Health and Vaccinations

Travel Insurance

We recommend that you take out comprehensive travel insurance. You should make sure it covers all medical expenses for injury or illness, as well as theft of valuables, damage to baggage, and cancellations or interruptions to flight plans. Make sure that you disclose any pre-existing medical conditions you have as this will save you the heartache and embarrassment of your claim being declined due to these conditions.

Medical costs overseas can be in the tens to hundreds of thousands of dollars and many families have been burdened financially by having to pay these costs unexpectedly.

If you are planning to rely on the travel insurance provided by your credit card, obtain written confirmation that you are covered and what exactly the insurance covers before you travel.

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Medication

If you are currently taking any prescription medication, or using needles or syringes it is extremely important that you make sure it is legal in the countries you are visiting by contacting the relevant foreign embassy.

I can't begin to tell you the importance of this but, when going on holiday, make sure you pack enough of your own prescribed medication. Make sure you have full supply and some more. Don't assume you will find a pharmacy with the medication you need at your destination. That goes in particular if you're traveling overseas. It's often extremely difficult to find the medications you need at a dose you need in foreign countries.

If you need to travel with large quantities of medication, it is good practice to separate the quantity between your luggage, in case bags go missing. Keep all medications in the original, labeled container and make sure you obtain a letter from your doctor explaining what the medicine is and stating it is for personal use only to avoid customs problems.

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Vaccinations and Immunizations

Hepatitis

Hepatitis causes serious damage to liver so it is not to be taken lightly. As a traveler, you are the most susceptible to Hepatitis A and Hepatitis B. There are other strains of Hepatitis, but when it comes to avoiding travel illness, Hepatitis A and Hepatitis B are the two you need to give a thought. Hepatitis vaccination is routinely performed in many countries - check with your local health center to see if you already have protection.

A vaccination to protect against Hepatitis A consists of a single shot that you should take few days before departing to your travel destination. More complete Hepatitis vaccination that gives protection against Hepatitis A and Hepatitis B is also available but needs to be taken as a series of three shots over the six month period.

More travel related diseases:

• Cholera
• Influenza
• Japanese Encephalitis
• Meningococcal Meningitis
• Rabies
• Tuberculosis
• Tickborne Encephalitis
• Typhoid
• Varicella (Chicken Pox)
• Yellow Fever

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Insect-Borne Diseases

Malaria

Malaria is transmitted by mosquitoes. Mosquito bites are unpleasant on principle, so the use of an insect repellent with a high DEET content is highly recommended in any area with these critters. It is also recommend that you purchase mosquito netting to cover your bed and protect you from being bitten you while you’re sleeping. They are generally cheap and they don't take much space in your backpack.

Malaria is no fun at all. It's actually a dangerous disease that could lead to coma and death. There are pills a doctor can prescribe to you that you should consider taking before and during your travels if you are going to a destination that is prone to Malaria. Just be aware of the side effects of these pills which is commonly photo sensitivity (your skin is more sensitive to the sun's rays) and nausea.

Dengue Fever

Dengue Fever is another nasty disease caused by mosquitoes and more distressingly has no preventative measures. The best prevention is to avoid being bitten so use a high DEET repellent.

If you are going to mosquito areas avoid soaps or lotions with floral scents (no scents is best). Eating massive amounts of garlic and vitamin B also makes you less tasty.

Other Insect-Borne Diseases include:

• Chikungunya
• Schistosomiasis
• Leishmaniasis

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Motion Sickness

If you're taking a cruise or bus tour you may experience motion sickness. Good thing is that most cruise ships will have medical professionals on board and guess what they deal with most - Sea Sickness. If you are at all concerned about your tummy then it's a good idea to get hold of some preventative medication before you set off.

Most people will get good results from simply sucking on ice. Accu-Pressure wristbands that rub anti nausea spots on people's wrists sound like a much better solution, but those may not work for everyone. Over the counter antihistamines can help since the center of motion sickness is the middle ear. Ginger is great for motion sickness. Whether in the form of tea, or just plain old ground it works. Chew on some ginger candy and prevent a plethora of tummy troubles.

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Altitude Sickness

If you are planning on traveling to altitudes above 8,000ft (2,400m) then we recommend spending a day or so acclimatizing before doing any strenuous activity. Especially when traveling to countries such as Nepal, Bolivia, Ecuador and Peru.

Altitude sickness is caused by a lack of oxygen or low air pressure and the common symptoms include headaches, fatigue, nausea, stomach upsets and dizziness. If you experience any of these symptoms at altitude it is a good idea to rest up and stay put. Drink plenty of water and avoid alcohol to avoid getting dehydrated.

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Stress and Exhaustion

Stress is a major cause of that run-down feeling which can make a person more susceptible to getting sick. You will no doubt encounter setbacks when you travel so it is important you don't let them get to you. It is important to remember there are some things you have no control of.

Don't try to pack too much into your day. Trying to see too many sights, particularly in a hot climate, can lead to exhaustion. Aside from tiredness, symptoms include dizziness and confusion. Related hot-climate risks: painfully blistered feet and raw, itchy groins (For the latter, over-the-counter anti-fungal creams are available in most countries).

Get Rest: Much like stress, exhaustion can also help make you more susceptible to the airborne germs that multiply during the colder months of the year. Make sure to get 6-8 hours of sleep nightly to help fend off any germs that may be attempting to bring down your immunity.

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Pregnancy

If planning a trip when pregnant, one has to think of the worst case scenario. Where would I be if this occurred? Would medical help be safe, clean, of good standard and accessible? The safest time for travel is between the 12th and 28th week of your pregnancy. After the twelfth week, a pregnancy is better established, the nausea has diminished and the woman's energy levels return to normal.

On the other hand, after 28 weeks the extra weight may cause fatigue and when traveling to a tropical climate the higher temperatures may not be well tolerated. In the final twelve weeks there is always the possibility of a major complication including: premature labor, toxemia or hemorrhage. For this reason frequent checkups are strongly advised.

Long flights and bus rides increase the risks of DVT in pregnancy. Sitting in an aisle seat, drinking plenty of water, taking frequent walks and wearing varicose support stockings in-flight help reduce the risk. Regulations forbid pregnant women traveling on international flights from 35 weeks onwards.

Generally, all vaccinations are best avoided in the early part of pregnancy. Fever, as a side effect of vaccination, can, in itself, unsettle an early pregnancy. Live vaccines, such as Yellow Fever, should not be given and killed vaccines best left until after the twelfth week of pregnancy or better still, completed prior to the pregnancy. For travel to less developed countries, Hepatitis A protection is essential. This is the commonest vaccine preventable disease of the serious food and water-borne infections and is much more severe if contracted during pregnancy.

High-risk malarial areas are best avoided by pregnant women. Malaria infection in the mother can be devastating to the fetus. The more effective anti-malarial drugs cannot safely be used.

High altitude trekking and scuba diving are contraindicated in pregnancy. Hot tubs and spas are best avoided because of the risk of raised body temperature and infection.

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Traveling with Children

Children have a short attention span and tire easily, so it is a good idea to avoid too many long bus trips or consecutive days in museums. Whenever possible, break long journeys and leave some unstructured time each day for children to play.

Arrive at the airport early and request seats in front of the bulkhead, or near an exit for more legroom. Feed during takeoff and landing to encourage swallowing which will minimize ear discomfort. Carry prepared bottles of juice - flying can be dehydrating, even breastfed babies may need supplemental fluids. Hand luggage should include disposable nappies, plastic bags, moist towlettes, a change of pants, a few books and favorite toys.

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Deep Vein Thrombosis (DVT)

For long air trips, doctors often recommend wearing compression socks. They're long (to just below the knee) and apply light pressure to the legs (where DVT most often occurs) to encourage blood to move more efficiently through limbs. Circulation hose are advisable for those at risk of developing clots in the calf veins, people who are overweight, or who smoke or are taking the oral contraceptive pill.

Though it's relatively rare, higher-risk individuals (people who've recently had surgery, for example) should ask doctors whether taking a prescribed blood thinner (anti-coagulant) is warranted.

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Ear Pressure

Doctors say that ear pain is one of the most common travel afflictions. Air pressure in the middle ear should be the same as that outside your body. The ear's Eustachian tubes help keep it this way. On a plane the pressure changes rapidly during take-offs and landings playing havoc with this.

So, the air pressure in the middle and outer ears becomes different - and eardrums are pulled towards the brain. In most cases this is merely painful but in very rare instances eardrums perforate.

Swallowing helps many people while others find chewing gum or sucking sweets helpful. Some say taking decongestants prevents pain. Symptoms are worse if you have a blocked nose.

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Jetlag

Jetlag is caused by a disruption to your daily rhythm when you travel long distances across time zones. You may experience fatigue, disorientation, sleeping difficulties, impaired concentration and loss of physical performance, anxiety, loss of appetite and even constipation.

There are a number of ways to minimize the impact of Jetlag including:

• Ensure a good sleep the night before flying and allow plenty of time to get to the airport.
• Plan a stopover if possible. Try to arrange the itinerary so that you are flying into the night.
• Reduce alcohol and coffee to a minimum during the flight. Minimize dehydration by drinking two or three glasses of water per sector. Carbonated drinks cause bloating through expansion of stomach gases on descent.
• Eat the lighter, more digestible parts of your meal and avoid fatty foods and carbohydrate rich foods like pasta.
• Wear loose clothing, long skirts or comfortable trousers, light sweaters. Wear comfortable shoes and take them off on the plane.
• Try to sleep on longer sections of the flight. Close the blinds, wear an eye mask and ask for a pillow.
• Take regular walks around the plane and stretch your arms and legs.
• Frequently wash your face and eyes. Use moisturizers to reduce feeling of dehydration. People with contact lenses should carry a lens case and saline solution in case of drying out.

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Sexually Transmitted Diseases and Infections

Travel provides opportunities for casual sexual encounters which may increase the risk of acquiring a sexually transmitted disease. It is important for everyone to be aware that while the symptoms of these diseases may be trivial, the long-term consequences for the individual and their partner may be very serious.

The only sure way to avoid STD's is to abstain from sexual contact altogether. Safer sexual practices such as using condoms may help prevent infection but don't provide any guarantees.

HIV/AIDS is a global problem of enormous proportions. AIDS is caused by a Human Immuno-Deficiency virus (HIV). Infection with HIV is more common than AIDS. It is contracted most frequently by unprotected sex with an infected person. It can also be transmitted by transfusions of HIV infected blood and from infected mother to child during childbirth or breast-feeding. There is currently no vaccine or cure for AIDS.

Other common sexually transmitted diseases include Gonorrhea, Syphilis, Hepatitis B, Herpes and Chlamydia. Practices used to reduce the risk of HIV transmission will also reduce the risk of these other diseases.

Although HIV is considered the most serious of the STD's, others may have long-term consequences such as infertility.

It is extremely important to practice safe sex when traveling to developing countries where medical care is less available and the prevalence of STD's is much larger. South Africa and India have the highest rate of AIDS worldwide.

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Food and Water

Contaminated food and beverages present one of the largest health risks for travelers, especially when traveling to developing countries. They are responsible for serious diseases such as Cholera, Typhoid, Hepatitis A and, most of all, travelers' diarrhea.

The golden rule is to NEVER trust the local water supply in a developing country without first treating it effectively.

Travelvax advises that even if the water seems safe for the locals, it more than likely contains bacteria and organisms you have never experienced before, and these could make you ill. Remember, at least half the people visiting a developing country will experience Travelers' Diarrhea at some point.

Effective treatment of water includes boiling water, disinfection using iodine tablets or chlorine and purification/disinfection using a water purifier (usually the most common and simplest method).

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Travelers' Diarrhea

It’s one of the most commons holiday illnesses a traveler could contract during their holiday. The cause of diarrhea while traveling is generally a bacterial infection due to poor hygiene.

How to avoid getting travelers' diarrhea:

• Make sure your food is thoroughly cooked. Raw food can be very unsafe, this includes salad. If you do want salad then make sure it has been washed in bottled water.
• Eat fruit you can peel like bananas
• Drink bottled water (make sure the seal is intact when you buy it
• Avoid ice cubes as they often contain bacteria

When traveling it's a good idea to take some Imodium or other anti-diarrhea medication with you, just in case you come down with a case of "the runs". If you do happen to get diarrhea make sure to drink plenty of water and replace your salts to avoid dehydration.

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Sunburn

If you're on an island holiday or a beach break it's easy to get excited and enjoy the beautiful, scorching sun a little bit too much. Do not under estimate the power of the sun. Have a waterproof sun block with you at all times. It is recommended to get a sun block with at least 30 SPF (Sun Protection Factor). It is important to know that this actually means your skin will take 30 times longer to burn than with no protection.

Tips to Relieve Sunburn:

• Apply cold compresses for immediate local relief. Wrap ice cubes in a towel and press against burnt skin
• Use pain killers (ibuprofen or acetaminophen) to relieve discomfort and suffering
• Apply aloe - aloe will keep your skin moist after sun dried it out
• Drink lots of water. Keep yourself hydrated - or better yet, over-hydrated. Drink way more water than you would otherwise

If you're traveling with children, be particularly careful not expose them to too much sun. Little children should wear sunglasses, hats and plenty of maximum protection sun block at all times. It's best to use a sun block that's not waterproof on children, as they rub their faces a lot and could get it in their eyes, making it rather difficult to get out afterwards. There are also specially designed swim suits that block out UV rays.

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Travelers' Health Checklist

• Aloe Vera Gel
• Hand Sanitizer
• Diarrhea Pills (Imodium)
• Anti-Nausea Medication
• Band-Aids
• Birth Control
• Condoms
• Eye Drops
• Insect Repellent with high DEET
• Mosquito Netting
• Painkillers - Ibuprofen or Acetaminophen
• Sunblock with 30 SPF - apply sunscreen regularly
• Your Prescription Medication
• Travel Insurance
• Ensure your vaccines are up to date
• Make sure to respect local laws and customs

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More Information

To find out more about healthy travel and vaccinations visit:

• World Health Organization: www.who.int

Image Credits

Creative Commons, GNU, and public domain licensed images used on this page.

• (polio vaccination) - http://www.flickr.com/photos/julien_harneis/4181939362/
• (mosquito) - http://www.flickr.com/photos/31031835@N08/4220922584
• (altitude sickness) - http://en.wikipedia.org/wiki/File:Altitude_sickness_warning.jpg
• (condom) - http://en.wikipedia.org/wiki/File:Trojan_her_pleasure.jpg
• (street food) - http://en.wikipedia.org/wiki/File:Making_candied_fruit_in_Tianjin_China_.JPG
• (toilet) - http://www.flickr.com/photos/runran/4378166435/
• (sunburn) - http://www.flickr.com/photos/kirinqueen/159448759/
• (tired) - http://www.flickr.com/photos/tomsaint/3752937440/
• (pills) - http://www.flickr.com/photos/flowers-of-the-sea/4361289396/