Gastro symptoms, such as diarrhoea, nausea and vomiting, are the most common health issues encountered by travellers, especially when travelling to developing countries. They're usually caused by bacteria such as E. coli, campylobacter or salmonella; parasites including cryptosporidium and giardia; or dysentery (bacterial or amoebic). Other causes are typhoid and cholera.
The bugs are spread in contaminated food and water, so the best way of preventing diarrhoea and other gastro symptoms is exercising good personal hygiene, and avoiding foods and drinks likely to cause problems.
- Salad and other raw or unpeeled fruit and vegetables may be contaminated by unclean water or bugs in the soil (human sewage is sometimes used as fertiliser).
- Any food can be affected by poor food storage and handling procedures. In particular, avoid uncooked, undercooked or reheated meat, poultry and fish, and be wary of crustaceans, shellfish and dairy foods.
- Boiled or purified water, or bottled water with a properly sealed lid (bottles are sometimes refilled with unclean water) should be used for drinking and when brushing teeth.
- Soft drinks, beer and wine are low risk.
- Ice and drinks with ice in them should be avoided.
Apart from food, drinks and related utensils, you can pick up germs from all sorts of things, including money, shaking hands with people, door handles, hand rails, hotel room surfaces, tap handles, touching animals or even handling fresh produce in markets. So it’s a good idea to wash your hands frequently throughout the day, and definitely after using the toilet and before eating.
Extra measures you can take if you really want to reduce the risk of sickness are to use a disposable paper towel or tissue to turn off the tap, and don’t use a communal cloth towel to dry your hands. Watch how many people don’t wash their hands after using the toilet, and then consider using a disposable paper towel, a tissue or part of your clothing when opening the bathroom door!
It’s not always easy to find somewhere to wash your hands before eating, such as when tempted by street vendors’ fare, so alcohol or anti-bacterial hand wipes or liquid hand sanitiser are alternatives, and can be used regularly throughout the day.
Treating diarrhoea depends upon the cause – in simple cases that last a day, rest and rehydration with electrolyte drinks (see Travel medical kits) may be enough.
However, if it lasts longer, is accompanied by fever, or if there is blood in the stools, antibiotics or other treatment may be needed. Your GP or travel doctor can advise you on an action plan, and perhaps provide antibiotics to take with you, 'just in case'. Otherwise see a local doctor recommended by your travel insurance company or, depending on the type of accommodation you're staying in, the hotel concierge may be able to recommend a doctor.
Stoppers like loperamide (Imodium) can be useful if you have to get on a bus or plane, but this keeps the infection within you so you have it for longer.
The world’s most deadly animal is depressingly common. The mosquito carries diseases including dengue fever, malaria, Japanese encephalitis, filiariasis, chikungunya fever and Ross River fever. Even if the disease doesn’t kill you, symptoms can be debilitating and it can take a long time to recover. The best prevention is to avoid contact with mozzies, and you can also:
• Use physical barriers (long pants and long-sleeves tops; bed nets)
• Avoid being out during biting times (usually dawn and dusk, but some species bite all day)
• Avoid attracting them (perfumes and dark clothing attract mozzies)
• Use chemical protection (such as repellent containing DEET or picaridin; permethrin-impregnated clothing, bedding and nets)
Ticks are another problem insect, and can cause serious diseases, including encephalitis and Lymes disease. Insect repellent and permethrin-impregnated clothing will help keep them at bay.
Bed bugs are small, non-flying biting insects that live in furniture, especially beds. They’re most active at night, and are increasingly reported to be in hotels, even upmarket ones, all around the world. While the effects aren’t serious, the itching is definitely a nuisance and you may end up taking them with you on your travels – and home. Look for small dark spots on sheets, and check crevices in the bed frame and walls near the bed for signs of the insects.
Lazing around in hot weather is unlikely to cause problems for most people, but doing strenuous exercise or a long duration of exercise when you’re not accustomed to the heat can cause problems such as heat stroke, dehydration or hyponatraemia (caused by drinking too much water without replacing salts lost through sweating). In some cases (such as sports or hiking in the tropics or desert) an acclimatisation program may be beneficial.
Wearing lightweight, loose and light-coloured clothing with a broad-brimmed hat can provide ventilation for evaporation and reduce exposure to radiant heat from the sun, keeping you cool. If you’re sweating a lot, drink plenty of fluids and eat salty snacks (most sports drinks don’t contain enough salts to replace those lost). And don’t forget the SPF 50+ sunscreen!
Deep vein thrombosis (DVT)
DVT occurs when clots form in the blood vessels in the legs, which can lead to a heart attack and stroke. DVT is referred to as 'Economy Class Syndrome' because sitting in cramped conditions for long periods can increase your risk.
However, flying isn't the only risk. Research from New Zealand revealed that you’re more likely to get DVT from sitting at your desk for extended periods than sitting on a plane.
Risk factors include having a family history of DVT or pulmonary embolism, recent surgery, smoking, and being obese, pregnant and over the age of 40.
In order to reduce your risk during a long flight:
- Stand up and walk around regularly and do exercises such as leg stretches every half an hour.
- Drink at least one litre of water for every five hours you're flying. And avoid alcohol and caffeinated drinks before and during the flight.
- Wear loose-fitting clothing.
- Avoid sleeping tablets as they limit your mobility.
- Avoid leg crossing and elevate your legs when possible. Talk to your doctor if you have any risk factors for DVT.