Common travel health risks and how to prevent them


  • Wellness
  • Wednesday, 05 Feb 2020

Make sure you pack all prescription medications when you travel.

Travelling overseas for a holiday has become common for many of us, especially to the neighbouring countries in South-East Asia.

While the word “holiday” stirs feelings of blissful moments, vacations are not without health risks.

Besides the current coronavirus outbreak which has disrupted some travel, here is a list of common ailments you might face on a holiday.

Diarrhoea

Travellers’ diarrhoea is the most common illness contracted abroad, affecting some 50% of overseas travellers. These infections are usually caused by bacteria in the majority of cases. Viruses and parasites make up the rest.

The prevalence of street food and less-than-satisfactory food-handling practices in some of these places may present an increased risk of travellers’ diarrhoea.

Sometimes, similar symptoms are also caused by contaminated food. Symptoms may present as early as a few hours from exposure or a few days after, and can include stomach cramps, nausea, diarrhoea, bloating, vomiting, fever and malaise.

It can be hard to prevent travellers’ diarrhoea, but avoiding raw foods, salads, ice or ice cream, and drinking bottled water or drinks instead of tap water are some ways to decrease your risk.

If you do get hit, try taking some over-the-counter (OTC) anti-diarrhoea medications such as charcoal or prescription medications such as loperamide for diarrhoea and buscopan for the cramps.

To be safe, it's best to drink bottled water and drinks when travelling.To be safe, it's best to drink bottled water and drinks when travelling.If you have fever, body aches or headaches, some antipyretic medications such as paracetamol can help you feel better.

The most important thing about the treatment of diarrhoea is hydration. Oral rehydration salts work better than isotonic drinks in this aspect.

If you are feeling extremely unwell, feel your symptoms are intolerable, or are unable to hydrate yourself due to continuous vomiting or diarrhoea, please seek medical attention immediately.

There are other serious diarrheal diseases like typhoid and cholera, which may be life-threatening.

Taking the same precautions as mentioned above can reduce your risk of contracting some of these infections.

Upper respiratory tract infection (URTI)

You can catch the common cold anywhere, not only at home. OTC medications can ease your symptoms such as runny nose, sore throat, cough, fever and nausea.

Symptoms usually abate within a week. Boost your immunity to minimise your risk of catching a cold while travelling.

Mosquito-borne and other vector diseases

Dengue is one of the most serious and endemic mosquito-borne diseases in this region. Symptoms usually present within a week and can include high fever, headaches, flu-like symptoms and a skin rash.

Most cases are fairly mild and most people are able to get past the infection without any serious complications.

However, some people may develop dengue haemorrhagic fever and dengue shock syndrome, which may lead to a dangerous drop in blood pressure and death.

There is no treatment for the dengue virus, except to provide symptomatic relief and supportive management. Regular antipyretics such as paracetamol and copious hydration are encouraged. If you experience bleeding gums or severe abdominal pain, seek medical attention immediately.

Other infections like malaria are seen more frequently in travellers visiting forested areas, but you can still get malaria in cities.

Malaria usually causes a fever, headache, nausea, vomiting, muscle aches and fatigue.

The fever may be high and start with chills and rigors (severe shivering accompanied by a feeling of coldness).

This may be followed by sweating as the fever declines. However, not everyone exhibits this pattern.

Malaria can be life-threatening but can be prevented by chemoprophylaxis (taking anti-malarial medications) before going to the area for travel.

Check with your doctor if these medications are suitable for you.It may take awhile for symptoms to show, sometimes a few weeks after the mosquito bite.

If you develop symptoms after returning from your trip, tell your doctor about your travel history.

Other less common mosquito-borne diseases seen in South-East Asia include chikungunya, Japanese encephalitis and lymphatic filariasis. Sandfly-borne disease (e.g. kala-azar) and snail-transmitted disease (e.g. schistosomiasis) are possibilities as well.

It may be impossible to prevent all mosquito/insect bites, but there are ways to reduce your risk.

Use insect repellent on exposed skin when you are outdoors, or wear long-sleeved tops and pants. Insect repellents with DEET or picaridin, as well as lemon eucalyptus oil provide good protection.

Mosquitoes tend to bite more often from dawn to dusk so staying indoors during this time can be helpful.

There are also more mosquitoes in forested areas so avoiding such areas can reduce your risk.

Allergies

In most people, bee stings result in pain and swelling for a few days; for others, the sting can be fatal.  — FilepicIn most people, bee stings result in pain and swelling for a few days; for others, the sting can be fatal. — FilepicExposure to different foods can trigger allergies; symptoms include itchy eyes, mouth and throat, puffy eyes, a rash (hives), swelling of the lips, face, tongue and throat or other parts of the body.

More serious food allergies may cause swelling of the throat, leading to difficulty in breathing, wheezing, giddiness, abdominal pain, diarrhoea, nausea or vomiting, or loss of consciousness.

Simple allergies can be treated with antihistamines while more serious ones need medical intervention as they can lead to death.

Environmental allergens may worsen pre-existing conditions like asthma and allergic rhinitis.

Remember to bring along your regular medications for your allergic conditions.

Bee and wasp stings are not as common, but may afflict travellers in the countryside and forested areas. In most people, these stings result in pain and swelling for a few days; for others, a bee sting can be fatal.

If a bee stings and you feel unwell, faint or experience shortness of breath, seek medical attention immediately.

Rabies and animal bites

Rabies is a viral infection that is usually transmitted by an infected animal bite – and rural areas carry the biggest risk.

Early symptoms may include

tingling around the bite, flu-like symptoms, fever, headache, muscle aches, loss of appetite, nausea and fatigue. Later, symptoms usually affect the neurological system and can include altered mental state/confusion, agitation, aggression, unusual posturing, muscle spasms and weakness.

Once it reaches the late stage, it is fatal. There is a vaccination available, which must be given before exposure or directly after exposure (before symptoms start).

Animal bites are likely to get infected by other types of bacteria as well. If you are bitten, wash the wound immediately and cover the bite with a clean bandage.

Go to the nearest emergency department.

Anyone with a possible rabies infection must be treated in a hospital. If the doctor deems it necessary to treat for rabies, the vaccination or immunoglobulin therapy will be initiated, along with antibiotics.

Trauma

While infectious diseases play a role in only 5% of visitor deaths, 50% of visitor deaths in Asia are the result of road accidents.

Avoid jaywalking, riding scooters or motorcycles if you are inexperienced, and always be aware of your surroundings.

Even if you are involved in a minor road traffic accident, it is still important for a doctor to assess you to make sure there are no injuries to the internal organs or injuries that are not visible to the naked eye.

Pre-existing medical conditions

Heart attacks account for 30% of travel deaths. If you have heart problems, get thoroughly evaluated to be certain you are fit for travel before booking your flight and ensure you have your long-term medication and prescriptions with you.

Travelling can be stressful to the mind and body, which can lead to an increased chance of a heart attack if you have existing cardiac conditions. If you have a history of fainting spells, low blood pressure or seizures, avoid water activities, hot springs and saunas.

Sexually-transmitted infection (STI)

When travelling, you never know if you might meet someone whom you are attracted to. And if things are going great, you may have sexual intercourse but remember that you can get a STI or HIV. This applies during your travels, as well as for your day-to-day life.

Make sure you pack all your prescription medications when you travel.Make sure you pack all your prescription medications when you travel.The most effective way to prevent contracting a STI or HIV is via abstinence. Should you partake in sexual activity, practice safe sex by using a condom properly.

To reduce the risk of contracting HIV, anti-HIV medications such as pre-exposure prophylaxis can be taken prior to sexual exposure.

High-risk activities such as usage of injectable illicit drugs and sexual encounters with commercial sex workers should be avoided. If there has been a high-risk sexual encounter, post-exposure prophylaxis, which are also anti-HIV medications that have to be taken for a month after the encounter, can reduce your risk of contracting HIV.

As the world becomes more interconnected and the ease of travelling increases, more of us are bound to visit another country at some point.

Travelling can be safe and fun if you take the necessary precautions. Do remember to get your vaccinations and buy travel insurance to put your heart at ease!


Dr Chester Lan is a Singapore-based general practitioner. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Bee sting , Travel , Diarrhoea , Malaria

   

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