Travel Health: Useful Medical Information For Good Health Before Your Departure, During Your Trip And After Your Return.
The diseases most commonly seen in travellers are diarrhoea, malaria (if you
travel in a malaria-infested area), accidents (when travelling by car or
swimming), wound infections and sexually transmitted diseases.
- Diarrhoea is caused by contaminated food and drinking-water. You must
therefore be careful if your are travelling in poor hygiene conditions.
- Malaria is transmitted by mosquitoes, so the first thing to do is to protect
yourself against these mosquitoes.
- In order to prevent accidents during travelling, it is wise to apply the same
precautions as those taken at home. In addition, it is very important that all
wounds should be thoroughly disinfected in order to avoid infection.
· TRAVELLER’S DIARRHOEA
Many intestinal infections are attributable to infections picked up by mouth or
hands. With a little care most of these illnesses can be prevented. Hepatitis A,
typhoid fever, polio and cholera still occur in countries with poor hygiene, but
these diseases are easily prevented.
However, the chance is rather large that you will still contract a light and/or
nondangerous form of traveller's diarrhoea. Traveller's diarrhoea almost always
spontaneously clears up after a few days, but can nevertheless be irritating.
And a risk to your overall and travel health.
In the first place measures must be taken against dehydration. Likewise,
treatment of the symptoms must be considered in order to reduce the number of
bowel movements and relieve other symptoms such as fever, vomiting and stomach
cramps. Sometimes a more serious form of diarrhoea occurs, for which specific
treatment with antibiotics is indicated or where hospitalisation or fluid
replacement appears unavoidable.
It takes only a few basic preventive measures to make your trip a success :
Total prevention of traveller's diarrhoea is impossible and it is obvious that
preventive measures can seldom be strictly followed at all times. But following
preventive measures do significantly reduce the risk of contracting serious
diarrhoea: In order to maintain good travel health wash your hands before eating
and avoid (if possible):
- raw vegetables and fruits that you have not peeled yourself
- uncooked or unpasteurized dairy products
- insufficiently cooked sea foods (+ Hepatitis A !) and meat
- “local meals” which do not smell fresh
- ice-cream bought from street merchants (industrial ice straight from the
deep-freeze is probably safe).
Cooked meals should be served hot. The place where you eat is also important. A
meal taken from a stall presents a greater risk than a meal taken in a
restaurant. Avoid restaurants where there are a lot of insects.
Avoid tap water and ice-cubes. Bottled water and soft drinks are safe. Watch out
for bottle caps that have already been used.
It is very important to disinfect drinking-water on adventure trips. Total
sterilisation of drinking water is impossible. The following measures
considerably reduce the contamination risk and safeguard your travel health:
- Boiling the water is very effective.
- A good alternative is chemical disinfection with chlorine drops (e.g. Hadex®,
Drinkwell chloor®; available in sport shops specialized in outdoor activities)
or chlorine tablets (Certisil Combina®; chloramine tablets; available at the
pharmacy). Their effect can be improved by first filtering unclear water. Silver
salts (Micropur®, Certisil Argento®) are not very suitable to disinfect water,
but they keep disinfected water germ-free for a long time.
For adventurous travellers conscious to travel health it is best to buy a
portable water-filter. The use of antibiotics in order to prevent diarrhoea
before it occurs can be dangerous + Also the use of other preventive medications
is not recommended.
. How to treat diarrhoea?
It is extremely important to consume sufficient liquid and salt in order to
prevent dehydration. You can do this by taking salt solutions, but tea with
lemon, broth, soft drinks and fruit juice, supplemented with salt crackers are
tastier. Commercial salt products are available on the market (ORS-solution).
Taking an anti-diarrhoea preparation (loperamide, e.g. Imodium®) can greatly
reduce the number of bowel movements, with a considerable reduction of the
complaints as a result. Imodium® may only be used by adults and older children
and only for treating ordinary watery diarrhoea: 1 capsule after every loose
movement up to a maximum of 4 per day.
Antibiotics are indicated :
1. If blood, mucus or pus are present in the stools.
2. If after 24 to 48 hours, there is no sign of improvement and the diarrhoea is
accompanied by fever (above 38.5 C) or severe abdominal cramps, or if there are
more than six stools per 24 hours and especially when these also occur at night.
3. Or if because of travel circumstances a quicker solution is absolutely
desirable . Appropriate antibiotics are only to be used on doctor’s prescription
· SEXUALLY TRANSMITTED DISEASES
Casual sexual contacts tend to be higher while on holiday abroad. Sexually
transmitted diseases, particularly AIDS, form therefore an important risk for
travellers. Quite often unintentional and unsafe sexual contact takes place
under alcohol influence. Prevention while on holiday abroad is no different from
the precautions you take at home. Adequate use of a condom, preferably bought at
home, is absolutely essential. Only a water-soluble lubricant should be used,
but it only offers a partial guarantee (e.g. KY gel). Vaccination against
hepatitis B is advised. Always consult your doctor if you think you are at risk,
even when there are no symptoms.
· MALARIA (swamp fever, malaria)
Malaria is an infectious disease caused by a parasite (called Plasmodium)
transmitted by the bite of the Anopheles mosquito. There are four different
types of which Malaria falciparum is the most dangerous and the most widespread.
The incubation period – the time between an infecting bite and the appearance of
the disease – varies from ten days to four weeks (rarely several months).
The symptoms include attacks of fever, but can initially be quite similar to
influenza. If adequate treatment is not started in time, an attack may sometimes
result in death within a few days.
. Where does malaria occur?
Malaria only occurs in those areas in which Anopheles mosquitoes are present :
in the tropics and in a large number of subtropical areas. From a height of
1.500 to 2.500 m onwards, depending on temperature and climate, Anopheles
mosquitoes are either rare or non-existent.
In most big cities there is little or no risk at all of infection, except in
Africa where a real risk exists.
Risk also exists in the suburbs of the big cities in Asia (e.g. in India). In a
number of areas the risk varies according to the season.
. How can malaria be prevented?
It is very important for travel health to avoid mosquito bites : the Anopheles
mosquito only bites between dusk and dawn, is rather small and hardly makes any
noise.
- In the evening wear light-coloured clothing which covers your arms and legs as
much as possible. Apply repellent cream with a DEET basis (20 to 50%, for
children and pregnant women preferably 20 to 30%) to the uncovered parts of your
body. Repeat this every four to six hours (it will not protect you all night).
Non containing DEET repellents were less examined; Autan-Active. and Mosegor.
are however excellent safe products.
- Sleep in rooms that leave no access to mosquitoes, (mosquito nets on the
sills, electrically-warmed anti-mosquito plates, air-conditioning) or sleep
under a mosquito net impregnated with permethrine or deltamethrine hung over the
bed with the edges tucked under the mattress.
If these measures are carried out correctly, the risk of malaria will be reduced
by 80 to 90% and travel health is maintained
. The intake of pills as prevention
There is no drug efficient enough to prevent malaria 100%, which means that
quite often a combination of measures is preferable. Also the drugs used have
changed over the years. Moreover, the advantages and disadvantages of drugs
should be considered against the risk of malaria infection. These risks are
dependent on the visited country, and on the region, the season, the duration of
your stay and the kind of trip.
Some people might be troubled by the side effects while taking antimalarial
drugs. These are usually mild and are not always a reason to stop taking the
pills. Sometimes it may be necessary to change to another type of medication due
to intestinal problems, allergic reactions or other intolerance symptoms.
Therefore it is the doctor who can best decide for each individual which drug to
use. This explains why individuals from the same group may end up taking
different drugs.
Finally, as no drug is 100% effective in preventing malaria, it is important
that if an attack of fever occurs in the first three months after your return
from the tropics, a malaria infection should be considered as a possibility
despite the correct use of the drug prescribed.
However, it is reassuring to know that malaria, provided it is recognised in
time, is easy to treat without any danger of recurrent attacks. The belief that
"once malaria always malaria" is totally untrue.
You can find even more travel health tips in the next pages:
DISEASES FOR WHICH VACCINATIONS ARE AVAILABLE: http://www.spain-holidays-advisor.com/vaccination.html
MORE TRAVEL HEALTH TIPS : http://www.spain-holidays-advisor.com/more-travel-tips.html
CAUTION: The information provided here should not be used during any medical
emergency or for the diagnosis or for the treatment of any medical condition. A
licensed physician should be consulted for any and all medical conditions. Call
911 for all medical emergencies.
About the Author:
Eddy De Vos is the owner of
http://www.spain-holidays-advisor.com/, a website about travel and Spain. It
contains usefull tips for your next trip, be it to Spain or anywhere else in the
world. Of course if you are planning a trip to Spain there is no better place to
start than there
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