Eight Steps for a Healthy Happy Holiday
Step 1: Get up to speed before you travel
Are there any infectious disease outbreaks to be aware of where you are going, which vaccinations are required, what health care might be available, should you need it, and is the water safe to drink? These are all questions that you need to get answers to BEFORE you jump on that plane.
Know Before You Go is a government guide to staying safe and healthy when travelling outside of the UK. A joint enterprise between the Foreign & Commonwealth Office (FCO) and members of the travel industry, Know Before You Go offers advice, checklists and region-specific information to consider before embarking on a trip abroad. To find health related information relevant to your destination - including information about any essential and recommended vaccinations and up-to-date information about any infectious disease outbreaks - visit the Public Health England commissioned Travel Health Pro website.
For up-to-date health warnings by location in an easy to understand format, you can also try the Fit for Travel website.
Step 2: If you have an existing health condition
Extra preparations should be made prior to travel if you have an existing or chronic health condition, for example if you have recently undergone treatment for cancer or have a chronic condition such as diabetes, cardiovascular or a respiratory disease. Check in with your GP well in advance of travel to chat over any concerns you may have about managing your condition while you are away, to get some medication advice and to make sure that you are – in their medical opinion - fit and well enough to travel. You will also need to ensure you disclose all relevant information relating to your health to your travel insurer, or you might find your policy doesn’t provide sufficient cover when you need it most.
Step 3: Travel during pregnancy
According to the NHS, with a little research and some careful planning, most women are able to travel safely during pregnancy. However, the arrangement of comprehensive travel insurance that covers any pregnancy-related eventuality is an absolute must. While insurance policies often differ when it comes to terms and conditions, women are urged to check whether specific pregnancy-related occurrences are covered – including premature birth, associated medical care and treatment, hospital stays and repatriation costs.
Finding out in advance of travel about local medical facilities, should you require them, is another essential task to add to your planning to-do list.
Pregnant women should also aim to consult with their midwife at least six weeks before travel. Women who are having a complicated pregnancy or have a history of complications during previous pregnancies may be advised against foreign travel. Complications include but are not limited to gestational diabetes, history of pre-term birth, history of pre-eclampsia, premature rupturing of the membranes or bleeding.
Travel vaccinations that contain live or active bacteria or viruses are not recommended for pregnant women because any effects on the unborn child are not known, but some inactivated vaccines are considered safe during pregnancy. Travel to malaria-effected regions is also not recommended as pregnant women have an increased risk of developing severe malaria - which can unfortunately in some cases prove fatal - and some of the most effective anti-malarial drugs are not suitable for pregnant women. For advice on suitable vaccinations relevant to your destination, see your GP or midwife well in advance of travel and preferably before you choose your destination.
In addition, long-haul flights (longer than four hours) carry an increased risk of developing a blood clot, or deep vein thrombosis (DVT), and this risk is greater for pregnant women. See step 5.
Pregnancy and air travel
In an uncomplicated pregnancy, travelling by air is generally considered safe up to 36 weeks, or 32 weeks if you are carrying more than one baby. However, many airlines require a medical certificate for travel after 28 week’s gestation – so check before you book.
Extra care should also be taken to avoid food and water-borne illnesses when travelling, since gastrointestinal illness can become serious more quickly during pregnancy, posing a risk to both the mother and the unborn baby. For more on eating and drinking while you’re away, see Step 7.
Many women find travel easier during the second trimester - between four and six months - when energy levels return after the initial nausea and tiredness of the first trimester but before the uncomfortable, heavy, puffy-ankles of the third stage arrives!
Last but most certainly not least, pregnant women should make sure they pack a copy of their antenatal records and details of next of kin, taking these along on any day excursions. For more on travel during pregnancy from NHS Choices, click here.
Step 4: Travel insurance
It could be you
It sounds obvious but arranging adequate insurance prior to travel is always absolutely essential. Newspapers frequently feature horror stories of individuals becoming stranded at a less than ideal medical facility only to be landed with a monumental medical bill they can ill afford - all because they didn’t have the foresight to arrange the right insurance policy. Don’t let this happen to you or your loved ones, do your research, shop around and get the right level of cover in place to meet your requirements before you go.
For more information on what your travel insurance policy should cover and why, view the Gov.UK page on arranging Foreign Travel Insurance.
The European Health Insurance Card (EHIC)
Not intended as a substitute for adequate insurance, the EHIC card allows British citizens to access state-provided or reduced cost healthcare within the European Economic Area (EEA) and Switzerland, offering another layer of cover should the worst happen while you’re away on holiday. The EHIC card covers treatment deemed medically necessary and is provided on the same basis as it would be to a resident of the country you are visiting. To find out more and apply, visit NHS Choices.
For more information on specific regulations by your destination country, and for a list of destinations that are not covered by the EHIC, click here.
Please note: The above information is possibly subject to change as a consequence of the EU referendum decision of June 2016 to leave the European Union.
Other countries outside Europe may also have a limited reciprocal emergency health care agreement in place for visitors from the UK, but such agreements do not usually cover treatment for pre-existing conditions. Find out more information on which countries have an agreement with the UK. Again, there is no substitute for a comprehensive travel and health insurance policy.
Step 5: Deep vein thrombosis and long distance travel
Deep vein thrombosis (DVT) is a potentially very serious condition whereby a blood clot forms, usually within the deep veins of the leg. Long distance travel by any transport mode can increase the risk of developing a DVT due to the prolonged period of immobility, but medium and long-haul flights are also said to present an increased risk, particularly if you are over 40.
Medium and long-haul flights (generally classified as three or more hours) increases the risk of developing a blood clot, but these risks are increased further if you have had a blood clot previously, if you have been told you may be more susceptible or you have a family history. Pregnancy and certain health conditions also present an increased risk. If you fall into any of the above categories, see your GP for advice.
To avoid the formation of a blood clot during a long flight, the NHS advises mobilising or walking around at regular intervals, such as half-hourly, drinking plenty of water and, for those who are more at risk, the use of properly fitted below the knee compression stockings, available from major pharmacies. For more on DVT visit NHS Choices.
Step 6: Managing jetlag
By all means have a short rest when you arrive - packing, airport queues and travelling can be a tiring business - but keep curtains open during daylight hours to give your body a chance to adjust and reset your body clock. Avoid the temptation to sleep and once you’ve rested and unpacked try to get outside and expose yourself to some natural light, whatever time of day it is.
It also helps if you are able to adhere to the new mealtimes at your destination – another trick that helps your body adjust to the time change. If you have a health condition which requires you to eat at fixed times however, snack when necessary.
British Airways, with help from a leading sleep expert, have developed an excellent jetlag advisor tool to give you the most appropriate advice relevant to your usual sleeping pattern, and the time zones crossed during your journey.
Step 7: Eating and drinking while you’re away
While many all-inclusive holiday food offerings involve self-serve buffet type meals, you really can’t beat fresh food cooked to order – even better if the food is cooked in front of you while you wait. That way you know it’s fresh and hasn’t been sitting around for unknown periods of time - particularly if the food has been left uncovered and therefore vulnerable to contamination from insects. Take extra care when choosing meat or seafood dishes.
Beers, wines and spirits and bottle or canned soft drinks are usually considered safe to drink, as are hot drinks such as tea and coffee. However, if you know the water quality at your destination is below UK standards, or if you are at all unsure, drink only bottled or boiled and cooled water, avoid ice in drinks and only eat fruit and vegetables that have been cooked thoroughly or can be peeled just before eating. One thing that many people neglect out of habit is when brushing their teeth – use bottled water, not water from the tap. Try keeping a large bottle of water next to the toothpaste to remind you!
It’s always better to err on the side of caution, particularly in the case of elderly people or young children, so be prepared to stock up on bottled water as soon as you arrive.
Feeding babies and young children on holiday
Travelling to foreign countries with a baby or young child requires careful planning, research and preparation to ensure all their needs can be met while away from home. This is when breastfeeding really comes into its own, since breast milk requires no preparation or supplies, is readily available, sterile and at the correct temperature, as long as the mother is eating well and is adequately hydrated.
If your child is bottle fed, the NHS recommends that travellers take along their own supplies of formula milk, bottles and all associated cleaning and sterilising equipment as these may not be reliably available at your destination. Extremely thorough cleaning and sterilising measures are essential when making up formula feeds as babies are more susceptible to illness. While bottled water is considered a safer option than boiled local tap water, take extra care to check the label for sodium or salt content. Sodium (Na) should be less than 200mg per litre and sulphate (SO or SO4) should be less than 250mg per litre. In addition, always check the seal has not been broken and if the water appears slightly milky or cloudy, discard. Always make up feeds as required and do not store them, even in an in-room fridge, as this may not be sufficiently cold enough to prevent bacteria forming.
It is best to only feed young children foods that have been freshly washed, peeled and prepared by you, have been reliably and thoroughly cooked to high temperatures or pre-packaged non-perishable foods and snacks that you have brought with you.
It should go without saying, but alcohol, excitement, cool water and high temperatures can be a dangerous combination. And if you are in charge of young children, it’s really not a good idea at all. If you are free to enjoy an alcoholic drink or two, try not to drink excessively. Making a rule for yourself that you won’t drink alcohol before a set time in the afternoon and not drinking on an empty stomach should help to minimise your chances of becoming inebriated. Getting drunk will increase your potential for accidents, the chances of engaging in risky behaviour and - at the least - sunburn, heatstroke, vomiting and dehydration. All major holiday spoilers - so have fun but stay safe!
Step 8: Avoid sunburn and heat exhaustion
Before you travel, ensure you buy plenty of appropriate sunscreens and after sun lotion for everyone in your party. Ideally, everyone should have their own SPF-appropriate supply. Purchase everyone in your party their own sunhat and pair of quality sunglasses to keep eyes and face protected from the sun. Health watchdog the National Institute for Health and Care Excellence (NICE) recently updated its advice relating to staying safe in the sun and recommends that all adults use a minimum factor 15 sunscreen, and crucially, that enough sunscreen is applied to achieve the correct coverage – 35ml or six to eight teaspoons for adults per application.
NICE also says that babies, children and those with fair skin - particularly those with freckles or moles and/or a family history of skin cancer - should take extra precautions when it comes to being out in the sun and the correct use of a good quality high factor sunscreen.
Avoiding heat exhaustion and heatstroke
According to NHS Choices, heat exhaustion and heatstroke are two potentially very serious conditions that require immediate treatment. Both can occur during a heatwave at home or- in particular - when you are on holiday in a hot climate that you are not accustomed to.
Heat exhaustion is when you become overheated and are sweating heavily, leading to a loss of water and salts from the body and a general unwell feeling. If left untreated, heat exhaustion can quickly lead to heatstroke, a more serious condition.
Heatstroke can quickly become a life-threatening situation which occurs when the body is no longer able to regulate its core temperature – this rises to a very high level, putting vital organs under serious strain. Symptoms can develop very quickly or build up more slowly, over the course of a few days. Symptoms include tiredness, weakness, feeling faint, headache, muscle cramps, vomiting, intense thirst, a fast heart rate and low blood pressure. If you suspect heatstroke, seek urgent medical help.
For more on what to do to help someone suffering from heat exhaustion, visit NHS Choices.
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