A bit of forward planning before a holiday can go a long way towards preventing health problems and preparing for any that do occur, so that the time abroad can be enjoyed without being interrupted or ruined by ill health.
The following is a guide not only to minimising the damage when illness hits, but also to maximising the fun when it doesn't.
Before you travel
As soon as the destination and route are known, make sure that you know the health requirements for your journey.
This means knowing the immunisations required for the destination and any countries visited en route, and any special health hazards that might be present (e.g. malaria). You can start collecting this information through your travel agent or from a specialist travel clinic.
Immunisation can protect the body against many of the more serious illnesses that can be contracted abroad but they can take several weeks to take effect and provide the body with maximum immunity. It is advisable to contact your surgery at least two months before departure for immunisation advice.
Some countries require yellow fever vaccination in order to cross their border, the practice nurse or travel clinic professional will inform you if this is the case (sometimes you will be asked to go to a special centre to obtain the yellow fever vaccine as not all centres are approved to give this). Immunity is said to start from 10 days after the vaccination has been given. An International certificate of vaccination is supplied to the patient to reflect this. There may be a charge for some immunisations.
Current medical conditions and treatment
It is a good idea to discuss any significant health problems with the doctor or nurse giving the travel vaccines in case you need particular advice regarding your condition. It is also sensible to take an adequate supply of essential medication with you, although for travellers going abroad for a long time it is wise to check how much you are able to take. NHS doctors are restricted in the amount of medication they are allowed to prescribe for people going abroad for many months.
A clear record of any current medical condition, drug treatment and allergies is useful to take with you and it is best to record the generic or actual drug name, not just the brand name. Keep prescribed medication in its original labelled container at all times. If necessary, take a printout or surgery-stamped record of the prescription medication and keep it with the drugs. This will present no problems at the customs gate.
Common problems and essential items
With ever increasing travel to varying destinations abroad it is likely that contraction of malaria will rise in the future. Most cases of malaria occur in people who do not take adequate preventative measures. It is therefore important to do as much as possible to avoid contracting the disease. Two areas of prevention exist.
The chief means of preventing malaria is to avoid being bitten by a mosquito in the first place because anti-malarial tablets do not provide 100% protection against the illness. Measures such as insect repellant, clothes which cover most of the body and mosquito nets at night are very important in areas prone to malaria.
You will need advice (eg through a travel clinic or GP) about what kind of malaria tablets are required for the part of the world being visited since in some countries the malaria parasite is resistant to the usual malaria prevention medication. Many kinds of malaria prevention medication can be bought over the counter at the pharmacy, but it is important to know which ones to obtain. Follow the instructions given to you about the medication because malaria prophylaxis (prevention) needs to be started before travel and continued for up to several weeks after returning home.
Finally, if someone develops an illness with a fever after travelling to a country where malaria exists, within seven days of entering the country and up to one year afterwards, they should seek medical advice even if they have conscientiously taken their malaria prophylaxis tablets. It is still possible that they have developed malaria, which if diagnosed and treated early enough is almost always treatable.
Take a pack of assorted plasters; a crepe bandage for supporting minor sprains; a small pack for padding bleeding wounds; a roll of surgical tape for fixing the bandage and gauze; a dry antiseptic spray for sealing wounds (which is very important in the tropics where wounds fester easily); sharp scissors and tweezers (useful for removing splinters, sea urchin spines and other foreign objects); a few safety pins and some painkillers.
Remember that no sharp objects can be carried as hand luggage. Check with your airline before travelling.
Travellers tummy is very common. Take something to calm the bowel down. Loperamide is a good example, and though it doesn't treat the cause, it reduces the inconvenience and misery of diarrhoea, making travel possible. The main consequence of diarrhoea is dehydration, especially so in hot countries. The simplest and easiest way to replace the lost salt and water is to use rehydrating solutions. These are widely available as sachets of powder or effervescent tablets. Alternatively prepare your own solution, by mixing one litre of boiled, filtered water, with eight teaspoons of sugar and one further teaspoon of salt.
HIV and Hepatitis
The virus causing these diseases are transmitted in body fluids through immediate contact in unsafe sex or medical procedures, such as unclean instruments in surgery. Take a supply of condoms if casual sex is likely, and if you are travelling to remote areas of a developing country, a prepacked sterile kit of needles, syringes and sutures, which can be used by medical personnel on you. These are easily available.
Eating and drinking safely
Good personal hygiene is important. If the water quality is dubious, drink only bottled water, and preferably a known brand in sealed bottles, to avoid counterfeit and unclean water. Likewise avoid ice from street stalls and salads that may have been washed in local water. Go to cafes or shops. Avoid food which has been kept uncovered and avoid unpasteurised milk
When you return
If you were treated abroad, declare your medication in customs on return to the UK; it may not be legal to bring it in to the country. Remember to continue and finish your course of anti-malarials on return. If you have diarrhoea on return and your job involves food handling, tell your employer as soon as possible. If you were ill abroad, submit a note of the illness, with as much medical information as possible to your GP on your return. If you fall ill after returning, remember to tell your doctor where you have travelled.