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Travellers' health for exotic destinations
Published by Bupa's health information team, August 2008.
This factsheet is for people who are travelling abroad to exotic, long-haul destinations, or who would like information about it.
UK residents make around 70 million trips abroad each year and travelling to exotic destinations is becoming increasingly popular. If you travel abroad, you may be exposed to a variety of health risks that you wouldn't normally encounter at home. These include diseases that aren't common in the UK, as well as different standards of hygiene and sanitation.
About your health while travelling to exotic destinations
Broadly speaking, exotic destinations include Central and South America, the Caribbean islands, Sub-Saharan Africa, the Indian subcontinent, South East Asia, the Far East and the Pacific islands. The risk of you developing health problems isn't simply due to the tropical climate in these regions (although this is important), but also the level of local development. If you travel to areas in countries with milder climates, but relatively poor hygiene and sanitation standards, you may be at a greater risk of getting ill.
There are a number of factors that can affect your health risk. These include:
- the country you're travelling to - and the region
- the time of year
- your type of accommodation - in general, you're less likely to get ill staying in a first-class hotel than in a small hostel, where facilities may be basic
- your activities - for example if you take part in outdoor pursuits such as going on safari
- how long you go for
Most health risks can be minimised if you:
- make the necessary preparations before travelling (see Before you go)
- take sensible measures while you're away
- watch out for any problems after you return
Before you go
There are a number of considerations you should make before you travel. You should check with the Foreign and Commonwealth Office if they have any advice concerning the country you're travelling to.
Some of these are outlined below.
It's important to seek up-to-date advice about vaccinations before you travel to exotic destinations. The requirements for immunisations change frequently and vary from country to country, and between regions in large countries. Always seek advice from your GP or a travel clinic.
You should seek advice four to six weeks before your planned departure as it can take time for some vaccination courses to be completed and effective. However, if you have left this until the last minute it's still worth getting some medical advice before you leave.
You will usually have to pay for travel vaccines.
You should seek advice about malaria at least four to six weeks before your trip as preventive medicines may need to be started two to three weeks before your departure. Each year 1,750 to 2,000 people a year from the UK get infected with malaria while abroad.
Malaria is caused by infection with a parasite transmitted by the female of the Anopheles species of mosquito.
The first step in preventing malaria is not to get bitten. However, there are a number of anti-malarial medicines, known as malaria prophylaxis, which can significantly reduce your risk of getting malaria.
You may need to start taking these medicines two to three weeks before travelling (depending on the type of medicine) and continue for one month afterwards.
Taking medicines abroad
If you're taking prescription medicines, ask your GP for advice on whether you will be able to get them while you're away, or if you need to take a supply with you. You might wish to get a letter from your GP detailing your conditions and medications in case of emergency. This service isn't provided on the NHS and you may be asked to pay. Also be sure to check whether or not your travel insurance policy covers providing this letter, as it can be very expensive.
It may also be useful to take some basic medical supplies with you, particularly if you're travelling to a remote region. You can buy kits from pharmacies for example that contain syringes as well as antiseptics and other medical equipment.
It's important to get travel insurance and to ensure this covers your activities and includes adequate medical cover, including emergency assistance. If appropriate care isn't available locally, you may need to be evacuated or repatriated (returned to the UK). Your insurance policy needs to cover this very high-cost service.
While you're away
There are a number of simple precautions you should take while travelling to help prevent many health problems.
Hygiene and sanitation
Poor hygiene standards can expose you to food or drink contaminated with a variety of bacteria, viruses or parasites. These can cause a range of illnesses such as travellers' diarrhoea and cholera.
There are a number of precautions that you should take.
- Wash your hands after going to the toilet and before handling food.
- Boil tap water or sterilise it with iodine or chlorine water purification tablets. Alternatively, drink only bottled water (and break the seal yourself).
- Don't have ice in drinks.
- Don't have ice cream from unreliable vendors (such as street vendors).
- Take care with uncooked foods, including salads and fruit and vegetables (unless they are peeled by you), as the water they are washed in may be contaminated.
- Only eat freshly cooked food that is served piping hot
This is the most common health problem in travellers to exotic destinations and is usually caused by bacteria and viruses in contaminated food and water.
Insects, especially mosquitoes, can carry a variety of tropical illnesses. Therefore, it's important to try to prevent insect bites. Use an insect repellent and cover your arms and legs, especially at sunset.
A range of diseases can be carried by animals:
rabies - spread through bites or saliva of infected animals
Lyme disease - caused by bacteria transmitted through the bite of a tick
bilharzia - caused by a parasitic worm that lives in a snail host found in some freshwater lakes, rivers and streams
You shouldn't come into contact with animals, or swim in fresh water, in tropical regions. Seek medical advice if you're bitten or scratched.
HIV and other sexually transmitted infections are extremely common in certain regions. At the end of 2007, an estimated 4.9 million people were living with HIV/AIDS in Asia - this is the second highest number of people with HIV/AIDS in the world after Sub-Saharan Africa.
Using condoms with any new sexual partner is essential.
The risks of sunburn and sunstroke are much higher in the tropics than in the UK. You should use high-factor sunscreens, clothing and shade to protect your skin, and drink more fluids.
A significant number of medical problems that occur abroad are as a result of accidents. In particular, take extreme care on the road, as both a pedestrian and a motorist, since road and vehicle safety standards can vary greatly. Traffic laws may also vary between countries.
You should be aware of the risks associated with activities that are new to you, such as riding a scooter or water-sports.
Remember that if you're scuba diving, you must allow 24 hours between your last dive and a flight so that you aren't at risk of decompression sickness.
When you get home
With some diseases, you may not realise you have become infected until you get back to the UK. Often, diarrhoea illnesses can be evident on returning to the UK and you should see your GP if they don't clear up within a week or so, or if the diarrhoea is severe or contains blood.
You should tell your GP which countries you have recently visited as it will help him or her diagnose your illness. You may have an illness that is uncommon in the UK, and may need to be referred to a doctor specialising in tropical medicine.
It's particularly important to seek medical advice for any feverish illness that develops for up to one year after you have travelled to an area where malaria is present. You should tell your GP where you have travelled in the last year.
Most preventive medicines for malaria need to be continued for one month after you have left the malarial region, even if you have no symptoms.
- Overseas travel and tourism. National Statistics, 2008, published 16 January 2008. www.statistics.gov.uk
- Before you go. Department of Health. www.dh.gov.uk, accessed 7 February 2008
- International Travel and Health. World Health Organization, 2007. www.who.int
- Malaria. National Travel Health Network and Centre. www.nathnac.org, accessed 7 February 2008
- Simon C, Everitt H, Birtwistle J, Stevenson B. Oxford Handbook of General Practice. Oxford: Oxford University Press, 2002:416-419
- While you're away. Department of Health. www.dh.gov.uk, accessed 7 February 2008
- AIDS Epidemic Update. Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization. www.who.int, accessed 7 February 2008
- Travel advice by country. Foreign and Commonwealth Office. www.fco.gov.uk, accessed 21 May 2008
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr W H Simpson, MBBS, General Practitioner, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: August 2008.