The diseases most commonly seen in travellers are diarrhoea, malaria (if you travel in a malaria-infested area), accidents (when travelling by car or swimming), wound infections and sexually transmitted diseases.
- Diarrhoea is caused by contaminated food and drinking-water. You must therefore be careful if your are travelling in poor hygiene conditions.
- Malaria is transmitted by mosquitoes, so first thing to do is to protect yourself against these mosquitoes.
- In order to prevent accidents during travelling, it is wise to apply same precautions as those taken at home. In addition, it is very important that all wounds should be thoroughly disinfected in order to avoid infection.
Many intestinal infections are attributable to infections picked up by mouth or hands. With a little care most of these illnesses can be prevented. Hepatitis A, typhoid fever, polio and cholera still occur in countries with poor hygiene, but these diseases are easily prevented.
However, chance is rather large that you will still contract a light and/or nondangerous form of traveller's diarrhoea. Traveller's diarrhoea almost always spontaneously clears up after a few days, but can nevertheless be irritating. And a risk to your overall and travel health.
In first place measures must be taken against dehydration. Likewise, treatment of symptoms must be considered in order to reduce number of bowel movements and relieve other symptoms such as fever, vomiting and stomach cramps. Sometimes a more serious form of diarrhoea occurs, for which specific treatment with antibiotics is indicated or where hospitalisation or fluid replacement appears unavoidable.
It takes only a few basic preventive measures to make your trip a success : Total prevention of traveller's diarrhoea is impossible and it is obvious that preventive measures can seldom be strictly followed at all times. But following preventive measures do significantly reduce risk of contracting serious diarrhoea: In order to maintain good travel health wash your hands before eating and avoid (if possible) :
- raw vegetables and fruits that you have not peeled yourself - uncooked or unpasteurized dairy products - insufficiently cooked sea foods (+ Hepatitis A !) and meat - “local meals” which do not smell fresh - ice-cream bought from street merchants (industrial ice straight from deep-freeze is probably safe).
Cooked meals should be served hot. The place where you eat is also important. A meal taken from a stall presents a greater risk than a meal taken in a restaurant. Avoid restaurants where there are a lot of insects. Avoid tap water and ice-cubes. Bottled water and soft drinks are safe. Watch out for bottle caps that have already been used. It is very important to disinfect drinking-water on adventure trips. Total sterilisation of drinking water is impossible. The following measures considerably reduce contamination risk and safeguard your travel health:
- Boiling water is very effective. - A good alternative is chemical disinfection with chlorine drops (e.g. Hadex®, Drinkwell chloor®; available in sport shops specialized in outdoor activities) or chlorine tablets (Certisil Combina®; chloramine tablets; available at pharmacy). Their effect can be improved by first filtering unclear water. Silver salts (Micropur®, Certisil Argento®) are not very suitable to disinfect water, but they keep disinfected water germ-free for a long time.
For adventurous travellers conscious to travel health it is best to buy a portable water-filter. The use of antibiotics in order to prevent diarrhoea before it occurs can be dangerous + Also use of other preventive medications is not recommended.
.How to treat diarrhoea?
It is extremely important to consume sufficient liquid and salt in order to prevent dehydration. You can do this by taking salt solutions, but tea with lemon, broth, soft drinks and fruit juice, supplemented with salt crackers are tastier. Commercial salt products are available on market (ORS-solution).
Taking an anti-diarrhoea preparation (loperamide, e.g. Imodium®) can greatly reduce number of bowel movements, with a considerable reduction of complaints as a result. Imodium® may only be used by adults and older children and only for treating ordinary watery diarrhoea: 1 capsule after every loose movement up to a maximum of 4 per day.
Antibiotics are indicated :
1. If blood, mucus or pus are present in stools. 2. If after 24 to 48 hours, there is no sign of improvement and diarrhoea is accompanied by fever (above 38.5 C) or severe abdominal cramps, or if there are more than six stools per 24 hours and especially when these also occur at night. 3. Or if because of travel circumstances a quicker solution is absolutely desirable . Appropriate antibiotics are only to be used on doctor’s prescription
·SEXUALLY TRANSMITTED DISEASES Casual sexual contacts tend to be higher while on holiday abroad. Sexually transmitted diseases, particularly AIDS, form therefore an important risk for travellers. Quite often unintentional and unsafe sexual contact takes place under alcohol influence. Prevention while on holiday abroad is no different from precautions you take at home. Adequate use of a condom, preferably bought at home, is absolutely essential. Only a water-soluble lubricant should be used, but it only offers a partial guarantee (e.g. KY gel). Vaccination against hepatitis B is advised. Always consult your doctor if you think you are at risk, even when there are no symptoms.