DVT advice

A Deep Vein Thrombosis occurs when a clot develops in one of the deep blood vessels in the leg, which can then dislodge and travel to the lungs and cause a serious and life threatening illness.

To reduce the risk of DVT it is sensible on any long haul flight to
•    Be comfortable in your seat
•    Drink plenty of water, and be sensible about alcohol, which can lead to dehydration.
•    Exercise your legs while sitting every half hour or so, and take short walks in the plane when you can. Also exercise your upper body, which can improve circulation.
•    Think about travel socks which can be purchased from chemists.
Mediven travel socks

Drinking water

A number of diseases can be picked up from drinking water, so unless you know the water is safe
•    Drink boiled water
•    Drink bottled water or canned drinks
•    Drink water treated with water purification tablets
•    Don’t take ice cubes in drink
•    Don’t use tap water for cleaning your teeth

Food safety and hygiene

Poor hygiene standards can expose you to food or drink contaminated with a range of bacteria, viruses or parasites. These can cause a range of illnesses such as traveller’s diarrhoea or cholera.
Remember to
•    Wash your hands after going to the toilet and before handling food
•    Follow the advice about drinking water above
•    Don’t buy ice-cream from unreliable vendors
•    Only eat well cooked fresh food
•    Avoid leftovers and reheated food
•    Ensure meat is cooked thoroughly
•    Eat cooked vegetables, avoid salads
•    Only eat fruit you can peel
•    Never drink un-pasteurised milk
•    Avoid shell fish
•    Be careful with alcohol. You could become careless and avoid the precautions.

Diarrhoea and vomiting

See above for prevention.
It usually lasts 2-4 days and whilst not life threatening can disrupt your trip.
The main danger of diarrhoea and vomiting is the risk of dehydration. If this is very severe it can kill.
It is important to keep drinking fluids, especially water. There are oral re-hydration solutions e.g. Dioralyte, which can be bought from pharmacies. When your appetite returns try bland foods such as toast, rice or pasta first.

If you need to travel then short - term use of medicines such as Imodium or Lomotil may be useful. These can be purchased from the chemist.


Contact medical help if
•    The symptoms don’t settle within 48 hours
•    Blood or mucous in the diarrhoea
•    Fever
•    You experience dry mouth, reduced urine, sunken eyes, confusion or irritability.

Very occasionally antibiotics are needed to treat diarrhoea. This decision should be made by a doctor.

Remember, diarrhoea can affect the absorption of the contraceptive pill. Condoms should be used during the episode and for 7 days after or sex should be avoided

Jet lag

When travelling on a long-haul flight your body clock, which controls the timing of routine functions such as eating and sleeping can be disrupted.
Your body clock can take a number of days to adjust to the new rhythm of daylight and darkness and this is called jet lag.

The world is divided into 24 time zones. If you travel over 3 time zones you are at risk of jet lag. This means that if you fly from the UK to Europe or Africa and the Middle East you will not be affected. If you travel from the UK or Europe to Asia, Australia, USA or South America you will be.

It tends to be more of a problem if you are flying east.

Symptoms
•    Indigestion
•    Disturbed bowel habits
•    Loss of appetite
•    Difficulty concentrating
•    Memory problems
•    Clumsiness
•    Feeling generally unwell
•    Lack of energy
•    Feeling light headed


What makes it worse?
•    Dehydration
•    Tiredness
•    Lack of sleep
•    Alcohol
•    Stress

Prevention

Before travel try
•    Going to bed and getting up earlier if you are flying east
•    Going to bed and getting up later if your are flying west

Whilst in the air try
•    Adjusting your watch to the destination time as soon as you get on the plane
•    Drinking plenty of non alcoholic fluids
•    Moving about as much as you can

When you arrive try
•    Getting into a routine immediately – eat and sleep at the correct times for your new time zone
•    Spend daytime outdoors as light can help your body clock adjust
•    Not to nap during the day

Sun sense

Over the past 20 years, cases of skin cancer have doubled in the UK. This is partly due to more people taking overseas holidays and exposing their skin to a sudden burst of ‘binge’ sunbathing.

People most at risk
•    Fair skin
•    Lots of moles or freckles
•    Family history of skin cancer
The SUNSMART Message

Spend time in the shade between 11 and 3
Make sure you never burn
Aim to cover up with a t-shirt, hat and sunglasses
Remember to take extra care with children
Then use Factor 15+ sunscreen

Stay Safe
Drink extra fluids in a hot climate
Be aware that alcohol can make you dehydrated.


SUN SCREENS
•    Reapply often (at least 2 hourly) and always after swimming and washing
•    Use liberally.
•    Make sure the sunscreen is labelled ‘broad spectrum’ – to protect against UVA and UVB
•    Choose water resistant
•    Check the use by dates
•    You don’t need expensive brands.
•    Factor 15 offers about 93% protection
Factor 30 offers about 96% protection
Factor 60 offers about 98% protection


Sexual health

Remember unprotected sex can lead to anything from Chlamydia to HIV.
HIV and other sexually transmitted infections are extremely common in certain areas, particularly South – East Asia and Sub-Saharan Africa.

SAFER SEX – USE A CONDOM

Insect bites and bite avoidance

It is important to try and prevent being bitten. Your chances of getting malaria are increased with the number of bites you receive. Mosquitos that transmit malaria bite mainly at night, but this can be any time from dusk onwards.

Use, but don’t rely on
•    Insect repellents containing at least 35%DEET
•    Wear long, loose, light coloured clothing
•    Take a mosquito net impregnated with permethrin to sleep under.
•    Avoid camping near stagnant water
•    Electric insecticide vaporisers.
•    If your room is not air conditioned but screened make sure shutters are closed from early evening and spray the room with insect repellent.

Diving

If you have a chronic medical condition such as Diabetes or Epilepsy it is advisable to check the safety guidelines about diving.

Remember if you are scuba diving you must allow 24 hours between your last dive and your flight.
www.scuba-doc.com/
www.traveldoctor.co.uk/scuba.htm

Travellers to high altitude

Altitude sickness (also known as acute mountain sickness) can occur in healthy adults at heights of around 2,500 metres above sea level. It is more severe at higher altitudes. It is not related to physical fitness. It is treatable but in rare cases can lead to two serious conditions that are potentially fatal: High Altitude Pulmonary Oedema and High Altitude cerebral oedema where fluid collects in the lungs and / or brain.

Symptoms can occur within 6-36 hours of reaching high altitude
•    Headache
•    Tiredness
•    Feeling sick or vomiting
•    Loss of appetite
•    Shortness of breath
•    Racing heartbeat
•    Dizziness
•    Difficulty sleeping
•    Irregular breathing when sleeping

The treatment ranges from rest, re-hydration, pain - killers, to oxygen therapy and descent. If symptoms develop it is important to rest for at least 24 hours at that altitude. If there are more severe symptoms it is important to descend to the altitude when the climber last felt well.

More severe symptoms can include confusion, behaviour changes, hallucinations, disorientation, shortness of breath, and coma.

Prevention
•    Slow ascent
•    Keep warm
•    Drink plenty of fluids
•    Avoid alcohol and tobacco
•    Eat carbohydrate rich food such as pasta
•    Do not do any strenuous exercise or activity for the first few days after arrival at high altitude and have rest days if you are ascending further.

•    Acetazolamide
This medication has been used increasingly to decrease the symptoms of altitude sickness. It needs to be discussed with your doctor and a trial in the UK is recommended before travel.
For more information visit

The British Mountaineering Council

http://www.thebmc.co.uk

www.high-altitude-medicine.com

Oral contraceptives and high altitude
Visit the 'Women and altitude link at http://www.thebmc.co.uk
Personal safety

•    Make 2 copies of your passport and insurance documents and leave one copy with your family
•    Fill in the emergency contact details on your passport.
•    Avoid travelling alone
•    Don’t use your home address on luggage labels
•    Don’t wear too conspicuous clothing or expensive jewellery
•    Do not pull large amounts of cash out in public
•    Make a list of your credit card and travellers cheque numbers
•    Never accept gifts or packages from unknown parties
•    Do not accept drinks from anyone you don’t know in case they are spiked
•    Do not get involved with drugs under any circumstances
•    Be careful of the effects of too much alcohol