Holiday and travel health FAQs
The world is full of travel advice. Don't eat the food. Don't drink the water. One of our favourite travel books warns 'swimming is not advisable when crocodiles are in the vicinity'. Boy, am I glad they pointed that out.
The trouble is tourism is a massive business these days and when there's money to be made, the advice is rarely as independent as it should be. Some travel companies pretend that the world is one big adventure playground where you can jump off mountains and plunge to great depths in total safety. Others imply that the world is a very dangerous place and that unless you travel with them you're going to be mugged or worse.
Before you go on holiday check whether you need any jabs. The further you are going and the longer you are going for, the more important it is to take advice. Don't assume that just because somewhere is a common holiday resort that it will be just the same as being at home. Don't leave it too late to check. Your doctor should be able to advise you but if you're on a more unusual trip - backpacking, for example - talk to a specialist travel clinic. There's one in most big cities. Your GP or travel agent can tell you where. GPs should be cheaper for common jabs such as tetanus, travel clinics cheaper for the more unusual such as rabies.
You're at risk of tetanus if you cut yourself on something rusty on the beach so make sure you're immunised with a ten-yearly booster. If you have a more serious accident while playing watersports in south-east Asia or the Indian subcontinent you might end up being exposed to hepatitis from unsterilised instruments or unscreened blood while being treated in a local hospital. Get vaccinated for hepatitis B before you go.
It's certainly unhealthy for the planet. According to environmental groups such as Friends of the Earth one return flight from the UK to Florida creates as much carbon dioxide - the major greenhouse gas - as the average British motorist can generate in a year.
As for the passengers, half of long haul passengers suffer from digestive problems and, because most airlines recirculate air mixing half fresh with half recycled, flu bugs and other airborne diseases are among the most frequent of frequent travellers.
There is a risk of blood clots and deep vein thromboses from sitting in cramped conditions for a long period of time. As many as one in ten passengers could be affected and - smug business travellers, be warned - not just those in eceonmy class. Reduce the risk by drinking plenty of non-alcoholic fluids and keeping mobile by walking about and moving the legs even while seated. Aspirin thins the blood but it is not suitable for everyone. Seek medical advice if you're considering this option.
The World Health Organisation is also worried about the risk of cancer among regular flyers following research showing that flight attendants were twice as likely to get skin cancer and 30% more likely to get breast cancer than the general population. These figures may be the result of lifestyle rather than airline travel but with the average long-haul flight attendant being exposed to radiation equal to 250 chest X-rays a year there is understandable concern.
Flying can also bring on a heart attack. The reduced cabin pressure at high altitude reduces the amount of blood in the body and brain and can increase the chance of serious illness including heart attacks in at risk individuals - older passengers and those with high blood pressure or vascular disorders. Eating and drinking before travel can help reduce the risk.
Finally, don't underestimate jet-lag. It disrupts at least fifty biological rhythms including hormones, body clock and blood pressure, can affect memory and is even implicated in cancer. It is usually at its worst 2-5 days after the trip but German research suggests it can take 11 days for blood pressure, heart-rate and levels of the antioxidant melatonin to return to normal. Daytime flights are generally less disruptive.
You can reduce jet lag's impact by resetting your watch when you get on the plane, drinking plenty of water and exercising. Store up sleep before you travel. Aromatherapy might help on arrival (peppermint and eucalyptus oils).
Some flyers swear by melatonin tablets but they are not licensed in the UK without prescription (though they are in some health food shops). A 2006 study suggested they were ineffective. Moreover, they are a hormonal treatment so you need to take the right dose at the right time for your body and type of journey.
Sunscreen is a must for any beach bum. Sunlight is good for you - it boosts vitamin D - but a sun tan is the skin's protective reaction to too much of a good thing. It's damaged skin. The fairer your skin, the greater your risk from sunburn and the risk of cancer that it brings. The sun's ultraviolet B rays burn and its longer ultraviolet A rays cause ageing. You need to get a sunscreen cream that protects against both.
At least 40,000 new cases of skin cancer are reported each year in Britain and the most serious form, malignant melanoma, claims the lives of over 1500 people a year. To protect yourself, apply Factor 15+ sunscreen as a matter of course but, more importantly, also stay out of the midday sun, make the most of shady areas and wear loose, protective clothing. If you're swimming - or if you're just a bloke who sweats a lot - use a water-resistant sunscreen. To maintain its level of protection, any sunscreen should be reapplied at least every two hours.
The SPF (sun protection factor) indicates the protection from ultraviolet B. Choose at least 15 but many people go higher - kids creams have an SPF of nearer 40. Ultraviolet A protection is shown by stars. Go for at least three stars.
Use a moisturiser or body lotion if your skin has had a lot of sun - it won't repair damaged skin but will help to tackle dry areas. If you do get sunburn, splash on calamine lotion to soothe the exposed areas and take paracetemol to ease the pain. Bad cases could need a doctor's prescription for steroid creams and antibiotics.
Use natural protectors too such as a T-shirt and, regardless of whether or not you're thinning on top, a sunhat. A wide-brimmed or legionnaire's hat offer most protection.
- UPDATE 2008: check our latest advice on suncreen
Cool idea - but, please, not like these.
Ultra-violet light is very damaging to the back of the eye, causing premature ageing and affecting vision so your best bet is to buy sunglasses which comply with BS 2724. These also have a 'shade number' that relates to the amount of UV allowed through - the higher the number, the better the protection. Aim for a shade number of 2.5 or 3.1.
Avoid bargain basement sunglasses that don't conform to the British Standard. The pupil in the eye opens wider when you're wearing sunglasses, so you need a lens that filters out the UV. Cheaper lenses actually allow in more UV light than would happen normally and can therefore do more damage than none at all.
Green lenses are among the most effective and, for safety, it's best to choose plastic, toughened glass or laminated glass. Wrap-around glasses are better for skiing but offer few practical advantages on the beach. Polarising lenses reduce glare from but can prove distracting on the road because they reveal the stress patterns in older types of toughened windscreens. You can check lenses for imperfections by holding them at arm's length and looking through each separately at a vertical line. You've got a dud in your hands if the line distorts or wavers when the lens is rotated slightly.
You can buy contact lenses with UV filters but you shouldn't be wearing any contacts on the beach. If sand gets in the lenses you can scratch the eye and, if you're swimming, bugs can get under the lens and cause corneal ulcers and nasty infections that would need urgent medical attention. Goggles won't help much as they almost always leak.
Just sitting in the sun will make you sweat and if you exercise you'll lose even more water (perhaps up to 1-2 litres a hour). Unless you want to feel hot and tired, or even develop a headache, drink loads of water (beer doesn't count). Aim to produce frequent, high volumes of light coloured urine.
If you start sprouting vast numbers of tiny blisters set in red, mildly inflamed skin then you've probably got prickly heat, an irritating but non-serious rash. Your best bet is to take cool showers, gently dab-dry the skin, apply calamine lotion and wear loose-fitting clothes.
Sharks attack 100 people each year, mainly between latitudes 30 degrees North and 30 degrees South. You're more likely to be attacked by much smaller venomous fish such as stingrays, weeverfish, scorpionfish or stargazers. The best first aid is to immerse the stung area in hot water and get straight to a doctor for an anaesthetic and, if necessary, a shot of antivenom.
A few jellyfish can sting very heavily and even cause death. But most stings are mild and feel like an intense burning sensation, rather worse than a nettle-sting. If you're stung, deactivate any remaining sting capsules attached to your skin with household vinegar and, if you develop a severe reaction, find a doctor.
Wasps are the most common insect pest on beaches. Deter them with an insect repellent and, if you're stung, remove the sting by scraping it away from the skin with a fingernail or credit card. Apply a sting relief cream or spray and take painkillers if necessary.
In many countries, clean, environmentally-friendly beaches are designated through the Blue Flag scheme. Find out what flag system(s) is used in the country you're visiting before you dive in. Different countries use different flags to show when it's safe to swim, when a beach is supervised etc. No flag - you're on your own.
Where sewage isn't treated to the highest level, harmful bacteria and viruses aren't killed and can survive in the water or beach sediments for up to 100 days. The main problem is diarrhoea but you're also at risk of skin rashes and ear, nose and throat infections. If you should get diarrhoea, take an over-the counter drug like Imodium and try an oral rehydration treatment.
The pollution of sea water with fertilisers and sewage has caused sudden increases in the growth of algae which can sometimes be toxic and cause skin irritation, gastro-enteritis, nausea, muscle cramps or much worse. Your best bet is to avoid beaches with red algae floating in the tide. If you know you're in an area with algal blooms, avoid eating the local shellfish at all costs - they can become highly toxic and leave you with serious problems, including diarrhoea, vomiting and even paralysis.
Yes but remember that four out of five cases of HIV in British heterosexuals result from sex abroad (2003 stats). If you're planning on making your own personal contribution to international relations, take some good old British condoms with you and use them. Standards and sizes are different in different countries. Click here for more info on using condoms.
Get real about the risks. Both fellow travellers and luscious locals may - like you - be telling the odd porky.
Easy. Visit the Foreign Office web-site either here or, if that fails, here. It has information on how to avoid being targeted because you're a tourist, health and all sorts of other useful advice. Highly recommended.
Be street-wise. Think before wandering around alone or late or going off the beaten track. And be prepared for culture shoc. Shake it by the hand. Other countries are different. That's why we go to them. Don't hide away in English pubs serving 'ye olde fish and chips'. Get out and you'll enjoy yourself more. Speak a bit of their ridiculous language rather than shouting at them in yours. Shout at them in their own tongue and they'll probably think you're one of the family.
Make sure your travel insurance covers health. The free travel insurance you got with the holiday may well not cover that 'underwater basket weaving in shark infested waters' excursion you've got your eye on.
In many places, it can cost you a fortune if you're not properly insured. Go to hospital with chest pains in the USA and you could get a bill for £6,000 even if it's just indigestion (a full heart attack comes in at £25,000). A broken bone's a snip at a grand (2003 figures).
With an European Health Insurance Card (EHIC), right, which replaced the E111 in 2006 most UK residents are entitled to medical treatment at reduced cost or sometimes free when temporarily visiting a European Union (EU) country, Iceland, Liechtenstein, Norway or Switzerland. Get it before you go. More information on the EHIC from the NHS here.
Plan ahead for any medical problems you might personally have abroad. Hot weather, for example, could see athlete's foot flare up or dry skin get drier. Dandruff will reappear the second you walk into a resort night club.
Delhi belly, Montezuma's revenge, Maltese dog - you can run into the runs anywhere. The main thing with diarrhoea is not to get dehydrated. Drink plenty of non-alcoholic, non-fizzy drinks. Mixing a litre of water with half a teaspoon of salt and six to eight teaspoons of sugar or honey and drinking that will keep your salt level up too. Don't overdo the salt as this will dehydrate you further.
If you are somewhere where you need to be careful about the water, remember also to say no to ice in your drink. Boiling water for a full two minutes will get rid of most impurities (though you should remove the dead fish and bicycle wheels by hand first).
Check out the NHS information for travellers abroad.
Have a great time!
Peter Baker and Jim Pollard.
Page created on May 9th, 2003
Page updated on August 12th, 2010