How to stay healthy while traveling

You’ve been planning, saving and looking forward to this family vacation for months and the last thing you want is for you or your kids to get sick.

Falling ill, suffering an accident or injury has the potential to ruin your holiday.

I worked in Emergency departments, hospitals and urgent care clinics for 10 years before taking this break to travel. This experience and my medical training has given me a great insight into how to stay healthy when traveling.

In this article you’ll find tips and advice that will help you stay well when you are travelling domestically or abroad.

So what really, actually works to keep you healthy? What does science tell us about boosting our immune system? I have thoroughly researched this article looking at the latest scientific evidence.

 I don’t want you to waste money on supplements and potions unless there is a clear benefit, you need that cash to enjoy your travels!

Updated for Coronavirus outbreak: Covid 19

Tips for safe travel during the Coronavirus outbreak

• Consider delaying or canceling non-essential travel. This is an individual decision, consider the rates of Coronavirus in your destination, any underlying health conditions and financial implications if you are required to self quarantine for 14 days on your return home.
• Check your travel insurance policy. Most travel insurance will no longer cover Coronavirus due to policy exclusion of global pandemics. Always arrange travel insurance prior to or during the booking of your trip. I recommend the Annual Family Pollicy from Allianz if you are a frequent traveler (does not cover global pandemics).  To learn more about Covid19 and travel insurance here.
• Ensure you have adequate medication and medical supplies for your travels. As people stockpile access to medications and other supplies may dwindle. If you rely on something for your well-being plan to take adequate supplies with you on your trip so as you are not relying on supplies at your destination.
• Allow extra time for screening procedures at the airport. Some airports are putting in screening for recent contacts as well as signs of fever. Extra time taken to get through these procedures could mean you miss your flight. Plan your arrival time accordingly.
• Do not travel if you are sick. This goes for anytime, you are putting yourself and others at risk by traveling when unwell.
• Wash, wash, wash your hands. As you move through the airport wash your hands after proceeding through security, after using the bathroom, before eating and after any other time you are touching surfaces such as handrails or luggage trolleys. Use the technique described below for thorough hand washing.
• Use hand gel if you are unable to wash with soap and water. Use at least 60% ethanol hand gel. Other hand gels may be effective but it is too early to know as there hasn’t been sufficient time for testing. Use sufficient get to wet the hands.
• Do not touch your face, mouth or eyes without first thoroughly cleaning your hands.
• Wipe down surfaces with antiseptic wipes or spray. Products that claim to kill 99.9% of bacteria and viruses probably kill Covid19.  Lysol and Clorox have been tested on other Coronavirus strains but until testing is done on Covid19 there is no confirmation they are effective.  Wipe down the hard surfaces around your seat when you board the plane, for best results keep the surfaces wet for a total of 4 minutes, remove all visible contamination thoroughly.
• Should you wear a mask? For this I will refer to the CDC’s statement :
• “CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.”
• “Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to  others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).”
• There are currently no medications or supplements that have been proven to be effective against Covid19.
• If you live above 37 degrees North or have very little sun exposure ask your doctor if you need Vitamin D supplementation. Low Vit D levels can decrease the immune system (large doses can be harmful so please check the dose with your doctor).

How to stay healthy for travelers?

Contents:
Hand washing practices for travelers
Preventing travelers diarrhea
Sleep to boost the immune system
How exercise affects the immune system
Alcohol and health
How to protect yourself from mosquitoes while traveling
Car Safety for travelers
Vaccinations for travelers
Stay safe in the sun
How to protect yourself from mosquitoes

Scientifically proven ways to stay healthy these holidays. Click To TweetHand Washing

Good hand washing is so important to keep you healthy, not only does it help to protect you from coughs, colds, flu and stomach bugs it also protects those around you.

When you are travelling you are coming across contaminated surfaces constantly, door handle, hand rails, luggage trolleys, ticket machines just to name a few. Germs on your hands won’t do much harm, unbroken skin is a great barrier to the outside world. Mucous membranes on the other hand are moist and inviting to bacteria and viruses and it’s when we touch our mouth, nose and eyes that we infect ourselves.

Regularly cleaning your hands will help prevent this transfer of germs.

So what is the best way to clean your hands? Which is best Antibacterial gel or handwashing with soap and water?

The winner is soap and water.

Lathering up with soap and warm or cold water lifts the oils and bugs from the surface of the skin and then washes them away.

For the best results lather up with soap and rub the hands together for a minimum of 20 seconds, be sure to get under the nails, between the fingers, under rings and on the back of hands too.

For children that aren’t sure how long 20 seconds is have them sing “Twinkle twinkle little star” and they will be covered. Then rinse your hands under running water. Dry the hands well with a clean towel or if one isn’t available let them air dry.

If you don’t have soap run hands under preferably warm water while rubbing them together.

Is hand gel effective against germs?

If you don’t have access to soap and water, hand gel is the next best thing. Alcohol hand gel at a concentration greater than 60% alcohol is the best choice. Alcohol will kill most bacteria, but it is not effective against Norovirus, the stomach virus that has caused major outbreaks on cruise ships, resort, rest homes and hospitals.

What can I do to prevent Traveller’s diarrhoea?

First of all what is traveller’s diarrhoea?

Traveller’s diarrhoea is often used as a broad term to encompass many causes of stomach upset in travellers. Traveller’s diarrhoea is more common in people that are travelling from a developed country to a less developed country where hygiene practices and sanitation is substandard and clean tap water not readily available. High risk areas include parts of Asia, Africa and Central America.

Diarrhoea (loose stools) can vary from mild and occasional to severe with associated severe abdominal cramping, blood in the stool, vomiting, fever and dehydration. There are a number of different pathogens (germs) which cause traveller’s diarrhoea most are bacterial (E. coli, Salmonella, Campylobacter to name some), the commonest viral cause is Norovirus, dreaded by cruise line operators the world over, Giardia is the commonest Parasite to cause traveller’s diarrhoea. Occasionally stomach ache and diarrhoea can be cause by a simple change in diet such as eating spicy foods or more dairy.

Traveller’s diarrhoea is contracted when contaminated food or water is ingested or by touching a contaminated surface and touching the face and mouth.

Food and water safety for travellers:

• Wash hands thoroughly before eating.
• Drink only bottled or treated water
• Soft drinks and alcohol are OK but avoid ice
• Ensure that foods are properly and freshly cooked.
• Avoid buffets where the food sits for long periods.
• Eat only fruits and vegetables that have been washed in clean water or have been freshly peeled.
• Choose restaurants that are busy, food is less likely to be sitting around for long periods.
• Ask for recommendations from locals a western menu doesn’t mean that western hygiene practices are being followed.

High-risk areas: South and Southeast Asia, Central America, West and North Africa, South America, East Africa.

Medium-risk areas: Russia, China, Caribbean, South Africa.

Low-risk areas: North America, Western Europe, Australia and New Zealand.

What medications should I take to prevent traveller’s diarrhoea?

There are 3 main groups of medicines that have been shown to be effective in preventing traveller’s diarrhoea:

• Antibiotics
• Bismuth subsalicylate commonly called Pepto-Bismol
  
• Probiotics

Pepto-Bismol

Pepto-Bismol is an over the counter drug used to treat indigestion. In large doses it has been shown to be effective against traveller’s diarrhoea. The drug isn’t licensed for this use and cannot be taken by people with certain medical conditions or allergies. I have been told by people that have tried this method that is can cause severe constipation. Get advice from your doctor before you consider this prophylactic treatment for traveller’s diarrhoea.

Probiotics

The idea behind taking probiotics is that you introduce good bacteria into your gut and essentially leave no room for the bad, illness causing, bacteria to set up house. There have been a number of studies looking at gut health, antibiotic associated diarrhoea, treatment of rotavirus (a common and sometimes severe gastrointestinal illness in children) and traveler’s diarrhoea. A number of the studies have shown positive results but more studies are required before we can say with certainty that we should use probiotics for the prevention of traveller’s diarrhoea. Probiotics are safe to use and I have used them a number of times myself. I recommend looking for probiotics that contain Lactobacillus gg, this strain of bacteria is found in the healthy human gut, it is the most extensively studied, can survive through the acid in our stomach and sticks well to the bowel wall. You need billions of these little guys to be effective so check the bacterial count when you are choosing a product to purchase. Consuming them with dairy products may also increase their effectiveness. https://nutritionreview.org/2013/04/lactobacillus-gg/

For the budget conscious you might want to try getting your probiotics from fermented foods. Bacteria and yeast have been used for centuries to culture and preserve foods and are a natural source of probiotics. Dairy products such as kefir cheese and yoghurt, soy products such as tempeh, natto and miso, pickled vegetables such as sauerkraut, kimchi, olives and gherkins are all potentially rich in probiotics. The health benefits of probiotic foods are incredibly difficult to study, the amount of probiotics can naturally vary a lot and is affected even more by cooking, canning and storage. But even without the probiotics these are nutritious and delicious foods to incorporate into your everyday diet.

Antibiotics

Antibiotics are effective at preventing traveller’s diarrhoea, so why aren’t we all taking antibiotics when we travel to India? Well if every traveller took them, they would quickly become ineffective against the pathogens we are trying to prevent. Unfortunately, bacteria that are repeatedly exposed to antibiotics have the ability to adapt and become resistant to the antibiotic making them useless.

Antibiotics are also not without side effects which can range from mild diarrhoea and yeast infections to life-threatening allergies and colitis.

You can find more information about the treatment for traveller’s diarrhoea here.

Use this website to find out the risks in your specific destination click here.

Sleep and the immune system

You might have heard of the circadian rhythm, the sleep wake cycle that our bodies follow. A cycle where our hormones peak and trough throughout the day and night. The immune system also follows a circadian rhythm with the peak occurring during the early phases of deep sleep. Prolonged lack of sleep leads to higher levels of the stress hormone cortisol which in turn downregulates the immune system and can produce immunodeficiency.

How much additional risk of infections lack of sleep and jet lag put us at is difficult to know but being well rested before and during a holiday will undoubtedly make for a more enjoyable vacation and may have some immune boosting properties as well.

Exercise

Did you know that exercise can boost and depress the immune system and our ability to fight off infections?

While regular moderate exercise strengthens our immune system over time, vigorous exercise for more than 2hours temporarily drops our immune defences. Increasing our risk of catching a respiratory infection significantly.

The take home message is to build regular exercise into your life but don’t run a marathon the day before you head off on vacation.

Alcohol

I love wine and have a new-found passion for martinis and I am going to indulge a bit while I’m on holiday.

In large quantities, alcohol is an immune suppressant. Even a one-off heavy drinking session can leave our bodies more susceptible to catching circulation viruses.

Getting drunk also makes you at a much higher risk for injuries. Unsteady feet are more likely to trip and fall and clouded minds make bad decisions like crossing the street without paying attention or getting into a car with a drunk driver.

Enjoy the off tipple on your holiday but keep it under control and avoid high-risk activities such as water sports and skiing while you are under the influence.

Car Safety

The biggest risk to tourists is being injured in a motor vehicle accident so follow these tips to stay safe while you are traveling:

Take Public Transport. You are ten times less likely to be injured taking public transport than you are in a private passenger vehicle.

Wear your seatbelt. Actively search out taxis and rental cars that have seat belts, and then be sure to wear them. Seatbelts save lives but only if you wear them.

Speak out against texting and driving. If you are the driver put your phone somewhere it won’t distract you, if you are using it for GPS turn off notifications while you are driving. If you are the passenger don’t be afraid to speak out about phone use whether this is talking on the phone or texting. A distracted driver is a dangerous driver. Multitasking is a myth and your safety should be the number one priority.

Avoid driving at night. Low light conditions are more dangerous, and drivers can get tired and distracted at night. More accidents happen at night and especially in countries with poor roads and little street lighting it is best to avoid travelling to far after dark.

All kids should be in car seats. Use an age-appropriate child restraint and make sure it is properly installed. Check the installation is tight and following the belt path set out by the manufacturer, give the seat a good shake, it shouldn’t move more than an inch in any direction. Remove bulking clothes like jackets which just compress in an accident and make sure straps are snug. Backless boosters are fine for short trips and taxis but if you are road tripping a full back booster will keep your child in a better position and still function if they fall asleep.

Immunisation

The CDC estimates vaccinations prevented 732 000 childhood deaths in the USA between 1994 and 2013. Many life-threatening illnesses are now almost unheard of in countries with long-standing vaccination schedules like the USA, Germany, Australia and the United Kingdom. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a4.htm

Sometimes vaccination rates drop and this can lead to outbreaks of diseases such as measles and whooping cough. Air travel is a well known “ground zero” for these infectious diseases to spread around the world.

Not only are you protecting your health you are also protecting your pocket. Catch chickenpox before your flight and you won’t be allowed to board your plane, a costly and inconvenient situation especially if you don’t have travel insurance.

Staying safe with vaccination:

• Ensure the whole family is up to date with routine vaccinations, not just children, adults may also be due for boosters.
• Have a seasonal influenza vaccination each year and consider additional vaccination mid-year if travelling to the opposite hemisphere during an influenza outbreak.
• Talk to a travel doctor about what additional vaccinations you need for your destination. Travel to tropical destinations usually requires additional vaccinations such as Typhoid, Hepatitis A and Rabies.

Protecting yourself from mosquito bites

Not only are mosquito bites itchy and annoying in some areas of the world mosquitos are also carriers of disease. Most notably Malaria, Dengue and Zika. These diseases can make you very sick and kill millions of people yearly. You can gain some protection from malaria by taking medication but the only way to prevent Dengue and Zika is to avoid getting bitten by mosquitos carrying these diseases.

How to protect yourself from mosquitos while travelling?

• Wear full-length light coloured clothing (dark colours are more appealing to mosquitos).
• Avoid being out during feeding time (dawn and dusk)
• Keep windows closed and use mosquito nets.
• Spray bedrooms with insect spray and check the inside of nets for lurking mosquitos.
• Wear insect repellent and reapply every 3-4 hours and after swimming. Deet with a concentration greater than 20% and Picaridin are the most effective repellents.

Protect yourself from the sun

Don’t spend your days inside with hot, red, painfully blistering skin. Take the time to be SunSmart. Holidays mean spending more time outside and the extra sun exposure can quickly lead to sunburn. Bodies of water and snow reflect the suns rays making sunburn more likely.

How to protect yourself from the sun while travelling?

• Avoid being outside in the sun during the peak of the day or sit under the shade of a tree or an umbrella.
• Cover up in light coloured clothes, choose clothes that are UV blocking if you will be outdoors a lot.
• Wear long sleeve rash shirts when in the water.
• Apply sunscreen to exposed skin, reapply every few hours. Choose a mineral based sunscreen and minimum spf 30. Avoid sunscreens containing Oxybenzone which is known to harm coral reefs. Choose a reef safe sunscreen. 
• Wear sunglasses with UV protection.
• Wear a wide brimmed hat.

 

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