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MEDICINES AND TRAVEL

MEDICINES AND TRAVEL

Low-cost air transport has resulted in enormous growth in international travel
for both business and pleasure in the last 25 years. This expansion has Been
paralleled by a more adventurous approach to leisure destinations – few areas of
the world are not on someone’s itinerary – and travellers are more likely than
ever before to visit destinations with unusual health hazards and poorly
developed local health services. Although few travellers run into serious
medical problems each year, it is worth paying a little attention to the health
aspects of travel when planning a trip. This should help to prevent problems
later on and ensure that any that do arise will not be serious.

BEFORE YOU GO

If you take medicines regularly

Pack sufficient supplies to last for the duration of the trip. Some drugs may
not be available at your destination, or may require a local prescription. If
any of your medications are Schedule II or III controlled drugs, check with your
doctor or pharmacist as these may be stopped by Customs in some countries.

…And even if you don’t

Take a few everyday medicines with you, including a motion sickness remedy;
simple painkillers; an antidiarrhoeal and rehydration salts for traveller’s
diarrhoea; a laxative for constipation caused by changes in diet or routine; an
antiseptic cream for small injuries and insect bites; a high-protection factor
(15+) sunscreen lotion; and an insect repellent. If you are going to a high-risk
area for malaria, start antimalarials a week before going to ensure that any
intolerable side-effects become apparent before departure.

Vaccinations

These are not normally necessary when travelling to Western Europe, North
America, Australia, or New Zealand, but consult your doctor if you are visiting
other destinations. If you are visiting an area where yellow fever is prevalent,
an International Certificate of Vaccination will be needed. Other infectious
diseases are a risk in many parts of the world, and appropriate vaccinations are
a wise precaution. Immunization should be done well before departure as the
vaccinations do not give instant protection, and some require more than one
dose, e.g., typhoid.

Insurance

Being taken ill abroad, especially outside the European Union (where healthcare
is available to all EU residents) can be expensive. Even in the European Union,
repatriation by air ambulance in the event of serious illness is rarely
included. You should always take out travel insurance, which is inexpensive,
before you leave.

WHILE YOU ARE TRAVELLING

Travel sickness

If you are a poor traveller, take a travel sickness medicine about half an hour
before travel begins. Ask your doctor or pharmacist for advice on which drug to
choose. While you are in motion, look at the external view, not the scene inside
the vehicle, to minimize symptoms.

Dehydration

The dry atmosphere inside the cabin of passenger planes makes it very easy to
get dehydrated, especially if you over-indulge in alcoholic beverages. Drink
plenty of other fluids and limit alcoholic drinks, and you will feel fresher
when you reach your destination.

Taking medicines

International travel in which time zones are crossed and airline meals are
served at apparently random intervals may make it difficult to decide when to
take regular medications. Fortunately, precise timing is not critical with most
medicines; take them at the correct intervals (e.g., every 8 hours for a drug
normally taken 3 times daily) regardless of the current clock time, then adjust
to the original schedule upon arrival at your destination. The timing of a few
drugs is more critical. Progesterone-only oral contraceptive pills  must be
taken at intervals of almost exactly 24 hours to remain effective; a delay of
more than 3 hours will interfere with contraceptive protection. Timing is less
critical with the combined (oestrogen-containing) oral contraceptives.
Insulin-dependent diabetics also face problems when travelling as their dosage
regimen is governed both by the clock and by the timing of their meals . Such
individuals should consult their doctor or diabetic nurse before travelling.

ON ARRIVAL

Malaria prophylaxis

Travellers to malaria-affected areas should protect themselves by taking
antimalarial tablets regularly and taking steps to prevent mosquito bites. Wear
long-sleeved shirts and trousers, apply insect repellent regularly, and sleep in
screened Accommodation (or under an insecticide-impregnated bed net) that is
sprayed with an insecticide before bedtime and protected by an insecticide
vapourizer.

Traveller’s diarrhoea

This unpleasant, although usually short-lived, condition affects up to 50 per
cent of travellers to the developing world and

is usually the result of a gut infection. The condition is largely avoidable by
drinking only mineral water and other bottled beverages or sterilized water,
avoiding ice, uncooked and unpeeled fruit and vegetables, salads, and meat that
is not freshly and thoroughly cooked. Traveller’s diarrhoea normally disappears
quickly without Medication, so your primary emphasis should be on preventing the
dehydration that may accompany it, especially in young children, by using
rehydration salts.

Antidiarrhoeal drugs are of no value in reducing the duration of traveller’s
diarrhoea, but they may be useful for adults wishing to reduce the frequency of
bowel movements. Co-phenotrope and loperamide are often used for this purpose.
Remember that severe diarrhoea can reduce the absorption and effectiveness of
other oral medications.

Sun

In the UK, 40,000 people develop skin cancer each year, and this figure is
Increasing by 8 per cent annually. Sun-induced skin damage can be avoided by
following a few simple precautions. Travellers (Especially those with fair
skins) should avoid exposure to the hottest sun (from 11.00am to 3.00pm), apply
a high-protection factor (15+), broad-spectrum (UVA and UVB protection)
sunscreen on exposed skin, and use a hat and clothing for additional sun
protection.

A traveller who is unaccustomed to hot climates may experience sunstroke
-weakness, dizziness, nausea, and muscle cramps leading to unconsciousness. This
condition can usually be prevented by drinking plenty of non-alcoholic fluids,
limiting exposure to the sun, and avoiding physical exertion until acclimatized.

Bites and stings

Seek immediate expert advice if stung or bitten by any unfamiliar wildlife or by
any mammal and try to avoid such incidents by following local advice on where it
is safe to walk or swim.

ON RETURN

If you develop any unusual symptoms such as persistent diarrhoea or fever after
you have travelled, tell a doctor exactly where you went. Continue to take any
antimalarials for 4 weeks after your return.

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