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Travel Medical and Health Advice.
(with extracts taken from The British Medical Association leaflets and Books.)

More than 40 million people are going abroad each year from the UK. A small percentage of these travellers will either be ill on their trip, or when they return home. Most times these illnesses can be prevented. We have compiled the following advice for your reference and hope that you find it interesting too! We hope also your trip, wherever it may be, is Safe, Healthly and has no side efffects. You'll be amazed at how some obvious precautions can avoid health risks.

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INDEX
(click on heading to view)

Deep Vein Thombosis & Air Travel.	Fatigue.
Travel Cover (Insurance).	Health Information and Links.
What Immunisations do I need?.	"Don't drink from the Tap!" by Billy Connelly

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Read, digest and don't forget... "Always get medical advice from your Doctor before you go away!!

 

 

 

Fatigue:

Altitude Fatigue
Altitude Fatigue is not fun! If you are going to Peru, Ecudor or Bolivia Make sure that you have time to relax once you've arrived. These places are so high that you will have no energy for great activity for a while after arriving!

Heat Fatigue.
Heat Fatigue can lead to serious illness. What about the temperature where you are going? Will you be able "to do the do" in all that heat? You won't if you drink loads of alcohol and dehydrate in the sun.

Holiday Fatigue
Holiday Fatigue is more common than you think. How many people have said to you "We need another Holiday/Vacation to get over this one!!!"? Are you are going to spend hard earned money on a Holiday and then need another one?

Always check to make sure of distances you are to travel whilst away and the times given on your itinery. Does the holiday have time for you to relax and can you take it easy. If you don't have time to relax you may be damaging your health! Many tourists, understandable, try to see everything they can, in the short time they are away, and then realize that two days into the holiday they are tired! (Fatigue!). Pacing yourselves can benefit your health and allow you to absorb what you see too!

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Travel Cover:

Okay, you've got your travel insurance and the agent told you it covers you for everything! So does the NHS, but do you really want to have a stay in Hospital? No! You're on holiday aren't you! And have you checked that you are fully covered, with no exceptions, clauses etc. Don't take the agents word for it! Read the documents when you receive them. The first question you may get asked after you've been run over by a crazy local, doing 60mph on his donkey,could be; "Have you got ambulance cover!". Are you covered? Check before you go!!!! Places like the US are really expensive if you don't have total medical cover! Also see if there is an emergency telephone number and make sure that you phone it before any major medical decisions are made. Remember to get receipts for every payment you make, failure to do so may invalidate your claim!

EUROPEAN FREE TRAVEL COVER:
If you are a European travelling within the European Union and a few other countries, you may be covered by reciprocal health care arrangements. Details of these arrangements are in the Free Booklet 'Health Advice for Travellers' (T6) available from the British Deptment of Health and most UK Post Offices. You will need to fill out the forms CM1 and E111 at the back of this booklet to prove you are entitled to treatment. Then take them to any Main Post Office to get stamped - Before you go away! And don't forget to take the forms with you when you go away! Obviously this is not as good as a correct Travel insurance, but it's great if you're on a budget!

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Immunisations and diseases:

Responsible Tour Operators and Travel Agents are now giving brief advice on health precautions on their brochures etc. Read them and then ask your Doctor or GP (or even your pharmacist) to check what you need to be immunised against for your holiday.

Tetanus. Diphtheria , Polio and TB. Everyone born in the UK should have protection against these. If you are older than about 55 you should check with your GP that you are still immunised. If you are not sure, check and make sure before you go away! (Have you got the BCG scar? This is from TB immunisation)

Typhoid. This immunisation is given to those who are travelling to places where food and water hygiene is poor. This includes the Tropics, Tropical Climate Countries and Developing Countries. For instance the Caribbean may be a risk to you, but by taking a few basis precautions, you may reduce the risk. Be careful that what you eat is well cleaned and cooked fully. Check water has been sterilized. Clean your teeth with bottled water!

Hepatitis(A and B). Hep' A can be transmitted through food and water, you have a choice of vaccines depending on length of travel to the risk area. Risk areas for Hep' A are similar to Typhoid (above). Hep' B is transmitted as HIV, through sexual contact or blood and non-sterile equipment. The Risk areas are the same as for Typhoid, basically. There is a vacinne for Hep' B, but normally only given to those in risk of needing medical attention whilst away, or those who likely to have sexual relations whilst in risk area! It is not normally given for Holidays - so take those B.S. 'kitemarked' condoms and, if necessary, your own needle & syringe kits!

What and where are you eating and what are you drinking? "A street stall may not be a good idea!"

Tick-Borne encephalitis. You should consider this particulary if you are going on a walking or camping type holiday in wooded areas or the surrounding countryside in parts of Europe, especially Central and Eastern Europe including the former USSR. The disease is transmitted by ticks attatching to people when they brush the undergrowth, so you can discourage them by tucking your full length trousers into your socks, using insect repellent and checking yourself frequently! Areas of risk in the Czech Rep', Slovakia, Austria, Germany,and Scandiavia are well mapped. (Areas of risk in USSR are not!) The risk of TBC is greater in spring and early summer. The Vaccine for this is not licensed for general use in the UK, and as a result is not widely known to the UK public, but you can ask your GP about it and they will inform you if you are at risk. Be warned it is an expensive vaccination.

Cholora/Smallpox were both a risk in many countries! Years ago you used to need a certificate for both of these to travel outside Europe, but as Smallpox is so rare now, and as Cholora can't be stopped by immunisaton, this is no longer required.

Meningitis strikes fear into every parent, but actually there are serveral types. The Meningitis vaccine given for Travel protects against Menigococcal Meningitis A and C and is a totally seperate type to the Hib vaccine given to children routinely. Strain A is rare in the UK, but vaccine is recommended if you are staying with local people or backpacking in certain parts of the world. These include, among others, Nepal, India(especially around Delhi), Mongolia and parts of Brazil. Also the Meningitis belt of Africa, which stretches from Senegal in the West to Ethiopia in the East and down to Zambia. Package Holiday to Gambia and Kenya are not normally considered a risk, but check with your GP before you go. You must have a Vaccination Certificate if you are going to Mecca in Saudi Arabia.

Take care of personal hygiene! "Cleanliness often greatly reduces risk of illness!"

Japanese encephalitis is rare and rarely known by GPs. Although called 'Japanese' this is very rare in Japan now! Vaccine for this is not often suggested for short holidays, but is increasingly used for those on overland trips and extended Holidays to affected areas. The vaccine is not licensed in the UK and only one type is in the USA. The endemic area stretches from India across Southest Asia to China. It is spread by mosquitoes which breed in rice fields and bite farm animals, they particulary like pigs. Therefore being in rural areas, especially after dusk, in the endemic zone may warrant having the vaccination against Japanese encephalitis.

Yellow Fever exists today in some countries! You need to check your destination and take an Immunisation Certificate with you too, if required!

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DEEP VEIN THROMBOSIS & AIR TRAVEL.

What is DVT

Thrombosis is formation of blood clots - lumps composed of red blood corpuscles, blood platelets, and fibrin fibers - normally in the deep veins of the thigh and/or the calf. The formation of blood cloths in the deep veins of lower extremities can have two serious consequences

If the clot blocks the blood flow through the vein, blood in the vein beneath the cloth begins to pool. Swelling and pain may develop in the leg; these are the signs of the Deep Vein Thrombosis ( DVT).

A large clot (thrombus) may break free, travel through the vein system and ultimately plug one of the arteries of the lung. This is a dangerous condition called pulmonary embolus, it can be life-threatening if left untreated.

The majority of DVT do not cause any inconvenience and are not detected. Only about 5 % of all DVT cause symptoms. In spite of being silent, large thrombus in the calf or thigh vein may still brake free, travel "upwards" and cause pulmonary embolus.In the very rare cases the clot is so big that it occludes a large pulmonary artery so that the blood flow to the heart is impaired and death may follow. The body can take care of the absolute majority of blood clots. Clots are either dissolved or new veins grow through large clots.

The signs of DVT

The DVT most commonly occur in just one leg. The symptoms include any or all of the following:

• Pain in the calf or in the thigh,
• Swelling of the lover leg and foot,
• The calf and thigh muscles are painful for palpation,
• Passive stretching of the calf muscles by pushing the foot cranially ( towards head) provokes severe pain in calf muscles,
• Discoloration or redness of the calf or thigh area.

If you observe any of these signs see your doctor immediately and he will decide whether you need further tests or treatment.

The signs of pulmonary embolus:

• Dizziness,
• Shortness of breath,
• Severe Coughing,
• Painful Chest pains.

If you get some or all of these symptoms see you doctor because this must be treated immediately.

Two sides to the story...

Linked to Flying?

Some people beleive Deep vein thrombosis can leave airline passengers crippled or dead, fifty-six people have been fighting a landmark legal case in the UK against 28 airlines for failing to warn them or their relatives about the risk of DVT, also known as economy class syndrome.

Counsel Stuart Cakebread told the court there was a "profound" impact of flying for long hours in cramped conditions. The three-day hearing considered whether DVT can be classed as an accident under the terms of the 70-year-old Warsaw Convention. This case was lost when it was decided that DVT cannot be classed as an accident.

All 56 claimants say that they or their deceased relatives have been injured (or killed) as a result of flying in aircraft.

Emma Christoffersen from south Wales died after a long-haul flight. "All the victims suffered their injury whilst in the care of the defendant airlines, the symptoms appearing either at the time or shortly afterwards." Mr Cakebread said there was "a causal link between air travel and DVT". He said the claimants suffered because of "acts and omissions" by the airlines, including seating too close together and a failure to warn passengers of the dangers.

Lawyer Des Collins, who is representing the claimants, said he believed these claims were just the tip of the iceberg. He condemned the airlines for an "appalling silence" about the alleged risk.

No link to flying?

The airlines are expected to argue they are protected under the 70-year-old convention from paying compensation for medical problems classed as a passenger reaction to the normal operation of an aircraft. They have denied liability and say advice given by the government and the World Health Organisation suggests no specific link between flying and DVT. The advice they offer passengers during flights is a reaction to their concerns and media reports, the airlines claim.

A 28-year-old died two years ago after developing a blood clot on a 20-hour flight from Australia to London.

Tips to lower the risk of developing DVT...

• Walk around the aircraft during a flight
• Wearing tight stockings.
• Exercise your muscles.
• Drink lots of non-alcholic fluids.
• Don't drink to much alchohol
• Invest in a medical approved pair of Travel Socks available at most airports.
• Don't sit in the same position during the whole flight.

 

 

More information

More details on Health and travelling are available in the Free Booklet 'Health Advice for Travellers' (T6) available from the British Deptment of Health and Post Offices.

Hard copies of publications are available from

Department of Health,
PO Box 777,
London SE1 6XH

Phone for booklets in the UK on 0800 555 777.or Fax 01623 724 524
Email doh@prologistics.co.uk for a copy.

Check their website Department of Health Publications here.

Travel-insurance-online.com is one of the leading providers of online travel and holiday insurance for UK and Irish residents on the Internet.
They have been on the Internet since 1999 and has now over 25,000 policyholders. Our visitor to conversion ratio is high due to the ease of use of the site and the excellent products we provide at competitive prices. Insurance is the perfect web product, you see what you are buying before you purchase it and you receive it online. Our policies are tailor made for travelers going on holidays, business trips, weekend breaks or backpacking for 12 months. The policies are underwritten at Lloyds of London. The fulfillment of the insurance is by web page, email, post and we also SMS text message the synopsis of the Insurance to the customer?s mobile telephone.

GO! Online travel and holiday insurance.

This link is for an USA Florida Disability Holiday Company.

click here to go to their site.

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updated January 2008

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