Most of us these days have travelled abroad at some time and therefore have some experience of what is involved. However, this fact sheet is designed to be a quick reference guide to help you to get organised and stay organised for your trip. This is especially important if you’re considering going abroad for surgical reasons. The key areas to do with travel generally are listed below:
- Passport
- Passport Visa
- Vaccinations
- Malaria tablets
- Insect and animal bites
- Basic precautions
- Useful lists of things to pack.
Passport
You must make sure that your passport is current and valid. It is usually recommended that you have at least 6 months left before your passport expires from the date of departure. If not, you may well be advised to renew your passport before departure.
Passport Visa
Unless you are travelling from an EC country to another EC country, you will usually require some sort of travel visa. We can give you further information about this once we have established where you are flying from and where you are going to. For entry to such countries as India, a Visa is mandatory.
Vaccinations
Most people born and brought up in developed countries will have received most or all of the necessary childhood immunisations as well as the relevant boosters which follow. Therefore, according to the UK immunisation schedule, you should already be up-to-date with the following vaccinations:
- tetanus
- diphtheria
- pertussis (whooping cough)
- polio
- possibly mumps, measles and rubella (from MMR injections in younger patients)
If you are in any doubt about these, please check with your practice nurse at your local medical practice or health centre for confirmation.
However, depending on where you are going, you should also seek advice on receiving vaccines for the following conditions:
- typhoid
- hepatitis A
- rabies
- meningitis
- hepatitis B
- BCG (tuberculosis)
- cholera
- yellow fever
Vaccinations against typhoid and hepatitis A would generally be strongly recommended whereas vaccinations against rabies, hepatitis B, meningitis, BCG and cholera may be advised under certain circumstances, depending on where, when and for how long you’ll stay abroad. Certificates for yellow fever are mandatory for entry to certain countries if travelling through or from a yellow fever area.
Further information as well as the injections themselves can be obtained from your doctor or practice nurse. In the UK, some of these vaccinations are free of charge but others such as rabies and yellow fever will incur a charge as these are generally available on a private basis only.
Malaria Tablets
Tablets to prevent malaria are strongly recommended if travelling to a malaria zone. These zones are usually divided into low, medium and high risk zones and the recommendations for each area vary from time to time. It therefore not possible to summarise advice for malaria tablets for each country and region separately here. You can obtain further advice again by discussing this with your doctor or practice nurse. Some health centres and GP medical practices will sell malaria tablets to you. Alternatively, tablets may be bought from your local chemist or pharmacy. The table below details some of the options available although the exact choice will vary upon where you are going and for how long.
| Name of medication | Dose (For Adults) | Comments |
Atovaquone + Proguanil (available as Malarone in UK) |
Atovaquone 250mg plus Proguanil 100mg daily |
Start 1-2 days before entering malaria zone and end 7 days after leaving. |
Chloroquine |
300mg weekly dose |
Start 7 days before entering malaria zone and end 28 days after leaving. |
Doxycyline |
100mg daily |
Start 1-2 days before entering malaria zone and end 28 days after leaving. |
Mefloquine (available as Larium in UK) |
250mg weekly dose |
Can start 1 week, but ideally 2-3 weeks before entering malaria zone and end 4 weeks after leaving. |
Proguanil |
200mg daily |
Can start 2 days but ideally 7 days before entering malaria zone and end 28 days after leaving. |
Proguanil + Chloroquine |
Proguanil 200mg daily plus Chloroquine 300mg weekly |
Start 7 days before entering malaria zone and end 28 days after leaving. |
However, travellers to malaria zones are always strongly encouraged to take simple steps to help minimise the risk of being bitten by mosquitoes which carry this infection. These measures include using mosquito nets around beds at night and using insect repellent sprays and other devices. Travellers are also advised to wear long sleeve clothing.
Other Insect and Animal Bites
Malaria and insects bites from mosquitoes have already been discussed above. In the UK, most insect bites are harmless or may cause a minor local irritation at the site of the insect bite. Very occasionally, a more serious allergic response is triggered usually by wasp stings and requires medical treatment.
However, travellers to tropical countries should be mindful of the dangers of being bitten by other insects and animals. Bites from spiders, scorpions, snakes and jellyfish can and do occur, sometimes with serious consequences. Therefore, caution must be advised when walking barefoot or swimming in local ponds, lakes or rivers. The dangers of such bites include:
- local infection, possibly requiring antibiotics
- a general allergic reaction
- exposure to toxins or venom, with a potentially serious outcome
- other tropical infections such as malaria, rabies, dengue fever, yellow fever and many others
- infestations such as bilharzias, worms and many others
Therefore, avoid any un-necessary exposure if at all possible and seek advice locally if you are in any doubt about the possible dangers.
Basic Precautions
There are several other illnesses and ailments which travellers tend to experience much more frequently when abroad than when at home. These are detailed below.
1. Sunburn
This is one of the commonest problems encountered by travellers from colder temperate climates to warmer or tropical climates. It is especially serious for the fair skinned as they have less natural skin protection when compared with those who are darker skinned. However, the advice below applies to everyone.
Sun damage can vary from mild local redness and irritation of exposed skin to more tender areas with peeling of skin and in the worst cases to severe blistering, burns and pain. The more severe the exposure and the more frequently this occurs, the more risk of permanent problems and the onset of serious medical problems such as skin cancer (malignant melanoma).
Treatment of sun burned skin therefore depends on the severity of the exposure and symptoms. In milder cases, applying calamine lotion helps to cool skin and reduce itching or irritation. Some people prefer to use “after-sun” lotions, creams or gels which have a similar effect and which reduce peeling and blistering. In more severe cases, you may require pain killers such as paracetamol and anti-histamine tablets. For the worst cases, you may need to see a doctor or you may even need hospital admission.
As with many things, prevention is far better than cure. Please therefore read the following points carefully and remember them before exposing yourself to the harmful effects of the ultra-violet radiation in sunlight which is responsible for the problems mentioned above.
- avoid exposure during the warmest and brightest times of the day, i.e. 11am-3pm
- if you do go outside, wear as much protective clothing as possible with loose fitting, long sleeved tops and cover up your legs. A sun hat and sunglasses are also advised. Eyes can also be damaged by strong sunlight.
- if possible, avoid direct sunlight and stay in the shade.
- don’t wait until you start to feel the effects of sunburn before taking action. Take action before going outside.
- use high factor sun block, at least to begin with. This generally means at least Sun Protection Factor (SPF) 15 for adults but those who are fair skinned and all children should use much higher SPF lotions such as Factor 30-40.
- when applying sun block, cover up all areas. This includes hands, feet, face and other areas not usually exposed to sunlight.
- keep re-applying sun block every 2 hours or so as the protective effects may diminish especially after swimming or wiping down with a towel.
- the dangers of strong sunlight should not be under-estimated even on cloudy days. The above advice still applies.
- drink plenty of fluids such as water and try to avoid drinking too much alcohol as this can make dehydration worse.
In addition to the above points, it is also important to be vigilant for any moles which you may have or new moles which are developing. Please consult your doctor if you notice any changes to your moles. These changes include a change in size, colour, irregularity of the edges, itching, bleeding, swelling or pain at any site of a mole.
2. Heatstroke
This is a potentially serious condition caused by overexposure to hot temperatures, physical over-exertion, dehydration and sunburns. The symptoms of heatstroke include:
- headache
- nausea or vomiting
- extreme lethargy or fatigue
- fever (hyperthermia)
- red or dry skin
- symptoms of sunburn as described above
If heatstroke is suspected, you should take the person affected to a cool place, give them plenty of fluids, lie them down or shower them with cool (but not cold) water. In more severe cases, medical attention must be sought as a serious rise body temperature to over 41 degrees Celsius can be dangerous and require hospital admission for intravenous drips and oxygen.
Heatstroke can be prevented by reducing the time you spend in direct sunlight in hot conditions, keeping physical exertion to a minimum, preventing dehydration by drinking plenty of water and by avoiding alcohol.
3. Stomach Upset
Stomach upsets are common when travelling abroad and usually result in mild, transient symptoms. These symptoms include nausea, vomiting, diarrhoea, abdominal pain and occasionally a mild fever. It is caused by either eating contaminated food or drinking contaminated water and is sometimes called food poisoning or gastroenteritis. The types of germs causing the problem can be bacteria, viruses or parasites such as worms.
For most affected individuals, symptoms last for a few days before resolving without medical treatment. Some people use paracetamol to help the abdominal cramps or mild fever and occasionally use of anti-diarrhoea medication is useful. However, most advice on this subject suggests not treating symptoms of diarrhoea and letting this settle naturally. If however, symptoms are severe or last more than 3-4 days, it may be advisable to see a doctor. Drinking plenty of water and sticking to a very light diet is also recommended.
Reducing your risks of catching these common infections is most important. The following measures should therefore be adhered to:
- drink only bottled water unless you are sure that the local tap water is safe to drink
- avoid putting ice into drinks as the water used for ice may be local tap water. Otherwise, make sure the ice is produced using bottled water
- avoid eating foods such as salads that may have been washed using local tap water. Once again, ensure if possible that bottled water is used
- ensure cooked foods are adequately cooked, e.g. meats have clear juices and are cooked throughout and served hot
- be especially careful of seafood such as prawns
- be careful of eating too much rich or spicy foods which you may not be accustomed to
- in some cases where it is not possible to avoid drinking local tap water, this should be boiled and filtered or purified with water purification tablets.
The above are simple yet effective methods to prevent these types of illnesses.
4. Sexually Transmitted Infections (STI)
In some developing countries, the risks of catching STI’s are considerable more than at home. Infections such as Hepatitis B, Hepatitis C, HIV/AIDS, Chlamydia, gonorrhoea and syphilis can be contracted. This is particularly the case in some parts of Africa and Asia where the incidence of these conditions is particularly high. The most risky situation is having casual sex without a condom, with a prostitute. Using a condom will help to protect against these conditions but unfortunately, even using a condom cannot guarantee your safety.
In addition, avoid other risky behaviour such as intravenous drug use, especially with dirty needles. Avoid having tattoos done or body piercing as the cleanliness of the equipment used for these procedures cannot be guaranteed.
5. A First Aid Kit
A simple first aid kit should always be taken when travelling abroad. It should contain the following basic elements for self-treatment of minor ailments and injuries:
- paracetamol and/or ibuprofen tablets
- paracetamol and/or ibuprofen liquid sachets for children
- sachets of re-hydration powder e.g. dioralyte or rehydrat
- anti-diarrhoea tablets
- a selection of sticky plasters for minor cuts and abrasions
- adhesive dressings (if possible), scissors, safety pins
- a tube of antiseptic cream to apply onto minor cuts and abrasions
- a bandage with sticky tape to apply onto strains or sprains
- a packet of over-the-counter bought anti-histamines tablets and cream
- insect repellent
- water purification tablets
Simple first aid packs can be bought from most pharmacies and are recommended. Some of these may also contain sterile needles, syringes and sutures for emergency use but these are optional as you will still require a doctor to advise you on the use of this equipment.
6. Medication
Please ensure that you have an ample stock of your own medication and that you pack this with you, preferably in hand luggage as it may or may not be possible to obtain exactly the same drugs and medication in another country. Discuss this with your doctor if you are uncertain about what you need and how much you should take with you. For those with Diabetes Mellitus Type 1 (those requiring insulin injections), you must make sure that you take everything you need to continue using your insulin and monitoring your blood sugar levels as usual.
7. Travel Insurance
Although you may be travelling abroad for the purpose of obtaining medical or surgical treatment, you may still be at risk of developing an unrelated medical condition or be unlucky enough to be involved in an accident. In such cases, travel insurance is vital to ensure treatment is paid for and repatriation back to your country of origin is not delayed for financial reasons.
It is therefore strongly advised that you seek travel insurance well in advance of your trip or that current travel insurance is valid and in date.
8. Phone numbers
It is very useful to keep with you a list of the most important phone numbers and contact details should you have a problem abroad. Numbers you should keep and have access to include:
- the local emergency services number
- your local hotel number
- the number of your treating hospital
- the local representatives number
- your travel insurance company contact details along with your policy details
- an embassy or consulate details for you country of origin
- a list of family or friends contact details
9. Money
These days, most countries will accept major credit cards. This is especially true of hotels and hospitals. However, your options for taking and spending money include:
- cash – useful to have some, either in US Dollars or British Pounds Sterling as these currencies are recognised in most countries. However, the usual dangers of carrying too much currency apply, i.e. theft or accidental loss.
- travellers cheques – safer to carry than cash and can be converted into local currency at most hotels and hospitals.
- credit cards – safe to carry and use
Useful lists of things to pack
These have been divided into mandatory (those items without which you cannot travel), highly and recommended (those items which you should take with you if at all possible) and useful (which are optional but worth considering). These are presented below in table form.
Mandatory |
Highly Recommended |
Useful |
Passport |
Money – cash |
Travel Adaptor |
Passport Visa |
Travellers Cheques |
Camera |
Travel Tickets |
Credit cards |
Camera film or storage card |
Yellow Fever certificate (applies to some travellers) |
Contact details and phone numbers |
Batteries for all equipment |
Your usual medication |
Personal music player |
|
Malaria tablets |
Books/magazines |
|
First Aid Kit |
Basic toiletry kit e.g. soap, shampoo, cosmetics etc. |
|
Travel Insurance documents |
Tissues |
|
For EC nationals; European Health Insurance Card (EHIC) which replaces the E111 form. |
A suitable mobile phone |
|
Sun Block |
||
Sunglasses |
If you wish to contact us, please use our contact form to find out how we can help you.