
These are some suggestions about what you should consider
taking with you on holiday and can be used as a checklist.
First aid dressings
Gauze squares, non-adherent
dressings, bandage, fabric
plasters, adhesive tape, scissors,
tweezers and safety pins.
Antiseptic
Wipes, dry powder or spray:
Savlon, betadine, and tincture of
iodine.
Use for cuts and grazes.
Calamine lotion
Use for sunburn and/or skin
irritation.
Painkillers
Use for temperatures, pain and
inflammation.
Painkillers continued
Paracetamol or aspirin (aspirin
should not be given to children
under 12 yrs).
Calpol or other infant formula for
children or babies.
Thermometer
Oral rehydration therapy in sachets and different flavours.
Use for fluid replacement in
diarrhoea. Dioralyte and Rehidrat.
See below for homemade
mixture.
Antifungal cream
Miconazole cream/powder,
clotrimazole cream/powder.
Antihistamines
Chlorpheniramine, astemizole.
Promethazine (Phenergan) for
children.
Oil of cloves
For toothache.
Ephedrine nasal drops
For children with blocked noses
or catarrhal ears.
Insect repellent
Travel sickness remedy
Promethazine, cinnarizine.
Indigestion remedy
Protective sun cream,
sunblock and lip cream
Personal medication
A doctor’s letter should
accompany a larger amount of
personal medication, or syringes
and needles.
For Travel to less developed countries
Antidiarrhoeals
Not recommended for children.
Arret, Diocalm Ultra, Imodium or
Lomotil. Codeine phosphate
needs a doctor’s letter explaining
why it is necessary.
Water sterilisation
Sterile injection kit
Antibiotics
Water filter or sterilising tablets.
Iodine is better than chlorine
based tablets at killing amoebic
cysts.
Needles and syringes; may
include cannula.
The need for antibiotics should be
discussed with your doctor.
Possibly required
Contraceptives or condoms
Acetazolamide
For altitude sickness.
For travel to malarial areas
Antimalarial tablets
Insect repellent
Containing DEET; This can be
bought in various strengths:
Autan, Jungle Juice, Expedition.
Eucalyptus preparations such as
Mosi-guard.
Wrist and ankle bands
Soaked in insect repellent.
Mosquito net
Soaked in insecticide: permethrin
or icon. For those travelling
rough.
Stand-by malarial
If travelling to remote areas more
treatment
than 24 hours from medical
help.
Home-made oral rehydration mixture for diarrhoea
1 litre of water
1 level teaspoonful of salt
4 heaped teaspoonfuls of sugar
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Further Reading
Health Advice for Travellers. Department of Health. T5 1995
Leaflet. Available free from post offices. It also contains an
application form for the certificate E111.
Stay Healthy Abroad: The essential guide for all travellers.
Ryan R. Health Education Authority 1995.
The Traveller’s Handbook. Gorman S. and Brandenburger C.
(eds) Wexas 1994
Very comprehensive.
The Tropical Traveller. Hatt J. Penguin 1993 (3rd edition).
Tropical travel tips.
First Aid Manual. St John Ambulance. St Andrew’s
Association, British Red Cross Society. Dorling Kindersley
1987.
National Suppliers of Medical Goods
Homeway Medical Ltd
The White House
Littleton
Winchester
HantsSO22 6QS
Tel: 01962 881526
Lifesystems
4 Mercury House
Calleva Park
Aldermaston
Berks RG7 4QW
Tel: 01734 811433
Industrial Pharmaceutical
Service Ltd
Bridgewater Road
Broadheath
Altrincham
Cheshire WA14 1NA
Tel: 0161 928 3672
Medical Advisory Service
for Travellers Abroad
(MASTA)
Keppel Street
London
WC1E 7HT
Tel: 0171 631 4408
Nomad (Pharmacy) Ltd
3-4 Turnpike Lane
London N8 0PX
Tel: 0181 889 7014
SAFA Limited
59 Hill Street
Liverpool L8 5SA
Tel: 0151 708 0397
Philip Harris Medical Ltd
Hazelwell Lane
Stirchley
Birmingham
B30 2 PS
Tel: 0121 433 3030
Williams Medical Supplies
Unit 6
Springhead Enterprise Park
Springhead Road
Northfleet
Kent DA11 8HD
Tel: 01474 535330