Animal contact and bites

  • Discuss with your Doctor or Nurse the need for rabies vaccination if travelling in areas more than 24 hours from medical help in risk areas.
  • Know what to do if you get bitten – wash the wound for 5 minutes under running water with soap. Rinse and pour an iodine preparation or 60-70% alcohol on the wound and get to medical help IMMEDIATELY.
  • Do not have the wound stitched for at least 48 hours.
  • If you are bitten by an animal abroad it is important to see your Doctor on return
  • Always wear long trousers and boots when walking through undergrowth or long grass
  • When sleeping outside always have the bed raised off the ground
  • If you meet a snake do not panic keep very still until it goes away!
  • Carry a torch and spare batteries when walking at night

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Preventing Insect Bites

First line protection for the traveller against any insect borne disease is not getting bitten in the first place.

Risk of contracting certain diseases varies with location of your accommodation and for those travelling to rural areas certain risks increase.

Mosquitoes

While malaria mosquitoes feed between dusk and dawn, other types of mosquitoes carrying different diseases bite at other times of day. It is important to discuss with your Travel Health advisor

  1. when you are at risk of mosquito borne disease and
  2. what time of day carries the greatest risk.

Mosquitoes tend to respond to light in their feeding habits, some preferring daylight, others darkness.

Malaria mosquitoes usually prefer low light hours after dusk until dawn. Dengue mosquitoes’ peak biting times are the few hours before dusk and the few hours after dawn and are present during the day light hours.

Avoid being bitten by mosquitoes by applying a good mosquito repellent to exposed areas every 6 hours. Clothes can also be impregnated with repellent for further protection. If wearing sunscreen, apply your repellent on top.

Keep your legs and arms covered with clothing to lower risk of bites on the skin. Avoid wearing dark colours, as they can attract mosquitoes. While mosquitoes are able to bite through many materials, canvas mosquito boots and thick denim jeans will make it more difficult in rural areas, where the risks are always the greatest.

Use a ‘knock-down’ spray in the evening to get rid of mosquitoes before going to sleep. Avoid strong perfumes, hair sprays or after-shaves as they can attract mosquitoes!

Use air-conditioning if it is available. Because air conditioning helps keep the mosquitoes away due to the lower temperature, it is important that it is left on all day and that the windows or shutters are not left open at night!

Try to avoid evening walks beside rivers and ponds as this is where mosquitoes breed.

Use this information along with any medication advice your doctor has given you.

Other biting insects include the small sand fly, which is capable of spreading Leishmaniasis in certain locations; ticks, which are responsible for diseases such as Lymes disease; and mites which can cause scabies; as well as many other different species.

In a risk area, it is wise to use a bed net, which is impregnated with permethrin. For a net to be effective, it needs to be impregnated with permethrin at least every six months or whenever it is washed. While sand flies will be able to get through the holes, by landing on a net that is impregnated, they will be killed.

Use a repellent that has DEET or contains a natural repellent such as lemon and eucalyptus; try to avoid using products that are connected to homemade concoctions!

Clothing that has been impregnated with permethrin will also help repel insects if you will be working in a rural area. This clothing, along with impregnated wrist and ankle bands, lower the risk of being bitten. If you are reluctant to impregnate everyday clothing, impregnated netting worn over the clothing will prevent chemical contact with the skin. It is important that fellow travellers are protected in a similar way, as repelled mosquitoes will go to another person who is not protected!

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Preventing Accidents

The tourist on holiday or away from home is relaxed, and in an uninhibited environment away from social restrictions that they might live by at home – being off guard means a higher risk of having an accident!

Beware of the risks on roads – driving ‘on the other side’, new signs, unfamiliar winding roads, badly maintained roads and different standards in car and moped safety.

Always check a vehicle before renting – especially the brakes, seatbelts, insurance and emergency numbers.

NEVER DRINK AND DRIVE

NEVER DRINK AND SWIM

Always swim with others, keep check on tides, currents and strong winds

Allow at least one hour after eating before swimming and never fall asleep on an airbed in the sea!

Check swimming pool depths before diving

Always look for emergency exits and check balconies and first aid arrangements on arriving at your chosen accommodation.

If you try a new sport check that there is adequate instruction, well kept equipment and you are at a good level of personal fitness.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Business Travel: Taking Time to Adjust

A person can be sitting in their GP surgery shortly after arriving home with a tropical disease such as malaria, dengue fever or diarrhoea. These conditions in times gone by were incubated on board ocean going liners and never reached the shores of the United Kingdom. This problem, brought on by the speed of international travel, is often overlooked. Another problem, which faces the frequent business traveller, is the issue of adjusting to time changes and Jet Lag. Good pre-planning and thinking through the issues will help in dealing with differences in time.

Good Pre-Planning

When booking your flight, look at the travel times available and plan for a time to sleep. Get a good nights sleep the night prior to travel, ensure you are well organised and everything related to your trip is in order. If you need to be in meetings as soon as you arrive, try to fly during a time when you usually go to sleep. Choose a direct flight that cuts down on travelling time.

On Board the Flight

When you are flying try to avoid alcohol. As well as dehydrating your body, and increasing your risk of DVT, it can leave you feeling sluggish. Drink plenty of fruit juices or water. Still water is better than carbonated, as this will keep you from the inevitable bloated, gassy feeling associated with carbonated drinks. Avoid any stimulant such as caffeine until you have had a nights sleep at your destination

Try to exercise regularly on the flight, as this will help your circulation. Just a short walk around the cabin or moving your ankles around can help improve your circulation in a pressurised cabin. Using an exercise aid can be useful on a long flight

Do not change your watch during the flight, stick to your home time until you reach your destination. This is especially important if you are a Diabetic and need to continue a strict insulin regime during the flight. If your watch says it is 11pm and time for bed – close your eyes and sleep (even if it means missing the movie!). If you need to make connecting flights however, do check the local time regularly as you could end up missing a vital flight.

When you arrive

When planning your schedule try to allow for a few hours to rest when arriving at your destination to give yourself time to be at your best for meetings. A warm shower is a good way to get refreshed, but avoid hot baths as they can relax the body and you might find it hard to get going again!

On arriving at your destination change your watch to local time. Try to adjust immediately to local food and sleep patterns. Exposing yourself to bright light is believed to help your body return to normal cardiac rhythms. Some travellers have seen positive effects using melatonin, but you should discuss its suitability with your Doctor, others suggest the use of short acting sleeping tablets to help you sleep those first few days away.

There are many suggestions and discussion on this issue of jet lag and many proficient travellers will have an established routine and way of dealing with it. But despite any suggestions to the contrary, the body still needs to adjust and it is essential to rest after any flight.

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Coping with Jet Lag

Time Zones

The earth is divided into 24 time zones, with time changing by one hour for every 150 of travel east or west of the Greenwich meridian. When travelling from London to New York you would need to turn your watch back by five hours, while travel to Japan from London means turning your watch forward by nine hours (nine time zones). Arriving in Tokyo by plane from London at bedtime your body will feel as though it is lunchtime.

It takes about one day per time zone crossed to adjust to local time.

Ways of reducing Jet Lag

In order to cope with Jet lag you should get a good deal of sleep before your journey. It is also important to rest as much as possible during your flight. Planning to arrive at your destination as near to the time when you normally go to sleep will also help with the adjustment. If you are able to plan your itinerary allow time on arrival for adjustment.

Some people advise changing their watches to destination time when they get onto the plane. While this helps many people, for those who are on regular medication, such as diabetics, watches should remain on home time until you are able to adjust your medication to local times on arrival at your destination or as suggested by your health advisor.

On arrival at your destination get active as soon as possible and adjust your meals and activities to local time as soon as you can. Exposure to light is also a good way of naturally allowing your body to adjust. If you need to take a short nap – use an alarm clock or a helpful friend to wake you up!

Medication in reducing the effects of Jet-lag

For those with important schedules and meetings it would be worth discussing with your doctor the possible benefits of a mild sleeping tablet for 2-3 days whilst you adjust.

The drug melatonin is used frequently in the USA – although research is limited. Taking the drug is advised just before bedtime. After taking the drug you should avoid driving as it can make you very drowsy.


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

When you’re not in the driver’s seat

Allow plenty of time to arrive at the station, airport or dock – much anxiety is involved in arriving late!

Check you have all travel documents before you leave home including visas and that your passport is valid for the return journey.

Listen carefully to any safety advice you are given and be aware of any emergency instructions

Carry any medication in your hand luggage.

If you have had any surgery, ear problems or other medical condition recently, discuss it with your doctor and tell the airline or travel company before you go.

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Travel Delays

Contact your travel provider

For those flying from UK airports to holiday or business destinations this summer, it is important that you contact your airline or tour operator BEFORE you leave home. This allows you to be prepared and, if necessary, make alternative travel arrangements.

Many schedule airlines will be prepared to offer flight vouchers for alternative flights, or book you onto another flight if your flight is affected. Those travelling with a tour operator on a charter flight to their holiday destination will need to get specific recommendations from their tour representative.

Waiting

While many people will be able to make alternative arrangements, others will find themselves spending extra time at the airport before they travel. If this is the case don’t let it ruin your trip – there really is not much you will be able to do about it and anxiety and anger will only make the situation worse – both for your own health and for those around you.

Take plenty to do in your hand luggage – a good book or a simple hobby to pass the time away.

Perhaps the ones who suffer the most when there are delays are those travelling with young children. Carry with you essential supplies for changing and entertaining and make use of the play areas situated in many European airports.

Where to call for help

For specific information regarding individual main operators:

Air France

BAA

British Airways

  


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Fear of flying

Many factors can be associated with this condition, all of which need careful consideration and help.  While factors associated with a fear of flying can be psychological in nature, travellers can also experience further pre-travel stress due to poor pre-travel preparation.

Plan Ahead

Good planning is essential to overcoming travel fears. Many in-flight medical emergencies can be attributed to the stress that builds up at the airport, before the traveller gets on the plane. Make sure you have visited your family doctor or nurse for general health advice. Sort out any required vaccinations and discuss malaria prevention well in advance of your trip. If you are at risk of DVT, discuss prevention with your doctor or nurse.

Know where you are going

Think about your day of flying before it happens — pre-book seats and order any special meals you might require, including any children’s meals. If you have any disabilities, contact the airline in advance of your trip to discuss special requirements, such as wheelchairs or assistance on and off the plane.

If you have never travelled to your airport before, allow plenty of time to get there. If you are unfamiliar with the airport layout, or are a first time traveller, try a practice run prior to your day of travel.

Allow plenty of Time

Arrive in plenty of time for your flight and always allow for delays when you travel. Carry a book in your hand luggage and have letters to write while you wait. If you feel anxious, take a portable CD or cassette with calming music to listen to while you are waiting. Never find yourself stranded at the airport with nothing to do, and try to avoid the bar while you wait!

Fear is Common

Understand that travel fears are common. Try to avoid excessive alcohol or drugs as a way of helping you to cope. Alcohol will not get rid of fears and often exacerbates them; it will also leave you dehydrated.

If you have to travel a long distance by air, try to avoid connecting flights. A little extra money spent on a direct flight is worth the expense, if it means no added anxiety about possible delays or missed connections.

At the end of the day, if you are suffering from any form of psychological illness or depression, it is important that you talk it over with your doctor and consider postponing your trip until you feel better.

Further Information

Virgin Atlantic’s Fear of Flying website also features a number of courses and videos

   

Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Travelling with Medication

Some airlines now restrict the amount of hand luggage allowed on flights, it is essential to check with your individual airline prior to flying.

The Chief Medical Officer in the UK has issued a procedure for those taking medication on flights (DOH 2006).

  • It states that travellers should be discouraged from taking medication onto flights unless it is for the immediate journey and an allowance of time at the other end to pick up your baggage (allow at least 4 hours).
  • It also recommends that all extra supplies of medication for your arrival should be placed in the hold luggage.
  • Any powder/inhalers or tablets can be carried in the hand luggage – up to 50 grams
  • Any liquids, creams or gel medications which are essential for the flight may also be carried in the hand luggage as long as they are smaller than 50ml (such as a GTN spray)
  • If the amount is larger than 50mls you must make sure it can be tested before getting on the flight – in order to test the medication you will be asked to taste it – the airports have been advised to have plastic cups available for this procedure!
  • If an adult is travelling with a young child and wants to carry non-prescription medication onto the flight they will need to taste the child’s medication (as long as they are not allergic to it!)
  • If any of these regulations don’t fit your medication then further checks will be necessary

These regulations have been issued by the DOH and any updates to the information should be checked on the DOH website.

As well as trying to follow these guidelines it is a good idea to carry a copy of your prescription or a letter from your doctor stating the amounts and types of medication verified for your use, including any essential non-prescription medication.

Special Advice for Travel with Insulin

If you are a diabetic you should first try to get an exemption certificate from the airline you are traveling with – for this you will need to get a letter from your doctor stating your need for insulin.

If this is not possible there is advice that has been issued by Novo Nordisk an Australian company. It contains good advice explaining how to pack insulin when it needs to go into the hold luggage as well as what to look out for to prevent it freezing.


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.

Before you Travel – travel preparation tips when going abroad

If you are travelling for more than a month, see them earlier.

  • Discuss Malaria requirements and sort out with your travel clinic, GP, practice nurse or pharmacist your required medication.
  • Sort out your first aid kit and any medication you might need – including enough prescription medication for the trip.
  • Read up about your chosen destination to learn about the culture, laws and customs.
  • Check that your passport is valid and does not expire before you return.
  • Check on visa requirements for your chosen destination.

 

 


Note: This information is designed to complement and not replace the relationship that exists with your existing family doctor or travel health professional.  Please discuss your travel health requirements with your regular family doctor or practice nurse.