Travel Health : London Health

Although many people have no health problems when they go abroad, it is advisable to plan for your trip abroad carefully and make sure you’ve done everything possible to protect yourself from illness when you travel. Whether you’re going on a short break or heading off to the other side of the world, there are guidelines you should follow to keep yourself safe and make sure you get the most out of your trip. The following articles will highlight some of the dangers and risks of travelling abroad and will outline some of the most common travel illnesses, as well as offering information and advice on how to keep safe abroad and where to go if you need help when you’re overseas.

Immunisations

Immunisations can protect against a whole host of illnesses but they are not necessary for many travellers. If you are travelling to another European destination, America, Canada or New Zealand you shouldn’t need any immunisations but if you’re unsure you should check with your GP or practice nurse.

If you are going further afield, you will almost certainly need at least a couple of immunisations and you should start arranging these with plenty of time to spare before you leave; some immunisations are only available at certain clinics and some have to be ordered by surgeries, so make sure you don’t leave this until the last minute.

If you are travelling to Africa, South America, the Pacific Islands, the Far East and South East Asia, there is a good chance you will need at least some of the following vaccinations:

  • Hepatitis A: this is a virus that can be passed on through poor hygiene. It develops in unclean areas, where sanitation is poor and the water supply is contaminated. Hepatitis A affects the liver and can cause nausea and a soaring temperature as well as jaundice.
  • Hepatitis B: this is one of the most common viruses in the world and can be particularly nasty so it is a good idea to get vaccinated before you travel to most exotic destinations. Hepatitis B can contribute to liver cancer and other health conditions affecting the liver; common symptoms of the disease include diarrhoea, nausea and a loss of appetite. Hepatitis can spread quickly, through unprotected sexual intercourse, blood transfusions, using non-sterile instruments (during medical or dental procedures, for example) or by using contaminated needles.
  • Typhoid: typhoid is a very dangerous disease that is caused by a bacterium known as Salmonella typhi. It is prevalent in areas where sanitation is poor and there is contamination of food and water supplies due to the lack of a proper sewage system. Symptoms of typhoid include sweating, a sudden fever, diarrhoea, nausea and abdominal pain.
  • Yellow Fever: yellow fever is a serious condition which is spread by mosquitoes. Symptoms of the disease include vomiting, soaring temperature, nausea and weight loss. Some countries insist that travellers have the vaccination prior to them being allowed access into the country. Yellow fever vaccinations are only available at certain clinics; you should ask your GP or consult the NHS website for details of services near you.
  • Rabies: rabies is passed on to humans by animals; it is a vicious disease that attacks the nervous system. It can be fatal in some cases. It is a good idea to have a rabies vaccination if you are travelling to Africa, Asia or South America; you will then be protected in the event that you get scratched or bitten by an infected animal.
  • Meningitis: meningitis is common in some parts of the world and it can prove fatal in some cases as the disease attacks the brain and the spinal cord. Many people in the UK will have had a meningitis vaccination during their teenage years but if you’re not sure whether you’ve had one or you know you haven’t had one, you should arrange to see your GP. Symptoms of meningitis include nausea and vomiting and a soaring temperature.

Other serious conditions to be aware of:

If you are travelling to tropical destinations there are a number of different health conditions you should be aware of; there is no vaccination to protect against the following illnesses but using common sense will help to reduce the risks of suffering from these illnesses:

  • Malaria: malaria is a dangerous and potentially fatal illness, which is spread by infected female mosquitoes. If you are going to a high-risk area you should take anti-malaria tablets; usually you will have to take them for a period of time before and after your travels, as well as while you are away. Try to avoid going to places where there are a lot of mosquitoes (such as swamps and watering holes), wear long sleeved tops and long trousers, sleep in nets and use anti-mosquito sprays with a high concentration of DEET. 
  • Dengue Fever: dengue fever is also spread by mosquitoes; there is no specific treatment so the best thing to do is to follow the advice above and try to avoid mosquito bites. Symptoms of dengue fever include a soaring temperature, nausea and headaches.

Flying

Many people feel that their holiday starts as soon as they board the aeroplane but flying does carry some health risks; following a few simple guidelines will prevent illnesses and ensure you have an enjoyable illnesses.

DVT (deep vein thrombosis)

Deep vein thrombosis occurs when the blood flows too slowly through the veins; over time the blood builds up and forms a clot. In many cases, the body breaks the clot down by itself but if the clot is too large it may break up and a piece may travel up to the lungs, causing a pulmonary embolism; this can be fatal. The risk of developing DVT is increased on long haul flights but it can be dramatically reduced by following the guidelines below:

  • Avoid alcohol: this dehydrates the body
  • Drink plenty of water
  • Do frequent exercises, get up and walk about and stretch your legs and arms (this will improve circulation and prevent a clot from developing
  • Avoid taking sleeping tablets
  • Wear loose clothes so your legs are not restricted
  • Wear flight stockings (these are widely available on the high street and can also be bought from the airport)

Dehydration

Many people feel the need to make the most of the free alcohol often supplied as part of the in-flight service but this can be really damaging to the body. The pressure and air conditioning in the cabin of the aeroplane contribute to dehydration, which is made much worse by drinking large amounts of alcohol. If you want to have a drink, make sure you drink plenty of water at the same time to keep your body hydrated (this will also help to ensure you don’t start your holiday with a hangover). Dehydration can cause headaches, as well as affecting your concentration and contributing to deep vein thrombosis.

Fear of flying

Flying is a common fear, mainly because of Hollywood films and tragic events which appear in the media; however, in reality, flying is much safer than any other form of transport and has an extremely good safety record. If you are afraid of flying try to distract yourself from the thought of flying by listening to music, watching a film, reading a magazine or talking to the people you are travelling with. Breathe deeply and try to keep calm.

Treatment abroad

EHIC and travel insurance

All UK citizens in possession of an EHIC card should be entitled to free or reduced price care in all countries belonging to the European Economic Area. You can apply for the EHIC card online; it lasts for 5 years and is free of charge. If you are travelling to a different destination it is vital that you take out travel insurance to ensure you are financially covered in the event that you need treatment in a different country. If you are planning to do adventure activities or winter sports, you will need to make sure your insurance plan covers these activities (many don’t so make sure you specify this when you’re searching for a policy). If you are going to an exotic destination or are planning to be away for a while, it is probably best to go for the most comprehensive policy you can find; this will cover everything from your luggage and cancelled flights, to a financial payout in the unlikely event that something happens to you while you’re away.

Emergency Care

You may require emergency medical help while you are abroad; the numbers you will need are listed below:

  • throughout Europe: 112 (this is a universal emergency services number that will put you through to a provider in the country you are calling from)
  • Australia: 000
  • America, Canada and most parts of the Caribbean: 911
  • New Zealand: 111
  • Hong Kong, Ghana, Uganda, Zimbabwe, Qatar: 999

You should look up the emergency contact details for all the places you are visiting before you go and make a note of them; some countries have separate numbers for fire, police and ambulance services.

You should be aware that hospital facilities in many countries do not offer the standard of care that we are used to here in the UK; hospitals in the developing world will be particularly basic and resources and staff may be stretched. It is unlikely that you will undergo treatment in a developing country unless you absolutely have to; your insurance policy should cover the cost of returning home for treatment if you are well enough to travel; non-essential treatment is not recommended in these countries because the sterilisation process is not as rigorous and many of the staff do not have the necessary expertise.

Staying safe in the sun

Sunburn is one of the most common travel illnesses amongst British travellers. Many people are desperate to get a tan to show off when they get back off holiday but lying out in the sun for hours on end can be very damaging to the skin. Sun damage is often not visible but it will age your skin and make wrinkles and fine line appear prematurely. Prolonged sun exposure can also contribute to skin cancer, which is increasingly common amongst British people.

Heatstroke is also a common travel ailment and is usually caused by people spending long periods of time in the sun and not drinking enough water; this causes body temperature to increase very quickly.  Symptoms of heat stroke include:

  • Soaring temperature
  • Hyperthermia
  • Exhaustion
  • Fainting
  • Red and dry skin

Tips for staying safe in the sun:

  • Stay out of the sun between 11am and 3pm as this is when the sun is at its strongest
  • Use sun cream; if you are fair you should use a higher factor. Experts recommend using at least factor 15 to reduce the chance of getting skin cancer
  • Apply sun cream to all parts of your body, including your ears and the soles of your feet; these areas are vulnerable to sun damage. You should also use a protective balm on your lips.
  • Wear a sun hat if you’re in direct sunlight; this helps to prevent heat stroke
  • Wear sunglasses to protect your eyes from UV rays
  • Drink plenty of water; sweating makes you lose water so you need to keep topping your body up to prevent dehydration
  • Moisturise your skin regularly; you can use normal moisturiser or aftersun, as this will help to nourish the skin
  • Try to avoid falling asleep in the sun!

People can usually feel the skin burning them and the skin starts to become pink; if this is the case take some time out in the shade and apply a higher factor. Having sunburn will be painful and it may prevent you from going out in the sun during the rest of the holiday.

Sexual health abroad

Many people abandon all sense of responsibility on holiday and do things they wouldn’t normally do at home. A combination of the excitement of being on holiday and plenty of alcohol usually leads to an increase in unsafe sexual encounters. Sexually transmitted infections are one of the most common types of travel illness, with an increasing number of young Brits returning home with an unwelcome souvenir from their travels in the form of an STI.

Staying safe

Being on holiday, especially in bustling hot spots where there are thousands of young people, can potentially be very dangerous, especially for young girls so try to follow the guidelines below:

  • Watch your drink, especially in busy night clubs where there are thousands of people; keep hold of it at all times and don’t leave it lying around; this will prevent your drink from being spiked.
  • Know your limits: everyone likes to have a few drinks and let their hair down on holiday but just because you’re on holiday doesn’t mean you need to drink as much as possible. Drinking too much could actually ruin your holiday as it can make you do things you’d never dream of doing at home.
  • Don’t get into an unmarked taxi or accept a lift home from a stranger; you wouldn’t do it at home and seems obvious, but many people still do it every year; it can have disastrous consequences, especially if you’re on your own.
  • Stick with your friends and don’t disappear on your own; most people don’t take their mobiles everywhere with them on holiday and it may be hard to get in touch with you and track you down if something does happen to you
  • Always use protection if you’re going to have sex: you should use condoms that meet European standards (they have a kite logo) as ones in other countries may not be as effective; it is best to take some with you from the UK.

Common travel illnesses

Roughly 1 in 4 UK travellers get ill when they are abroad; most are affected by mild conditions which are caused by a change in environment. Some of the most common travel illnesses are listed below:

  • Sunburn
  • Heatstroke
  • Diarrhoea
  • Vomiting and food poisoning
  • Dehydration
  • Alcohol poisoning
  • Malaria
  • Sexually transmitted infections

These illnesses are very common but they could be avoided in most cases; following the guidelines listed below could reduce your chances of falling ill abroad:

  • Stick to bottled water: the water in other countries is often not as clean as the water in the UK so stick to bottled water (it is very cheap compared to the UK so it shouldn’t cost much)
  • Avoid pre-washed fruits and vegetables (the chances are they have been washed in non-bottled water, which may upset your stomach)
  • Wash all your food with bottled or boiled water
  • Avoid food that has had flies or insects buzzing around it
  • Use at least factor 15 sun cream
  • Drink plenty of water, especially if you’re drinking alcohol
  • Avoid the sun between 11am and 3pm
  • Use protection if you have sexual intercourse with someone
  • Avoid mosquitoes by wearing long sleeved tops and long trousers and using an anti-mosquito spray

Staying safe abroad: additional information

Following the guidelines above will help to reduce the chances of you getting ill or ending up in a dangerous situation while abroad, but there are a few other practical concerns which you should be aware of; some of these are outlined below:

Hiring cars and bikes

Make sure the car or bike you are hiring has a valid insurance policy and is roadworthy; this may seem obvious but hiring out cars and bikes is a means of making money for locals, especially in developing countries and they may be more concerned about getting their cash than hiring you a safe vehicle. Try to use established firms rather than backstreet, local organisations. Make sure your license is valid to drive abroad and your travel insurance policy covers you if you do have an accident.

Each year, hundreds of tourists are involved in motor accidents abroad; if you’re not used to the roads or the vehicle and you’re driving on a different side of the road to the UK, slow down and take it easy. Don’t drink and drive; this is a given for most people but the number of people that drink and drive on holiday is much greater than the number of people that drink and drive at home.

Swimming

Every year we see tragic incidents of people drowning on holiday. Make sure you stick to designated swimming areas in the sea and watch children carefully. Don’t try and go out too deep as the currents may be much stronger further from the shore and it will be difficult to swim back. In hotel pools, keep an eye on your children at all times and advise them not to run and not to dive in shallow water; some pools have a lifeguard on duty, but many don’t so you should be vigilant.

Drinking

Everyone likes to have a drink on holiday but it can cause real problems if it gets out of hand and you have too much. Alcohol affects your ability to make sound judgements, as well as affecting your balance and concentration. If you drink too much you are at a much greater risk of having an accident, making unwise decisions relating to sexual health and getting yourself into a potentially dangerous situation; limit the amount you drink, stay with your friends and drink plenty of water between drinks and before you go to bed.

Drugs

Drugs are very common in some tourist hot spots, where dealers are aware that there are a large number of young people who will spend most nights partying hard and drinking too much. Just as in the UK, you have no idea what is in the drugs and drug use is illegal; you could end up in jail, or even worse, in hospital fighting for your life.