Health Professionals

Travel Health Information Sheets

Health Advice for Summer Travel

Key advice for travellers:


  • See your GP, nurse, pharmacist or travel clinic for advice well in advance of your trip.

  • Get travel health insurance.

  • Be safe - be cautious for accidents, injuries and theft.

  • Be SunSmart - protect your skin from the sun.

  • Be responsible for your alcohol intake and practise safe sex.

Introduction

Many people will be planning to travel abroad during the summer months. Overseas travel can pose various health risks, depending on the destination and type of travel. Potential hazards include accidents and injuries, travellers’ diarrhoea, sexually transmitted infections, insect bites and sunburn; with accidents and injuries being the greatest threat to life for healthy travellers [1].  

The information below is a summary of advice for summer holiday travel.

Before travel

  • Travellers should be encouraged to check the potential health hazards at their destination, preferably before booking their holiday, using our Country Information Pages. Guidance includes whether vaccines or malaria prevention tablets are recommended.
  • Ideally, an appointment for travel health advice should be made four to six weeks before departure, but travellers should be reminded that it is never too late to get advice. Travellers with pre-existing medical conditions should be encouraged to obtain advice before booking a holiday or trip to ensure their destination is appropriate.
  • Travellers should be reminded they need to obtain comprehensive travel insurance, making sure all medical conditions and medicines are declared and covered.
  • Travellers to the European Economic Area should also carry a European Health Insurance Card (EHIC). Payment for health services overseas may be required at the point of care; access to funds during travel should be ensured.
  • Travellers should be advised to put together a travel health kit including items like: antiseptic, painkillers, insect repellent, sun protection lotion, rehydration sachets and condoms. Travellers should also be reminded of the importance of carrying a good supply of any prescription medicines, along with copies of their prescriptions, in their hand luggage.
  • Travellers should provide as much detail as possible about their travel plans and medical history. This enables health professionals to undertake a comprehensive risk assessment, tailored to the traveller’s individual needs.

During travel

Accidents and injuries:

  • Particular attention should be paid to road safety by both drivers and pedestrians. Traffic may be driving on the right and road signs may be unfamiliar.
  • Children must be supervised at all times, but especially in and around water and near roads/traffic.
  • Travellers should be aware of the health risks of counterfeit (fake) alcohol, which has been associated with reports of serious illness and death [2]. They should be advised to only buy alcoholic drinks from reputable vendors, avoid alcohol in unlabelled containers, be suspicious of alcohol sold in informal settings like market stalls, check bottle seals are intact and watch out for badly printed labels with spelling mistakes. They should also be reminded very cheap alcohol is likely to be fake [2].
  • Every year holiday makers die or are seriously injured as a result of inappropriate behaviour on balconies, often after drinking alcohol or taking drugs. Travellers should be reminded to drink responsibly and avoid risky behaviour at heights. Diving into a swimming pool from a balcony is highly dangerous and can result in death or permanent disability [3].
  • Travellers should maintain a heightened awareness of personal safety in unfamiliar environments.

Food, water and personal hygiene

  • The importance of hand-washing, especially before eating or drinking and after using the toilet, should be emphasised. 
  • Unless water is safe tap water should not be drunk and ice should be avoided.

Travellers’ diarrhoea:

  • Travellers’ diarrhoea is a common illness affecting travellers [4].
  • Travellers should be advised to follow sensible food, water and personal hygiene precautions to reduce their risk. If travellers are affected, they should drink plenty of fluids and if appropriate use oral rehydration solutions according to manufacturer’s instructions.
  •  Cryptosporidiosis infections have been linked to swimming pools [5]. Travellers should follow good swimming pool hygiene advice: including showering before swimming and not entering the pool if unwell or suffering from diarrhoea. Babies should wear swimming nappies to avoid faecal accidents.

Insect bite avoidance:

  • Many insect-borne infections are not vaccine preventable including chikungunya, dengue fever and leishmaniasis. Also, as no malaria chemoprophylaxis is totally effective, all travellers to areas where malaria is a risk should receive advice on avoiding insect bites.
  • Travellers should be advised to apply insect repellents (preferably DEET based) regularly after sun lotion to exposed skin.
  • Care should be taken with children to ensure repellent does not come into contact with their eyes or mouths.
  • Travellers to any tropical regions, but especially those to malaria risk areas, should consider travelling with an insecticide-treated bed net.

Animal bites and scratches:

  • Rabies, a fatal virus carried in animal saliva, is a risk in many countries.
  • Travellers should be advised to avoid contact with wild or domestic animals and to seek urgent emergency medical treatment if any animal bites or scratches them, licks a broken area of skin or spits in their face in a rabies endemic area.
  • Rabies vaccine prior to travel does not eliminate the need for post-exposure medical evaluation and additional doses of rabies vaccine.  Travellers should be advised to seek urgent medical advice following any animal bite or potential exposure.

Sexually transmitted infections:

  • Even travellers not planning sexual encounters should be made aware of advice on avoiding sexually transmitted infections, including practising safer sex by using condoms.
  • Travellers should be aware that excessive alcohol consumption can lower inhibitions, which may make risky behaviour more likely.

Sun/heat protection:

  • Travellers should be advised to cover up with light, loose fitting, cotton clothes, seek shade, drink plenty of cold drinks, use high protection sun lotion and regularly reapply it, especially after swimming.
  • Particular care should be taken that infants and children are protected and babies should never be placed in direct sunshine.

After travel

Travellers should be advised of the importance of continuing any malaria prevention tablets for the recommended period of time on their return home.

Any unwell, returned travellers, especially those with a high fever, persistent diarrhoea, or flu-like symptoms, should be advised to seek urgent medical assistance, explaining they have been at risk of malaria.

Travellers should be aware that malaria is a risk after they have returned from the tropics. Malaria usually presents in the first three months after return from a risk area, but can occur up to a year later [6]. Returned travellers with a fever or flu like symptoms should be considered as having malaria until proven otherwise and referred urgently to a specialist centre for immediate diagnosis and treatment.

References

1. World Health Organization. International travel and health. Injuries and violence. Geneva. 2015. [Accessed 30 July 2015]. Available at: http://www.who.int/ith/other_health_risks/injuries_violence/en/ 

2. World Health Organization. Methanol poisoning outbreaks. July 2014. [Accessed 30 July, 2015]. Available at:

http://www.who.int/environmental_health_emergencies

/poisoning/methanol_information.pdf

3. Foreign and Commonwealth Office. Holiday Brits risking their lives on balconies. 28 June 2013. [Accessed 30 July 2015]. Available at:

https://www.gov.uk/government/news/holiday-brits-risking-their-lives-on-balconies

4. Steffen R. Epidemiology of traveller’s diarrhoea. Clin Infect Dis. 41(Suppl 8):S536-40, 2005.

5. US Centers for Disease Control and Prevention. Healthy Swimming/Recreational Water. Cryptosporidium. 20 May 2015. [Accessed 30 July 2015]. Available at: 

http://www.cdc.gov/healthywater/swimming/rwi/illnesses/

cryptosporidium.html 

6. Chiodini PL, Field VK, Whitty CJM and Lalloo DG. Guidelines for malaria prevention in travellers from the United Kingdom. London, Public Health England, July 2014. [Accessed 30 July 2015]. Available at: https://www.gov.uk/government/uploads/system/uploads/

attachment_data/file/337761/Guidelines_for_malaria_

prevention_in_travellers_UK_PC.pdf

 

Advice current at: July 2015