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Travel health; jabs and vaccinations

Staying healthy on your travels

Most common serious ailments that affect travellers are contracted either by the bite of an infected animal or insect, by ingestion of contaminated food or water or by close contact with infected individuals. The last of these three is very difficult to avoid so those at specific risk should be vaccinated where appropriate, but certain measures can be taken to avoid contracting an illness transmitted by the first two routes.

Bite Avoidance
The most commonly contracted mosquito borne disease is malaria (see above), it is certainly not the only one and therefore good bite avoidance knowledge is essential and should be employed by day, but especially at night when a majority of malaria carrying mosquitoes bite.

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Food and Drink
Contaminated food and drink can lead to a multitude of ailments from uncomplicated travellers diarrhoea to a variety of worms and parasites. It will always be a temptation to eat as the locals do or from street stalls serving enticing meals. Always ask yourself if it has been prepared from fresh ingredients and is well cooked.

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Motion Sickness
Some people are more susceptible than others to becoming nauseous whilst travelling, sitting in the front seat of a car, or towards the front of a plane may help, likewise being in the middle of a ship. Never attempt to read whilst feeling motion sickness. There are many brands of 'travel sickness' tablets on the market and your pharmacist will be able to advise you on the ones most suitable for you. Alternatively ginger tablets or capsules seem to provide some relief, as do wrist-bands that work on acupuncture points. Both will be available through local pharmacies.

Jet-Lag

There are many tales around about how to prevent jet-lag, but very few have any proof attached to them. There is much talk of melatonin (a hormone released by the brain just before sleep) but it is currently unavailable in the UK. There are a few tips that may make the transition to a new time zone easier:

- It is always best to avoid alcohol on flights and maintain a good fluid intake of water and fruit juices
- Change your watch to the time at your destination as soon as you board the plane
- Get some sun (sensibly) as soon as you get to your destination, this will suppress natural melatonin production and encourage your body to believe that it is in fact daytime
- Adopt local time as soon as you arrive, even if you are not tired go through the motions of going to bed to get a new rhythm as soon as possible.

Safety in the Sun
When first arriving in a tropical climate the high temperatures and humidity may well seem quite oppressive and you will sweat profusely, this can consequently lead to dehydration and lethargy. It will take about three weeks for you to adapt to your new environment, therefore during this settling in period it is advisable not to over exert yourself and maintain a high fluid intake of safe drinking water. Throughout your stay there are a number of other points that should help you stay healthy in the sun;

- Avoid prolonged exposure to the sun. You don't have to get a tan in the first week away - there'll be plenty of time to get one slowly and healthily by using sunscreen and building up the time you spend in the sun, which is at its strongest between 11am and 3pm
- Always wear a wide brimmed hat to protect your face and neck
- When purchasing the clothes for your trip, check on the UV protection rating. Closely woven cotton, is comfortable and protective, but some of the newer, lighter fibres are also very effective
- Always wear at least a factor 15 sunscreen that protects against UVA (burns and ages skin) and UVB (burns only), and if applying insect repellent as well, don't forget to put this on after your sunscreen.

Altitude
When travelling to altitudes above 3,000m it is imperative that the ascent is made slowly with time to acclimatise below this level. If this is not possible most individuals will experience breathlessness on even the most minor exertion, possibly with headache and nausea. Paracetamol should relieve the headache but if it is too severe and combined with nausea, medical attention should be sought. At least three days should be allowed for acclimatisation at this level before strenuous activity, but if this is not possible there is a drug called acetazolamide that may be help in some circumstances. It is available on prescription only and must therefore be discussed with your GP or travel health professional before you go. To limit the effects of altitude sickness:

- Avoid alcohol on the plane if flying directly to altitudes above 3,000m to prevent dehydration
- Rest as soon as you can when you arrive at you destination, and take it easy for at least 24 hours
- Local remedies such as coca tea are of dubious effectiveness, they shouldn't be relied upon but are culturally important
- Altitude sickness is potentially very serious, and therefore if the headache and nausea do not resolve, medical attention should be sought.

Safe Sex
Practice safe sex - take contraceptives with you and always use a condom. It's a joint responsibility so take control. Always look for the British kite-mark and make sure the condoms are in date. Aids is a real danger all over the world.

Before travel, it is likely that anyone would say that there is no chance of them having sex whilst travelling - its too risky. However, it is a fact that in a relaxed atmosphere after a few drinks the unexpected will often occur, and it is always better to be prepared than to run the risk of pregnancy and sexually transmitted diseases, not least of all HIV.

You may think that the partner you have chosen seems nice a nice bloke/girl, but the last person that they slept with may not have been! Condoms will not be available in many countries throughout the world and those that are available may be of poor quality due to bad storage or old age.

And finally...
Take your own supply of hypodermic needles in case you need an injection or to have blood taken - there's a slight chance hospitals in some less developed countries might use needles which haven't been sterilised properly.