Falling sick on a trip sucks—we not only lose the vigour we’d otherwise have for all the things we looked forward to seeing and doing, but sometimes also waste precious days recuperating in the hotel room. So how can we better care for our health when travelling? We got Dr Chester Lan, a resident physician at DTAP Clinic, to share some tips.
1. Traveller's diarrhoea
“The prevalence of street food and less-than-satisfactory food-handling practices in some of these places may present an increased risk of travellers’ diarrhoea. Symptoms may present as early as a few hours from exposure or a few days after and can include stomach cramps, nausea, diarrhoea, bloating, vomiting, fever and malaise.
It can be hard to avoid travellers’ diarrhoea but staying away from raw foods and salads, ice or ice cream, and tap water are some ways to decrease your risk.
If you do get these symptoms, you can try some over-the-counter anti-diarrhoea medications such as charcoal, or prescription medications such as loperamide for diarrhoea and buscopan for the cramps. If you have a fever, body aches or headaches, some antipyretic medications like paracetamol will help you feel better.
The most important thing about the treatment of diarrhoea is hydration. Oral rehydration salts work better than isotonic drinks in this aspect.”
2. Upper respiratory tract infection
“Dengue is one of the most serious and endemic mosquito-borne diseases in South-East Asia. Symptoms usually present within a week and can include high fever, headaches, flu-like symptoms and a skin rash.
Other infections like malaria are seen more frequently in travellers visiting forested areas, but you can still get malaria in cities. Malaria usually causes a fever, headache, nausea and vomiting, muscle aches and fatigue. The fever may be high and start with chills and rigors.
Malaria can be life-threatening but can be prevented by chemoprophylaxis (taking anti-malarial medications) before going to the area for travel. Check with your doctor if you are suitable for these medications.
Mosquitoes tend to bite more often during dawn to dusk, so staying indoors during this time can be helpful. There are also usually more of them in forested areas, so avoiding such areas can reduce your risk. If you are outdoors, wear long-sleeved tops and pants.
Insect repellents with DEET or picaridin have been shown to be long lasting and provide good protection. Lemon eucalyptus oil can also provide protection similar to products with low concentrations of DEET.”
“The most common allergy is in from food. Food allergies can present with itching of the eyes, mouth and throat, puffy eyes, a rash (hives), swelling of the lips, face, tongue and throat or other parts of the body. More serious food allergies may cause swelling of the throat, leading to difficulty in breathing, wheezing, giddiness, abdominal pain, diarrhoea, nausea or vomiting, or loss of consciousness.
Simple allergies can be treated with over the counter antihistamines. More serious allergies have to be treated by a medical professional immediately.
Environmental allergens may worsen pre-existing conditions like asthma and allergic rhinitis. Remember to bring your regular medications for your allergic conditions and your rescue therapy for asthma as well.
Prevention is always better than cure. If you see or hear a bee hive, avoid it. Should you already be stung by a bee(s) and feel unwell, faint or feel short of breath, seek medical attention immediately.”
4. Rabies and animal bites
“Rabies is a viral infection is usually transmitted by an infected animal bite. Rural areas carry the biggest risk.
Early symptoms may include tingling around the bite, flu-like symptoms, fever, headache, muscle aches, loss of appetite, nausea, and fatigue. Later symptoms usually affect the neurological system and can include altered mental state/confusion, agitation, aggression, unusual posturing, muscle spasms and weakness. Once it reaches the late stage, it is fatal.
There is a vaccination available, which must be given before exposure or directly after exposure.
Animal bites are likely to get infected by other types of bacteria as well. If you are bitten, wash the wound immediately and cover the bite with a clean bandage, then go to the nearest emergency department.”
“While infectious diseases play a role in only five percent of visitor deaths, half the visitor deaths in Asia are the result of road accidents.
Avoid jaywalking and riding scooters or motorcycles if you are inexperienced, and always be aware of your surroundings.
Even if you are involved in a minor road traffic accident, it is still important for a doctor to assess you to make sure there are no injuries to the internal organs or injuries that are not visible to the naked eye.”
6. Vaccination and chemoprophylaxis
“The US CDC publishes a list of vaccines that are recommended for travellers to each country according to how prevalent that disease is in the region.
The most common ones are the Flu vaccine, Hepatitis A vaccine, Typhoid vaccine, Tetanus vaccine and Meningitis vaccine.
These are in addition to the vaccines that you have already received as part of the National Immunization Schedule. The list of countries and their recommended vaccine can be found here.
If you are going to an area which is malaria-prone, it is advisable to start the appropriate anti-malarial course to reduce your risk of contracting malaria.”
7. Sexually-transmitted infections
“Remember that as long as you are having sexual intercourse, you can get an STI or HIV. This applies for your travels as well as for your day-to-day life.
The most effective way to prevent contracting an STI or HIV is abstinence. Should you partake in sexual activity, practise safe sex and use a condom.
Specifically for the reduction in risk of contracting HIV, pre-exposure prophylaxis (PrEP), has been shown to reduce that risk. These are anti-HIV medications that if taken prior to sexual exposure, can reduce the risk of contracting HIV.
If there has been a high-risk sexual encounter, post-exposure prophylaxis (PEP), which are also anti-HIV medications that have to be taken for a month after the encounter, can reduce your risk of contracting HIV.”