When you go away on holiday, you want to return with happy memories rather than an unhappy health condition. And the best way to avoid getting ill during your trip is to be as well prepared as possible.
Dr Andrew Devine, from City Hospital, Dubai, who regularly sees patients who have picked up an illness during their annual break, says, “If you’re spending thousands of dirhams on a dream holiday, you’d be stupid not to spend a little bit more making sure you’ve had all the relevant vaccinations before your trip.
“Nowadays there are great websites that give you accurate information about your destination such as the required vaccinations, the weather, and the types of diseases you need to be aware of.”
Dr Devine recommends booking an appointment with your regular doctor several weeks before you go away to ensure there is plenty of time to have all the vaccinations required.
“Vaccinations are not foolproof, but the risks of contracting something are exceptionally reduced when you are vaccinated,” adds Dr Devine.
“You also need to make sure you have enough medication for your existing medical requirements as well. And packing a first aid kit, containing basic medicines such as painkillers and anti-histamines, is also a wise idea.
“Remember when you visit a new place, your body is not conditioned to the local environment and will succumb to illness more easily than someone who lives there. So basic precautions such as avoiding tap water and using insect repellent and mosquito nets are key.”
Read our guide to some of the holiday ‘nasties’ you need to be aware of and what you can do to avoid them.
1. Malaria
A tropical disease spread by night-biting mosquitos, malaria kills one million worldwide every year and affected 2,696 people from the UAE who took overseas trips in 2008. It takes one bite to be affected and symptoms can develop between eight days and up to a year later, depending on the type of parasite you are infected with.
Malaria symptoms are similar to flu with high fever, muscle pain, diarrhoea and vomiting, but the deadly Falciparum malaria, can develop quickly with complications such as fits, breathing problems, liver failure and eventually coma and death.
PREVENTION: Find out if the country you are travelling to is a malaria area and speak to your doctor about anti-malarial medication. Most deadly malaria cases are imported from Africa, says Dr Devine, "People often travel to malaria areas without taking the medication and, yes, they might be fine, but you need to know that malaria still kills a lot of people every year." He advises using insect repellent, mosquito nets and wearing loose clothing to avoid being bitten in the first place.
2. Swimmers’ ear
Otherwise known as otitis externa, swimmers’ ear is swelling of the external ear canal – the tube between the outer ear and the eardrum. You are more likely to develop the condition
on holiday because it can be caused by excessive moisture getting into the ear
canal, therefore swimming, a common holiday activity, and humid environments can increase the risk.
Dr Devine says, “While swimmers’ ear is not life-threatening, it’s an infection that can wreck your holiday thanks to pain and discomfort and requires medication.”
Other symptoms include discharge from the ear, itchiness around the ear, swollen glands and even slight hearing loss. It is easily treatable with eardrops and painkillers but some sufferers can develop abscesses or even severe bacterial infections if the condition is left untreated.
PREVENTION: If you are prone to ear infections, wear a swimming hat that covers your ears as well as a nose plug and use acidifying eardrops before and after swimming to keep your ears clean.
3. Bilharzia
An infection caused by parasites called schistosomes, bilharzia is often caught by holidaymakers swimming in freshwater lakes and rivers, particularly in parts of southern Africa.
Schistosomes are small worms – up to 20mm long – that burrow under the skin and lay eggs in the liver or the bladder. This can lead to short-term symptoms such as a skin rash, high temperature, bloody diarrhoea and muscle aches and long-term problems such as weight loss, persistent diarrhoea and breathing difficulties. There is no vaccine for the condition but sufferers can take medication to kill the parasites. If the disease is left untreated, it can kill.
PREVENTION: Eight-five per cent of cases occur in southern Africa, but cases have also been found in China, the Middle East and the Caribbean so the best advice is to avoid swimming in any freshwater lakes or rivers. Dr Devine says, “In the past I’ve diagnosed ten cases and every single one of those people had been swimming in Lake Malawi.”
If you have to swim in a lake during your trip, wear waterproof trousers and boots and dry yourself thoroughly with a towel to stop the parasite entering your skin.
4. Bites and stings
There is a whole host of ‘nasties’ that can bite or sting during your travels such as snakes, scorpions, jellyfish or disease-carrying insects.
Some insect bites cause severe allergic reactions, others tropical diseases such as malaria, dengue fever and West Nile virus, and if the bite becomes infected, you could end up with cellulitis or impetigo.
A bite from an animal infected with rabies is also very serious and requires immediate medical attention. Rabies attacks the central nervous system and is potentially deadly.
Stings from marine creatures such as jellyfish, stingrays and stonefish can cause mild symptoms such as itching, pain and fever or more serious problems such as breathing difficulties, an irregular heartbeat and anaphylactic shock, which can be fatal.
PREVENTION: If you’re not sure what has bitten or stung you, seek medical advice immediately. While some stings or bites can be relatively harmless, others can be fatal so you don’t want to waste any time. Reduce the risk of insect-borne diseases with repellents, loose clothing and mosquito nets, avoid snake and scorpion bites, particularly in jungles or rainforests, by wearing long trousers and boots and don’t pet local dogs to avoid rabies. Marine life is also best admired from a distance, and it is a good idea to wear waterproof sandals to protect your feet.
5. Hepatitis
An inflammation of the liver usually caused by a virus, hepatitis can cause mild symptoms or severe liver damage depending on the type you have. Hepatitis A occurs in places with poor sanitation and is caught by consuming food or water contaminated with the faeces of someone already suffering from the condition. While the flu-like symptoms can be unpleasant, it is rarely serious.
Hepatitis B and C can be found in bodily fluids like blood and saliva and can be passed from one person to another through needles, toothbrushes or any implement that has blood on it. While patients recover from Hepatitis B within a couple of months, Hepatitis C can lead to complications such as liver damage and even liver failure.
PREVENTION: Vaccinations are available for Hepatitis A and B and are recommended for those travelling to affected areas. There is no vaccine for Hepatitis C, but the best advice is to never share any syringes, razors, toothbrushes or towels. Dr Devine says, “I regularly see people with Hepatitis A and it’s something that will floor you for three months, yet it’s easily prevented with a vaccination.”
6. Diarrhoea
Caused by a range of bacteria and parasites, travellers’ diarrhoea, otherwise known as gastroenteritis, is an infection of the stomach and bowel. This hampers your intestines’ ability to absorb water from the contents of the bowel into the body leading to watery diarrhoea and dehydration. The condition is caused by poor hygiene or consuming water or food that has been contaminated with faeces. The most common symptoms are repeated episodes of sickness and diarrhoea, stomach cramps and fever and patients rarely need medication. However, if the condition continues for longer than two days or the sufferer experiences symptoms of dehydration such as dizziness, muscle cramps, a dry mouth, sunken eyes and a rapid heartbeat, they should visit a doctor.
PREVENTION: Parts of the world with poor water hygiene include the Indian sub-continent, southern Africa and Central and South America so make sure you avoid drinking tap water or fruit juices and eating shellfish, eggs, salads, uncooked meats, ice cubes, ice cream or sauces.
7. Yellow fever
A potentially fatal viral disease transmitted by infected mosquitos in tropical regions of Africa and South America, yellow fever can affect the sufferer in two stages. In the first stage, patients suffer a high temperature, chills, nausea and loss of appetite and see their condition improve within four days. In the second, more toxic, stage, symptoms include jaundice, a constant high temperature, kidney failure and bleeding. Up to 50 per cent of people who enter the toxic stage die within two weeks. Those who recover are immune to the disease for the rest of their life.
PREVENTION: The condition is easily avoidable with a vaccination and a single dose will protect you for ten years. However, the vaccine is not suitable for pregnant or breastfeeding women and babies under six months. Some countries demand an International Certificate of Vaccination as a condition of entry. “If you fly back from a country where the condition is endemic and you haven’t got your certificate – you could be held in quarantine for a couple of weeks,” explains Dr Devine.
8. Sunburn and sunstroke
Despite living in the UAE, holidaymakers still make the mistake of spending too much time in the sun on holiday. This can lead to sunburn – caused by too much exposure to ultra-violet rays in sunlight – and those with fair skin, red hair or those who have not been exposed to the sun before such as young children and babies, are particularly at risk.
Sun burnt skin is red and painful to touch but severe sunburn can cause blistering, swelling of the skin and fever. There may also be symptoms of sunstroke such as dizziness, headaches and nausea. The long-term danger of too much sunbathing is premature ageing and skin cancer. Remember if a small baby or child has been sun burnt or is suffering from blisters or fever, head to a hospital immediately.
PREVENTION: Avoid the sun as much as possible and sit in shaded areas. Make sure you wear a hat, sunglasses and apply a generous amount of high-factor sunscreen half an hour before going into the sun so that it sinks into the skin as well as reapplying regularly throughout the day. Babies under 12 months should be kept in the shade and smothered in sun cream, and small children should also be well protected.
9. Typhoid
A potentially fatal bacterial infection, typhoid can be picked up from food contaminated with bacteria called Salmonella typhi. The disease is usually found in developing countries with poor sanitation; the Indian sub-continent has the highest incidence of typhoid.
Symptoms include sudden fever, nausea, headache, abdominal pain, loss of appetite, constipation or diarrhoea. Sufferers treated promptly with a course of antibiotics will recover quickly, but without treatment, their condition can dramatically deteriorate, leading to internal bleeding, multiple organ failure and death.
PREVENTION: Vaccination is recommended for travellers visiting high-risk areas. Basic precautions include only drinking bottled water, avoiding raw or uncooked meats, salads, ice cream and ice-cubes.
10. Lyme disease
A bacterial infection spread to humans via infected ticks – small insects that feed on the blood of animals as well as humans – Lyme disease mainly affects travellers holidaying in Europe and America.
Symptoms of the condition include a red rash, but if left untreated, it can lead to a high temperature, joint and muscle pain and more alarmingly, paralysis of the facial muscles. Antibiotics are the best course of treatment, but the length of the course will lengthen depending on the severity of the condition.
Prevention: There is no vaccine for Lyme disease but you can reduce your risk by wearing appropriate clothing in tick-infested areas, wearing insect repellent and checking your skin at the end of the day – particularly any skin folds such as the armpits and groin area. If you find any ticks, remove them by slowly pulling them off your skin with a pair of tweezers.
Protect yourself in the air
One of the worst aspects of travellingis picking up illnesses during the flight.From stomach bugs to coughs, colds and dehydration, flying can be hazardous to your health. Dr Lalit Uchil, who works in Specialist Internal Medicine at Welcare Ambulatory Care Centre in Dubai, says, "The common ailments that air travellers suffer range from respiratory illnesses such as colds and flu to gastrointestinal disorders and Deep Vein Thrombosis."
Here are Dr Uchil's top five tips to ensure you stay healthy in the air:
1. Drink plenty of water. Staying well hydrated helps you avoid dehydration and combat DVT.
2. Keep moving. Regular stretches and walking around the aeroplane will help you prevent the onset of DVT.
3. Wash your hands regularly. Good hygiene will help you avoid catching colds, flu or gastrointestinal disorders.
4. Take your contact lenses out. Wearing glasses will help you avoid dry, itchy eyes.
5. Don't fly if your health is not up to it. Remember you are not fit to fly if: you are 36 weeks pregnant or more; you have been scuba diving in the last 24 hours; you haveflu or a heavy cold; you have recently suffered a stroke; you have recently undergone major surgery.
