Jeannett Martin, MA, RN, PNCert.
Senior Nurse Manager, Medical Research Council’s General Practice Framework, London
There are over 50.8 million visits abroad by UK residents every year, of which eight million are to developing countries (Office of National Statistics, 1996). Although vaccination before travel abroad is an important preventive health measure, the main health risks are associated with behaviour when travelling (DoH, 2001).
During ascent, atmospheric pressure falls. Although aeroplane cabins are pressurised, travellers who are oxygen compromised, by chronic obstructive pulmonary disease or severe anaemia for example, may become hypoxic and require additional oxygen during the flight; oxygen must be pre-booked. During descent, pressure falls; if the Eustachian tubes are inflamed, a pressure differential may occur that leads to intense pain (barotrauma) as the eardrum is drawn inward.
This is the commonest illness in travellers to developing countries and is mainly bacterial in origin. Preventive measures include:
Malaria is a dangerous tropical disease caused by a parasite transmitted by a bite from an infected female anopheles mosquito.
Accidents while travelling abroad are very common. In some developing countries, medical treatment may involve additional hazards because of poor standards and facilities. For example blood transfusions, unsterile needles and syringes can carry an HIV/hepatitis B/malaria risk.
Animal bites abroad should always be treated with extreme caution. In countries such as Thailand and India, rabies is endemic. Bites should be washed thoroughly under a running tap for at least five minutes, and rinsed well before applying iodine or 40% alcohol (gin or whisky is an alternative) (DoH, 2001). Medical advice on the need for rabies vaccination should be sought within 24 hours.
It takes days for the body to acclimatise to the intense heat of the tropics and travellers can develop heat exhaustion or heat stroke. Heat exhaustion can be treated by rest and rehydration but heat stroke will require hospital admission. Exposure to sun increases the risk of developing skin cancer.
Casual sexual encounters abroad can result in sexually transmitted infections including hepatitis B and HIV. Condoms can provide some protection but will not make it completely safe. Condoms should be purchased in the UK before travel, as those available abroad may be of poor quality or too small to be used comfortably.
Health education leaflets, such as leaflet T6 available free from Post Offices.
- Age Concern. Tel: 020-8679 8000.
- British Travel Health Association (BTHA). Tel: 0141-300 1174.
- Aventis Pasteur MSD Vaccine Information Service. Tel: 07000-766 73 847.
- TRAVAX: www.axl.co.uk/scieh Tel: 0141-300 1100.
- Center for Disease Control and Prevention (CDC): www.cdc.gov/travel/index.htm
- MSc in Travel Medicine: Glasgow. Tel: 0141-330 5617
Department of Health. (2001) Health Information for Overseas Travel (The Yellow Book). London: The Stationery Office.
Office of National Statistics. (1996) Travel Trends Report. London: ONS.