Firstly, I am not a doctor (but I play one on TV). Therefore, I am not qualified to give . . . → Read More: General Medical Information]]>

Firstly, I am not a doctor (but I play one on TV). Therefore, I am not qualified to give any advice on health or medicine.

This section is just a list of things I found out about travel and health whilst reading about various countries around the world. It also serves as a checklist of things to do before I go travelling and the order in which I need to do them.

For all travel-related health advice consult an expert (your doctor or travel clinic, for example). You can also read books and browse websites, but remember that health advice changes all the time, epidemics come and go, new diseases appear, drugs become resistant, more effective vaccines are developed, and so on. And some of those websites may just be plain wrong.

It is a good idea to become familiar, in general terms, with what are the possible health risks in each country you intend to visit. Some of these risks should not be taken lightly but, on the other hand, you shouldn’t allow the fear of health problems to put you off travelling.

It is all a question of perspective. Whilst you hear about all kinds of horrible diseases in the news, like Ebola and Plague, travellers don’t get them. In fact, one of the deadliest viruses of all is found in the developed world and is far more widespread.

That said, in most countries in the developed world you will probably not have any health problems at all, just those you get at home, such as coughs and colds, diarrhea and constipation, and hangovers. Everywhere else in the world the worst you will probably get is a stomach upset from unfamiliar microbes.

As stated above, consult an expert, follow their advice, and take sensible precautions. Knowledge and prevention will greatly reduce the risks of falling ill anywhere in the world.

The Main Health Risks for Travellers

The main cause by far of preventable deaths and injuries among travellers is accidents. These include being run over by, or crashing in, a moving vehicle.

Thus the best advice is to do what you do back home; always wear a seat belt (or helmet on a bike), always look both ways before crossing a street, at the same time standing well back from the curb.



Studies have shown that around 50% of deaths while travelling are from heart attacks (which you probably would have had at home anyway), another 20% or so due to injuries, with the rest made up of such things as cancer, suicides and homicides.

Only around 1% of deaths are due to the infectious diseases and illnesses listed elsewhere on this website. Also, most deaths while travelling occur in Europe (where most people travel), and not in developing countries.

On Being Your Own Doctor

When you are at home and get a sniffle or cough you can either ignore it or hope it will go away. Others may try to treat it or at least ameliorate the symptoms. Doing this while travelling in the developing world, however, can have serious consequences.

You should never ignore symptoms or try to diagnose yourself (or anyone else) while travelling. Seek professional advice as soon as you can. Doctors in developing countries may not seem as well-qualified as those back home but they are usually familiar with local health problems, and the knowledge base they use to diagnose will be far more extensive than yours which will probably have been gleaned from books or the Internet.

After getting advice from a health professional, try to get to the best care available whenever you can, even if it means travelling long distances.

Upon Returning Home

If you feel ill after returning from the developing world, go and see your doctor and let them know you have just come back from there. You may be referred to a tropical disease specialist. Some people get tests to see if they might have picked up something, even if they have no symptoms.

Inadequate sanitation and contaminated water are the leading cause of stomach upsets in travellers.

Unfamiliar foods, changes in routine, . . . → Read More: Problems With Digestion]]>

Inadequate sanitation and contaminated water are the leading cause of stomach upsets in travellers.

Unfamiliar foods, changes in routine, diet, all can cause digestive problems.

While some are are not life threatening, they are still annoying and can make you feel sick for several days.

Traveller’s diarrhea

Found – common amongst visitors to the developing world.

Cause – usually caused by unfamiliar bacteria and sometimes even anxiety. Generally, lasts a few days and no great problem.

Treatment – best to let normal diarrhea run its course, drink plenty of liquids, eat no solid foods on the first day. On the second day eat bland foods (toast, soup, rice, bananas).

Recent research has shown that one dose of an appropriate antibiotic such as Cipro or Noroxin, combined with two Immodium AD tablets, will effectively treat more than 90% of cases of traveller’s diarrhoea. If you do get symptoms of traveller’s diarrhoea, which may include watery or loose stools, fever, nausea, and malaise, immediately take the appropriate antibiotic with Immodium. It can limit the period of being sick to an hour or two, instead of being sick two to three days longer.

Prevention – good hygiene.

Food poisoning

Found – worldwide. (I got it in Spain. I passed out at the main railway station in Barcelona and woke up in the emergency room).

Cause – unknown or undiscovered agents cause most cases. Known causes are infective agents such as viruses, bacteria, and parasites, or toxic agents such as poisonous mushrooms, improperly prepared foods, or pesticides on fruits and vegetables. Poor sanitation when preparing food, improperly packaged or stored food.

Symptoms – depend on what was ingested. Nausea, vomiting, abdominal cramping, and diarrhea within 48 hours. Then fever and chills, bloody stools and dehydration possibly to follow.

Treatment – do not eat solid food while nauseous or vomiting but drink plenty of (clear) fluids (not caffeinated or alcohol). Then bland solid foods when liquids are tolerated. Seek medical advice if in a developing country.

Prevention – safe shopping, storage, thawing, handling, preparation and cooking of food. Good hygiene.

Rehydration therapy

In case of dehydration due to severe diarrhea and vomiting, rehydration therapy is recommended. The two types of rehydration therapy are intravenous, performed with a salt/sugar/water solution in the hospital, and oral, which can be done anywhere.

Oral rehydration solution consists of:

water: 1 quart or 1 liter

salt: 1/2 level teaspoon

sugar: 8 level teaspoons

sodium bicarbonate (baking soda): 1/4 teaspoon

The sugar aids absorption of the water and salt. Sodium bicarbonate isn’t necessary if unavailable. Be careful with measurements as too much salt can increase dehydration. Dispose of unused solutions after twenty-four hours since bacteria may multiply. Patients should drink more solution as able. A gallon or more may be needed. Commercially prepared solutions to which you just add clean water are available from pharmacies.

Constipation

Found – worldwide. Common amongst all travellers.

Cause – usually a change in routine and diet.

Prevention – drink plenty of fluids, and eat lots of fibre or roughage.

The sun is very intense in the tropics and at higher elevation. For every 5000 feet (1500 meters) in . . . → Read More: Problems With The Sun]]>

The sun is very intense in the tropics and at higher elevation. For every 5000 feet (1500 meters) in altitude gain, UVB radiation increases by twenty percent.

Travellers should wear a hat with at least a three-inch brim all around, and use sunblock with a sun protection factor of at least fifteen.

Wear sunglasses with ninety-nine percent UVA/UVB protection, and protective goggles are a must for preventing snowblindness at altitude.

Heat and humidity

Unacclimated travellers run a risk of heat exhaustion or heat stroke if they try to do too much, too soon. Also, pricky heat may be a problem.

If you are AC-addicted or from a cool climate, use caution and allow time. Soon the hot environment will seem cooler. Knowing your body is adjusting should be a comfort. In one to three weeks the body gradually acclimates to heat through a physiological process.

Prickly heat is a red rash which occurs under clothing. It has a moderate prickly feeling, and goes away after a day or two.

Prevention – travellers may be able to partially acclimate themselves to a hot environment like Egypt by taking daily saunas for a week or two before departure, gradually building exposure levels.

Treatment – high humidity is the worst aspect of the tropics for many travellers. Wear loose cotton clothing and drink lots of clean water. A wet bandanna around your neck or forehead provides good cooling. Prickly heat is assuaged by cool showers, cold water sponging, calamine lotion, and loose-fitting, breathable clothing. In my case clothing should also be well-rinsed of detergent, which is harsh in developing countries.

Heat exhaustion

Cause – overexposure to heat by a non-acclimated person, or insufficient water or salt intake by any person.

Symptoms – fatigue, dizziness, nausea, headache, and possibly muscle cramps.

Treatment – rest, shade, and drinking water at a slow but steady rate, including water with a weak salt solution of approximately 1/4 teaspoon per eight-ounce (1/4 liter) glass. Cool the body with water, wet towels, and a fan, if possible. If the victim becomes unconscious, feet should be raised twelve inches above the head.

Heat stroke

Cause – untreated heat exhaustion. It often results in rapid death due to a breakdown of the body’s heat regulating mechanisms. Body temperatures can reach soaring levels.

Symptoms – a cessation of sweating, shallow breathing, hot, dry, and flushed skin, unconsciousness, and if conscious, disorientation or stupor.

Treatment – should be immediate. The victim should be placed in shade and his body cooled as quickly as possible. Remove all clothing and wrap him in wet towels, or sponge the body continuously with cool water. Direct a fan at the victim. If unconscious, raise feet twelve inches. If conscious, give the victim water, preferably with 1/4 teaspoon salt per eight-ounce (1/4 liter) glass. Medical help must be summoned.

Some problems with the cold aren’t necessarily associated with cold temperatures, for example, hypothermia.

Hypothermia

Cause – a life-threatening . . . → Read More: Problems With The Cold]]>

Some problems with the cold aren’t necessarily associated with cold temperatures, for example, hypothermia.

Hypothermia

Cause – a life-threatening condition defined as body temperature below 95 F (35 C).

Temperatures do not have to be extreme to cause hypothermia, since water and wind can combine to rapidly chill a person. Most deaths from hypothermia occur in well-above freezing temperatures.

Symptoms – a pale, drowsy, confused, and cold victim. She may become unconscious.

Treatment – consists of seeking immediate medical help and warming the victim. Warm drinks are effective, as well as hats, blankets, emergency aluminum blankets which reflect body heat, and, of course, warm shelter. Remove wet clothing.

Prevention – wear warm clothing in insulating layers, a windproof/waterproof shell, and a hat. An aluminum reflective space blanket should be in every traveler’s pack. Avoid cotton clothing in cold, wet conditions.

Frostbite

Treatment – must be immediate. Warming affected areas. Massage is not helpful, but placing feet and hands under armpits is. If warm water is available, place the affected areas in it. The water should not be hotter than 110 F (43 C). Remove constricting clothing, rings, and watches. Don’t warm affected areas with direct heat, such as from a lighter. Don’t allow someone to walk on a frostbitten foot, unless it’s necessary for survival.

These include the usual ones you would get at home, colds, sore throats, and other infections. Take proper medications, . . . → Read More: Other Travellers’ Ailments]]>

These include the usual ones you would get at home, colds, sore throats, and other infections. Take proper medications, or try to get access to good medical care whilst abroad.

Jet lag

Cause – crossing many time zones in a short space of time.

Symptoms – disorientation, tiredness, and irritability for several days after a long journey.

Treatment – take time to become oriented to the local time and climate when you arrive. Outdoor activity and exercise can help. Some take Melatonin or a short-acting sleeping pill. Afternoon naps can help also.

Prevention – rest well before leaving home. Sleep on the aeroplane on long journeys. Drink plenty of water.

Motion sickness

Prevention – if you are susceptible to motion sickness, Dramamine pills work better if taken before symptoms develop. Scopolamine ear patches may also help. While at sea or riding a bus get as much fresh air as possible, and focus vision towards the horizon. Think pleasant thoughts. Avoid greasy or spicy foods.

Altitude sickness

Found – occurs at altitudes above 8000 feet (2500 meters). About twenty-five percent of travellers to high altitudes will be affected, but younger people are more susceptible.

Cause – ascending to altitude before the body has time to adjust to the lower air pressure and lower oxygen content of the air.

Symptoms – mild and flu-like, such as headache, shortness of breath, dizziness, nausea, and fatigue. Insomnia often results due to shortness of breath. Usually these symptoms last only a short time as the body adjusts. Many travellers have trouble sleeping their first night or two in high-altitude cities.

Severe cases result in fluid buildup in the lungs. This leads to intense breathlessness, coughing and wheezing. Fluid may also build-up in the brain, leading to severe headache, seizures, vomiting, hallucinations, and even coma.

Treatment for mild cases – is usually just rest. Plan for an easy day or two upon landing in a high-altitude city. Aspirin may help. Avoid alcohol and drink plenty of fluids.

Treatment for severe cases – requires immediate action. Don’t wait until morning or the victim may die or suffer brain damage. They should be brought down at least two or three thousand feet and have oxygen administered. They should also be brought to a hospital as soon as possible where diuretic drugs may be given.

Prevention – best by slowly gaining altitude. If you walk to gain altitude you can go back down a few thousand feet if you begin feeling symptoms. One rule of thumb is to always sleep below the highest altitude achieved that day.

Infected wounds

Cuts, blisters, and other wounds can become infected very fast in the tropics due to the rich . . . → Read More: Other Medical Problems]]>

Infected wounds

Cuts, blisters, and other wounds can become infected very fast in the tropics due to the rich microbial environment.

Treatment – thoroughly clean wounds, and to treat with an antiseptic such as tincture of iodine, which also kills viruses. Keep wounds covered with a clean bandage and recheck. Double-strength triple antibiotic ointments such as Neosporin are also helpful.

Rashes

To combat itching from stings and plants in the tropics, be sure to have antihistamine pills and a tube of 1% hydrocortisone anti-itch cream.

Prevention – a layer of clothing and shoe leather.

Treatment – take immediate action by washing the affected area with water, beer, or spit. Run water over it for ten or more minutes if possible. Then disinfect with soap or alcohol. In the tropics you risk infection by scratching severe itches. Benadryl antihistamine pills and 1% hydrocortisone cream works well.
Blisters

Treatment – at the first sign of a “hot spot,” take action. The sooner the healing process begins the better. A piece of Compeed works, as well as Duct tape, Moleskin, and a liquid product called NuSkin also work.

Prevention – keep a thick pair of socks (such as Thorlo) in your pack in case blisters develop. Can become easily infected in the tropics, so be extra careful to avoid them, and keep them clean and disinfected when they develop. If you decide to pop a blister, use a sterilized needle and apply antiseptic. Cover and check regularly.

Foot infections

Treatment – Lotrimin AF (clotrimazole) antifungal solution can be used to treat athlete’s foot, ringworm, and other unusual skin infections which may crop-up during extended tropical travels.