Traveling – it leaves you speechless, then turns you into a storyteller. – Ibn Battuta
(This is part 1 in a three-blog series on travel readiness. Part two will focus on the importance of travel vaccination and part three on first aid kits and the management of medicaton, including chronic medication.)
Traveling is slowly opening up and we all are making plans to start exploring the world again. Take a few minutes to read through this three-part blog series on travel readiness to make sure that you are well prepared and that your travel will leave you speechless for the right reasons.
Did you know that global tourism has increased exponentially since World War II, from 25 million international tourist visits in 1950 to 1.4 billion in 2018? Europe remains the number one destination, with more than 700 million visitors in 2018.
Do you check the profile of your destination property before you travel? Did you know that there is an outbreak of typhus in parts of the Philippines, dengue fever in Kenya, diphtheria in the Dominican Republic, measles outbreaks in the Democratic Republic of Congo and yellow fever in Brazil?
To start, you need to be aware of the actions that you have to take BEFORE you travel, WHILE you travel and AFTER your travel.
- Important aspects to address before your planned travel include a good understanding of the COVID-19 requirements and the risks associated with your destination, and making sure that all your vaccinations are completed on time.
- During your travel, you need to be mindful of foodborne illnesses, malaria and other illnesses, and air pollution.
- And perhaps the most neglected piece: be aware of the development of any symptoms once you are back home. You may have been exposed to COVID-19, malaria or foodborne illnesses. Seek early medical help where needed!
Register with your government as a traveler. The purpose of this is to receive updates from your government about safety conditions in your destination country, helping you make informed decisions about your travel plans and possible evacuation in security situations. The Smart Traveler Enrollment Program (STEP) is a free service that is available to all US citizens and nationals traveling and living abroad.
Travel insurance often is a complex area to navigate. You should consider the following:
- Is COVID-19 included and covered or not? What will happen if you should become ill with COVID-19 shortly before the onset of your trip? What will happen if you become ill while travelling? What will the quarantine requirements be?
- Does the insurance provide coverage for the whole period, including departure and arrival dates and layover destinations?
- Does it cover pre-existing medical conditions, and can you afford the excess in case of hospitalization?
- Does it include evacuation for medical and security reasons, and does it include repatriation of mortal remains?
- READ THE FINE PRINT!
Schedule a pre-travel consultation 6–8 weeks prior to the scheduled trip. This can be at an airline travel clinic such as KLM Health Services, Lufthansa Global Healthcare and Medical Services, through your GP if you are living in the UK, or through known institutions, e.g., the Tropical Institute Antwerp or the Robert Koch Institute in Germany.
Topics that should ideally be discussed include the following:
- Itinerary, season of planned travel and the reason for your trip. Will your planned trip include more than one country? Will it be a combination of rural and urban travel? Is the trip in the summer or winter? Is malaria going to be a concern? What is the purpose of your trip? Is it a business trip, tourism, or perhaps volunteering or research?
- Suggested vaccination and malaria prophylaxis (where applicable).
- Traveler’s diarrhea, including strategies to minimize diarrhea, including the possible use of antibiotics for self-treatment and medications such as loperamide.
- Other vector-borne diseases: define the risk of disease in your specific itinerary and the insect precautions needed (e.g., dengue fever).
- Other environmental hazards, including contact with animals (bites and scratches), exposure to parasites through walking barefoot or swimming in fresh water where there is a risk of schistosomiasis (bilharzia) or leptospirosis.
- Sun exposure.
- Jet lag can be a debilitating issue for some, and it helps to be more prepared.
- Travelers can be at risk of developing deep vein thrombosis (DVT) or potentially the more serious pulmonary embolism. Be aware if you are at a higher risk.
- Pregnancy: always check with your health care provider before travel is scheduled, especially towards the end of the pregnancy. In uncomplicated pregnancies, travel is typically allowed until 38 weeks, while travel may not be allowed in a multiple pregnancy after 32 weeks.
- First aid kit? (to be discussed in the third blog in this series).
- Blood transfusions:
- Systematic blood screening of donated blood is not in place in all countries. The WHO estimated that 11–21 % of countries worldwide have inadequate screening in place. Therefore, blood transfusions should only be done when the testing of all donated blood for transmissible blood or blood products can be verified by the health care facility and the risks associated with a transfusion have been discussed.
- The traveller should always carry a medical card or other identification showing their blood group.
- Travellers with haemophilia or diseases that may require transfusion of plasma-derived products or immunoglobulin must ensure advance identification of appropriate medical facilities at the travel destination.
- Managing travel diarrhea: the best advice is “Boil it, cook it, peel it or forget it.” It is typically self-limiting (2–3 days); if it persists, consider antibiotics.
A few words about malaria
- The risk for travelers of contracting malaria varies greatly from country to country and even between areas within a country (urban vs. rural, altitude) and the season. Since 2000, there has been a significant increase in the number of countries that have moved towards malaria elimination, but the work of eradication teams has been hampered by the pandemic. It therefore remains important to discuss malaria as a potential risk.
- You always need to be reminded of the A, B, C, D & E of malaria prophylaxis:
- Be Aware of the risk, the incubation period, the possibility of delayed onset, and the main symptoms.
- Avoid being Bitten by mosquitoes, especially between dusk and dawn.
- Take antimalarial drugs (Chemoprophylaxis) when appropriate and as prescribed.
- Immediately seek Diagnosis and treatment if a fever develops during travel or after, up to 3 months after departure from a risk area.
- Avoid outdoor activities in Environments that are mosquito breeding places, such as swamps or marshy areas, especially in late evenings and at night.
A final word
Once your bags are packed, take a few moments to make a list of and copy of your important documents – passport (including pages with visas), identity page, residence card (back and front), credit cards, debit cards, blood type, driver’s license, and vaccination card/COVID vaccination card. And any other important documents that you will be carrying with you. Make sure that you have the contact details in case you must stop any cards. Leave a set of copies with a family member or friend.
SAFE TRAVELS!
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