Travel Health - Have you thought about it?

Going on an overseas holiday with your family is exciting for everyone, especially the kids, and planning for such a trip is a big part of the fun.

Have a look at this list — does it look familiar?

• Tickets? Check!
• Visa? Check!
• Accommodation? Check!
• Your 2-year-old’s favourite teddy bear? Check!

These are often the most common things we attend to (the teddy bear being especially important!) when planning to travel overseas with our family.

However, in the midst of all the excitement, it is really easy to forget about one very important item missing on this list, one that could potentially protect your family from getting ill while in a foreign country.

Yes, that’s right… it’s travel health and what you need to consider about it.

That’s why we bring you some important information about travel health that is worthwhile to keep in mind when you plan your next family vacation.

Common diseases to look out for when travelling

Listed below are just some of the common diseases that you should look out for when you are overseas¹. If you discover that you or any of your family members are showing some of these symptoms, monitor your or their conditions and consult a doctor when necessary¹.

1. Hepatitis A

Hepatitis A is transmitted primarily by the faecal-oral route — that is, when an uninfected person eats or drinks food or water that has been contaminated with the faeces of an infected person². Children are quite susceptible to contracting this disease².

Symptoms¹: Fever, nausea, fatigue, poor appetite, yellowing of eyes and skin, dark urine, pale stools.

Prevention¹:

• By using hand sanitiser (to a certain extent)
• By washing your hands with clean water before eating and after using the bathroom
• Through eating/buying food only from safe sources
• Immunization

2. Hepatitis B

Hepatitis B is contracted through the exchange of blood and bodily fluids, e.g. blood transfusions, the use of non-sterilised needles¹.

Symptoms¹: Jaundice, fever, nausea.

3. Influenza (Flu)

Influenza is contracted when you breathe in the germs that are expelled by an infected person near you¹. Many people think flu is the same as the common cold.

However, they are actually quite different. Even though both are respiratory illnesses, they are caused by different viruses⁴. Also, colds usually do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations⁴.

Symptoms¹: High fever (> 38°), cough, breathing difficulty.

Prevention:  Good personal hygiene (i.e., washing your hands with soap and water or using a hand sanitiser)¹, and immunization⁵.

4. Typhoid

Typhoid fever is caused by the bacterium Salmonella Typhi and there is a greater risk of contracting this disease when travelling to a country where the disease is prevalent.^6,7 Both ill persons and carriers shed Salmonella Typhi in their faeces⁷.

You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food⁷.

Symptoms: Fever as high as 39° to 40° C, weakness, stomach pains, headache, or loss of appetite8. In some instances, patients have a rash of flat, rose-colored spots⁷.

Prevention: Avoid risk food and drinks, and immunization⁷.

5. Meningococcal disease

Meningococcal disease is caused by the bacterium Neisseria meningitides and is associated with high morbidity and mortality⁶.

If you and your family are traveling to sub-Saharan Africa any time during December through June (dry season), do take extra precaution as this is when Meningococcal disease is at its peak⁶.

About 10% of people have this type of bacteria in the back of their nose and throat with no signs or symptoms of disease⁹. Such people are called ‘carriers’⁹. But sometimes Neisseria meningitidis bacteria may invade the body causing certain illnesses, which are known as meningococcal disease⁹.

Symptoms⁸: Severe headache, backache, stiff or painful neck, sensitivity to light, twitching or convulsions.

Prevention: Get plenty of rest, Avoid close contact with people who are sick¹⁰, and immunization.⁸

What should you do before you travel? ¹

When it comes to travel health, you may want to make an appointment with your doctor as soon as you know you will be traveling.

Speak to your doctor to find out more about:

• Good travel practices
• Necessary immunization(these should be scheduled at least 4-6 weeks prior to travel)
• Preparing medication if anyone in your family has a chronic condition
• Packing a travel First Aid Kit

Do keep these following tips in mind too:

• Buy travel insurance.
• Find out as much information as possible related to the health conditions in the country you are travelling to.
• E-register with the Ministry of Foreign Affairs
• Ensure that you give a copy of your itinerary to family members and close friends.
• Take with you a Health Card that includes important information about you and your family members.

Good travel practices¹

When you are travelling in another country, stay aware of your health and that of your family, especially if you are traveling with young children or babies.

Here are some simple health practices to keep in mind that will help keep your family safe.

Personal protection is paramount

• Wash your hands with soap before meals and after using the toilet. Ensure that all family members — especially kids — do the same.
• If you don’t have access to water and soap to clean your hands, use a hand sanitiser.
• Protect yourself and your kids against mosquitoes if you are traveling to a country where mosquito-borne diseases such as dengue or malaria are prevalent.

Drink only from safe/reputable sources

• Only drink bottled water, ensuring that the seal is unbroken before you drink.
• If you don’t have bottled water, drink boiled and cooled water.
• Avoid eating ice or adding it to your drinks.
• Avoid drinking or brushing your teeth with tap water.

“Boil it, cook it, peel it or forget it”

• Make sure your food is well cooked.
• Do not eat fresh salads or fruits if you are not sure about how fresh or clean they are.
• It’s best to eat fruit that can be peeled – avoid eating unpeeled fruit.
• Try to avoid eating street food, chef specials and whole-day buffets.

What to do if your child falls ill while travelling¹

Seek medical attention immediately for:

• Symptoms that cannot be controlled, e.g., continuous diarrhea, vomiting

Always maintain hydration

• Use oral rehydration salts (sachets). You could stock up on these before you leave on your vacation.
• Make your own emergency rehydration fluids with 4 heaped teaspoons of sugar, 1/2 teaspoon of salt and 1 litre of boiled and cooled water.

Activate your travel insurance if your child is seriously ill and requires emergency transport home for appropriate medical attention

References

1. Health Promotion Board, Singapore; Traveller Survival Guide: How to Stay Safe and Healthy on Holidays; Available at www.hpb.gov.sg/HOPPortal/health-article/5582; Last accessed 30/6/14.
2. World Health Organisation; Hepatitis A; Available at www.who.int/mediacentre/factsheets/fs328/en/; Last accessed 30/6/14.
3. Health Promotion Board; Hepatitis A; available at www.hpb.gov.sg/HOPPortal/dandc-article/534; last viewed 30/06/2014.
4. Centers for Disease Control and Prevention; Cold Versus Flu; Available at www.cdc.gov/flu/about/qa/coldflu.htm; Last accessed 30/6/14.
5. Health Promotion Board, Singapore; Influenza; Available at www.hpb.gov.sg/HOPPortal/dandc-article/552; Last accessed 30/6/14.
6. Centers for Disease Control and Prevention; Travelers’ Health; Available at wwwnc.cdc.gov/travel/yellowbook/2014/chapter-7-international-travel-infants-children/vaccine-recommendations-for-infants-and-children; Last accessed 30/6/14.
7. Centers for Disease Control and Prevention; Typhoid Fever; Available at www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/; Last accessed 30/6/14.
8. Meningococcal Education; Symptoms; Available at www.meningococcal.org/symptoms.html; Last accessed 30/6/14.
9. Centers for Disease Control and Prevention; Causes and Prevention; Available at www.cdc.gov/meningococcal/about/causes-transmission.html; Last accessed 30/6/14.
10. Centers for Diseases Control and Prevention; Meningococcal Disease; Available at www.cdc.gov/meningococcal/about/prevention.html; Last accessed 10/07/2014.

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