Health on Vacation

People interact continuously with the things around them. For example, countless potentially pathogenic, that is, disease-causing, bacteria live on our skin. Despite this, they seldom make us ill. We live with these bacteria in equilibrium.

Our body’s enormous capacity to adapt becomes evident in illness, which is in fact a symptom of our body fighting invaders from the environment. Similarly, if we leave our own familiar environment, as when we go on holiday, we often find that we need some time to adjust to the change in conditions. In the mountains we have to produce more red blood cells to combat the thin air, whereas in hot countries it takes us a while to get used to bacteria to which the local inhabitants are already adapted and immune. Conversely, Man has adapted the environment to himself. The twentieth century has seen a great many changes, both of a positive and a negative kind. As a result of improved hygiene, tuberculosis and typhoid scarcely occur any more in the Western world. On the other hand, the enormous pollution of the soil, water and air, has given rise to an entirely new source of disease.

New dangers to our health constantly emerge as a result of rapid advances in technology. The steps that are taken to contain these new threats often come too late.

Holidays

Holidays, whether at home or abroad, can not only provide a welcome break but also leave you refreshed and better able to carry on with normal everyday life. Different types of holiday suit different types of people. For some, a holiday with a high level of physical activity, such as skiing or scuba-diving, is the preferred choice; for others an ideal holiday would involve doing as little as possible other than lying on the beach.

The different psychological needs of people are also reflected in the way they organize their holiday. ‘Package’ holidays, where every detail, from the flight to the evening meal, is prearranged, have become increasingly popular with holiday-makers who only want to worry about making the initial booking. Such a highly structured routine is not to everyone’s taste, however, and some people prefer to make their own arrangements when they get to their destination. Whatever the type of holiday, whether in the sun or on the mountain slopes, the aim is the same: to escape from the stresses and the strains we all are exposed to in our daily lives.

A holiday should, of course, be a carefree time when you banish worries to the back of your mind, but, as with almost every aspect of life, there are precautions that should be taken and preparations to be made. Depending on the nature of the holiday, these range from simple, sensible forward planning to more complicated procedures taken when health may be at risk. It is only by planning ahead, and ensuring health risks are minimized, that your holiday becomes worry-free and a time to rest and recharge your mental batteries. If you are under medical care, for instance, there are several things you ought to do. First of all, ask your doctor if you are fit to travel. If so, ask your doctor whether any change in medication is necessary if you are on a regular course of treatment, such as insulin for diabetes. You should also ask your doctor to write down full details of any medicines you are taking and any allergic conditions you suffer from in case you need to see a doctor or go to hospital when away from your home area. If you intend to go on a long cruise, check what emergency medical care is available during the voyage. Also, be sure that you take out insurance against possible illness or injury abroad and find out if there is a reciprocal health-care scheme between your country and the one you are going to.

Immunization

Before going abroad, you may have to be vaccinated against one or a number of diseases. It is important to tell your doctor before you are vaccinated if you are pregnant, or suffer from any allergies, as both these conditions may make vaccination inadvisable. Travellers within European Economic Community countries and to and from Scandinavia and North America do not need any vaccinations other than those recommended for everyone. In the course of normal health care most people today are immunized against diphtheria, tetanus, whooping cough, poliomyelitis, measles, German measles (rubella) and sometimes tuberculosis.

However, if you intend to travel to areas where polio-myelitis is common, such as in southern Europe, Africa, Asia, the Middle East or South America, it is important you receive a ‘booster’ injection against polio. It is also worth having a ‘booster’ against tetanus if more than ten years have elapsed since your last vaccination.

You cannot enter certain countries unless you have proof of vaccination against particular diseases. These include yellow fever and cholera. Yellow fever is caused by a virus which is transmitted to humans by mosquitoes. It is not uncommon in tropical areas of Africa and South America. Vaccination against the disease is highly effective and does not cause an adverse reaction in adults. However, it is not recommended for children under one year old since there may be complications.

Cholera is characterized by violent diarrhoea and is transmitted in water or food contaminated by the excreta of an infected person. Vaccination against cholera seems to give only 40 to 80 per cent protection, depending on where you are exposed to the disease. It is best, therefore, to observe a rigorously hygienic regime as well as taking scrupulous care over what you eat and drink.

Another disease spread by contaminated food or water is typhoid fever, and vaccination against it is highly recommended if you are going to countries outside northern Europe, North America, Australia or New Zealand. Again, attention to what you eat and drink is important because immunization against the disease is thought to be only 70 to 90 per cent effective and then only for three to seven years. Protection against rabies is also available for people who visit countries where rabies is not under control. However, even if someone has not been immunized, and they are bitten by a rabid animal, the vaccine is still effective if administered quickly enough. It is a very good idea, though, to avoid potentially rabid animals, dogs and cats especially, in an area where rabies exists.

One illness against which there is as yet no effective vaccine is malaria. But there are tablets that, if taken as a precautionary measure, will arrest the disease if it is contracted. Pregnant mothers and babies under three months are advised not to take these drugs.

Car travel and motion sickness

If you are going on holiday by car, it is advisable to take a rest from driving every two hours. A short walk will refresh you and help to maintain your concentration. Remember that most countries require you by law to wear seatbelts.

Motion sickness can occur whether going by car, train, aircraft, or boat. Its effects are all too well known to some people and include nausea, culminating in vomiting. This is usually preceded by yawning, salivation, cold sweating and dizziness. People prone to motion sickness should have a light non-fatty meal before the journey and avoid alcohol. Reading and writing should also be avoided during travel. Tablets are available to help combat motion sickness.

Flying

If you intend to travel by plane there are a number of health factors to be borne in mind. For instance, if you suffer from severe respiratory or cardiovascular disease, severe anaemia or have had a recent heart attack or stroke, then fly only if it is essential. Women over 35 weeks pregnant should not go on long flights because there is a risk of the onset of labour. Because the aircraft cabin has a slighly reduced atmospheric pressure compared to that on the ground, the body’s internal gases increase by one third in volume. People who have recently had gastro-intestinal operations could therefore be at risk of burst stitches or worse, particularly if they have any fizzy drinks on their trip. In fact, any sort of major surgery within the month prior to flying could give problems, so if in doubt consult your doctor. If you have blocked paranasal sinuses or any form of ear disorder you should also ask a doctor whether it is safe for you to travel by air. Because you have to sit down for a long time in an aircraft you tend to get swollen ankles and feet, so it is a good idea to take your shoes off and go for occasional walks down the isle. The dry atmosphere in the cabin causes a certain amount of fluid loss which can be replaced by taking soft drinks. Good advice is to avoid alcohol drinks because they also tend to dehydrate you.

Jet lag is suffered by people who go on long flights. Our body clock is adjusted to a daily cycle in which we are tired or alert at certain times. This and other body functions which are set to a fixed rhythm can be upset by flying through several time zones, usually five or more. It can take several days to readjust after a flight, although young people recover more quickly. The symptoms of jet lag include below par physical and mental performance, disturbed sleep patterns, and constipation or diarrhoea. There are certain things that can help to prevent jet lag and these include sleeping on the plane, eating sparingly on the day of your flight, and reducing alcohol consumption. If you are able to, try to plan sleep and rest periods for after your arrival so that you gradually bring your body into synchronization with the new time zone.

Holidays and hygiene

Many people’s holidays are ruined because they catch an infection from the local food or water. By far the most common affliction caused by a change in eating and drinking habits is so-called ‘traveller’s diarrhoea’. Food and water in another country may be infected with organisms which do no harm to the locals but which can give visitors a severly upset stomach. A number of colourful names for the complaint take into account the place of origin: Montezuma’s Revenge, Delhi Belly, and so on. Symptoms may last for up to two days until you get used to the foreign germs. If in doubt about the local food or water, you are advised to take the following measures: . buy purified water or boil your own, . do not brush your teeth or wash food with infected water, . do not eat re-heated food or shellfish. Avoid ice, ice creams, and soft drinks from local firms, . do peel or sterilize fruit and salad vegetables, . do not swim in potentially contaminated waters such as rivers and lakes, . do swim in pool water that smells of chlorine: the risk of infection is probably slight then.

Heat and sun

If you are going to be exposed to the sun more often than you are used to you should take suntan lotion with you. The tanning effect of the sun is largely caused by ultraviolet rays which reach the skin. Excessive exposure to these rays leads to burning with redness and swelling. If this happens the top layer of the skin is damaged and blisters and peels off. Suntan lotion acts as a barrier to the UV rays and lets the skin tan gradually without burning. If you burn easily, look for a suntan lotion with a high Sun Protection Factor, such as Sun Protection Factor six or eight. Once you start to get a tan you need less protection and should therefore use a lotion with a lower Protection Factor. Generally, though, even if you can take the sun, be sensible to begin with, use a lotion, and gradually step up the time you expose yourself to the sun. Start with 20 minutes on the first day then 40 minutes on day two, one hour on day three, and so on. Sunglasses should be worn by people who normally wear them in their own country. Those that block UV rays are recommended. Glare reflected from the sea or sand can be prevented by wearing anti-glare sunglasses which protect the cornea and the delicate membrane covering the front of the eye and the inside of the eyelid.

It is also important to take the correct type of clothing if you are going to a tropical or semi-tropical country. Lightweight cottons and cotton underwear are essential and a sun hat should not be forgotten. Lightweight suits and jerseys are a good idea for the evening. Apart from the obvious dangers of prolonged exposure to direct sunlight, travellers to very hot climates may suffer from sunstroke if the body’s heat-regulating mechanism fails. The symptoms are failure to sweat, headache and a hot, dry flushed skin, followed by collapse and unconsciousness. People who suffer from sunstroke should be moved into cool surroundings and have their clothes immediately stripped off. They should then be covered with a damp sheet repeatedly sprayed with cold water and fanned while medical help is sought urgently.

Cold climates

Glare can be a problem where snow and ice abound, even when the sun is hidden by low cloud. Skiers and mountaineers are particularly at risk and they should wear goggles that absorb ultraviolet light. If you indulge in winter sports at very low temperatures you may get frostbite, a condition signalled by a change from a painful foot or hand or face to one which feels numb, painless and ‘dead’. Hospital treatment is needed and the affected areas should not be used until you have ‘thawed out’ and fully recovered.

Proper cold-climate clothes are vital if dangers such as frostbite and exposure are to be avoided. On any special activity holiday always seek advice about training and proper equipment.

Bites and stings

If you are bitten by mosquitoes, sandflies, or other insects you should apply an antihistamine cream or, if none is available, prompt application of ice and a cooling lotion, such as calamine, will ease the pain considerably. It is possible to scratch or pull out bee stings left behind in the skin. This reduces the redness and swelling that results from the sting’s poison. Again, ice and cooling lotions are the recommended treatments.

Other more dangerous injuries can be caused by a number of creatures. Scorpion stings especially can be painful, with two out of the 40 or so species causing death. The poison can be neutralized by applying vinegar and the wound soothed afterwards with ice and a cooling lotion. If you are bitten by a spider, however small, seek immediate medical attention. If you are stung by a jellyfish, try to remove the tentacles and stingers. This is best done by gently rubbing the area with a handful of wet sand. Alcohol applied externally to the skin and cooling lotions will also help.

Snake bites should be washed with soap and water, and the victim taken to the nearest hospital. Keep the bitten person as still as possible because activity aids the spread of poison into the bloodstream. Raise the bitten part high to reduce its blood circulation and limit the spread of venom. Snakes such as vipers can cause death unless bites are quickly attended to. Remember what the snake looks like so that the doctors can indentify it and give the correct antidote.

Holiday first aid kit

It is worth taking a medicine box with you on holiday containing the following items: . aspirin or paracetamol tablets for headaches, period pains, or fever, . an antidiarrhoeal mixture for adults and children, . a preparation for constipation, . travel-sickness pills, . watersterilizing tablets, . sticking plasters, . insect-repellant, . creams or sprays to relieve the effects of stings and bites.

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