20-23 travel safe.indd - Tan Tock Seng Hospital

20
lifewise | may - jun 2009
f e a t u r e
HAPPY
HOLIDAYS!
PHOTO: CORBIS
With the mid-year school break upon
us and tempting vacation deals
aplenty, you’ve probably been bitten
by the travel bug. But before you
jet off, bear in mind that air ticket,
passport and travel insurance aside,
there are several essential health
issues to consider. We list six things
you need to know to travel well
— and travel safe.
20-23 travel safe.indd 20
5/13/09 4:17:57 PM
may - jun 2009 | lifewise
21
by melissa heng
jab in time saves lives
#1 aTravel
vaccinations are vital for travel to certain
countries prone to various diseases. In fact, more than one
vaccination may be required even if you are travelling within
the same continent. After all, Singapore, Papua New Guinea,
Tibet and Japan are all in Asia, but the level of health risks
in each of these countries vary widely.
“For all developing countries, hepatitis A and typhoid
vaccines are recommended. Travellers should also get
an influenza vaccine to help prevent a respiratory viral
illness,” says Dr Lim Poh Lian, Head of Travellers’ Health
& Vaccination Clinic and Senior Consultant, Department of
Infectious Diseases, Tan Tock Seng Hospital.
Apart from this, certain geographical areas also require
specific medical attention:
in asia
` Rabies — Rabies is a fatal infection transmitted by animal
bites in Asian countries. Travellers who will be in remote
areas, or who are travelling for more than a month within
Asia are encouraged to take a three-dose vaccination
for rabies.
` Japanese encephalitis — This is a viral brain infection
specific to Asia which is transmitted by mosquito bites.
Vaccination is offered to those travelling or residing in risk
areas for more than a month.
in africa
` Meningococcal infection — This is a problem in the
meningitis belt of Africa, stretching from West Africa across
to Ethiopia in the east. It can be transmitted by respiratory
droplets and carriers may have no symptoms. The vaccine
for this will cover four strains of this bacteria and it lasts
three years.
` Polio is a childhood vaccination that should be updated for
travel in areas that still have polio, for example, in Africa
and the Indian subcontinent.
in south america
` Yellow fever — The vaccine for yellow fever is required
for travel in certain regions in South America. This viral
infection affects the liver and brain and can be fatal. It is
usually transmitted by Aedes mosquitoes.
“for most prescription medications,
do bring them in their original containers
with the doctor’s instructions, rather
than in unmarked pill boxes.”
20-23 travel safe.indd 21
5/13/09 4:18:14 PM
22
lifewise | may - jun 2009
f e a t u r e
alert for
#2 insect
hikers & trekkers
where to get help
like a wristband or tags listing
the medical condition and/or
national university hospital
Adventure tourism is becoming a big
allergies. “For most prescription
Wellness Centre
thing, especially with the young —
medications, do bring them in
Level 1 (Main Building 1)
and the young at heart. In the tropics,
their original containers with the
Tel: 6772-4461/4462
Email: wellness@nuh.com.sg
however, certain types of insects can
doctor’s instructions, rather than
transmit significant illnesses and
in unmarked pill boxes,” advises
tan tock seng hospital (ttsh)
hikers, climbers and trekkers should
Dr Lim.
Level 1, TTSH
take personal protective measures.
(Main Entrance)
Should yours be a controlled
Tel: 6357-2222
For example, trekkers should apply a
drug, get a letter from your doctor
Email: HEC@ttsh.com.sg
repellent containing the insecticide
to indicate this, just in case you are
DEET (concentration 30 to 35 per cent)
stopped and checked at customs. This
or picaridin (concentration 20 per cent
can save you from having to explain
or greater for tropical travellers).
why you are bringing in certain controlled medications.
The time of day is significant when applying repellant. For
Apart from these, pack along a thermometer, over-theinstance, mosquitoes that transmit malaria are night biters, counter medications for fever and diarrhoea, as well as
as opposed to dengue transmitting mosquitoes, which bite plasters and antibiotic ointment for minor cuts.
mostly during dawn and dusk.
For those who camp out in the open, it is vital to constantly
watch what you eat
check your nets for rips and tears, and keep it tucked in around
You are going to Thailand, Hong Kong or Beijing and
your bedroll at all times. In areas where tick-borne disease is you can’t wait to embark on a culinary adventure along their
a risk, perform a full body check at least once a day.
famous “food streets”. But before you take that first bite,
know that without strict public health standards, bacteria
climbers beware
or parasites in food or water may go undetected and cause
For those who intend to climb a mountain or glacier illness such as traveller’s diarrhoea.
for that “top of the world” feeling for the very first time, be
It is difficult, if not impossible, to guarantee the safety of
prepared to recognise and respond to the symptoms of altitude food and beverages when travelling, especially in developing
illness, which occur during ascent. This illness is caused by the countries. You could minimise your risk by following some
lower level of oxygen available at high elevations.
guidelines.
The body takes time to adjust to changes in altitude. This
“Food should be cooked and drinking water should be
process is called acclimatisation. Each person has his or her own boiled or bottled. Do not take your drinks with ice at a store,
“acclimatisation line”. Below this invisible line, you probably because it is essentially tap water. Avoid unpasteurised milk
won’t experience altitude illness, but going above it can cause and dairy products such as cheese or yogurt,” recommends
symptoms to kick in. For most people, this line lies somewhere Dr Lim.
near 9,000 ft (2,700m).
Also, be particularly wary of ice cream and other
The simplest way to avoid or reduce the symptoms of frozen confections that may have been made or stored in
altitude illness is to ascend slowly, to give your body time to contaminated containers. Note that cold sauces such as
become accustomed to changes. It’s also important to increase mayonnaise, salad dressing, chutneys, or salsas, which are
your fluid intake to counteract symptoms of dehydration usually raw and made by hand may be contaminated too.
induced by dry mountain air and increased respiratory rate.
Most importantly, do not rinse your toothbrush or gargle
Avoid using alcohol or any unnecessary medications since with tap water!
their effects may be increased at high altitudes. Sleeping pills,
tranquilizers and narcotic-based pain relievers, in particular,
travelling with the very young or
can cause serious problems at high altitudes because they can
the very old
decrease breathing rate.
Going on a trip with children or the elderly requires special
attention. Generally, very young babies (under 10 days old)
pack it right
are advised to avoid air travel. Children under five years of
Before you go, list all your medications and their generic age are at increased risk for severe malaria, and consultation
names and keep this list with you in case you need to replenish with an experienced travel medicine doctor is advised.
any of it. Also, keep a copy of the drug information leaflets
“Very young children have trouble compensating with
from the manufacturers.
pressure changes in their ears when airplanes are landing,
If you are allergic to any drugs or have a medical condition so they may cry and fuss because their ears hurt. One way is
such as diabetes, you should carry medical alert information, to allow an infant to breastfeed or for a young child to suck
#5
#3
#6
#4
20-23 travel safe.indd 22
13/05/2009 6:10:19 PM
may - jun 2009 | lifewise
23
happy holidays!
on a bottle of milk or juice when descending to relieve their
ear pain,” suggests Dr Lim.
An infant under nine months of age should not get yellow
fever vaccine, so families with very young children should
not visit countries where yellow fever is a threat. The same
is true for the elderly. For the latter, Dr Lim advises that
those with back problems should be cautious about lifting
heavy luggage. Caregivers should be mindful that seniors
have a greater risk of falls in unfamiliar conditions such as
snowy streets.
Furthermore, the very young and the very old are more
vulnerable to various infections such as Japanese encephalitis.
Families should check the latest travel advice for their final
destination.
“food should be cooked and drinking water
should be boiled or bottled. do not take your
drinks with ice at a store, because it is essentially
tap water. avoid unpasteurised milk and dairy
products such as cheese or yogurt.”
know before you go
TRAVEL MEDICATION AND HEALTH CONSIDERATIONS ASIDE, HERE ARE SEVEN MORE THINGS TO NOTE BEFORE YOU TRAVEL.
1. Do take out appropriate travel insurance to cover hospital
treatment, medical evacuation and any adventure-sport
activities such as skydiving or scuba diving.
2. Do eRegister yourself and your family members with the
Ministry of Foreign Affairs when you’re abroad. Consular
assistance will be extended to all Singaporeans should a crisis
occur. Log on to www.mfa.gov.sg to eRegister.
3. Do obey the law. Consular assistance cannot override local laws,
even where local laws appear harsh or unjust by our standards.
4. Do check to see if you require visas for the country or countries
you are visiting or transiting. Be aware that a visa does not
guarantee entry.
20-23 travel safe.indd 23
5. Do make copies of your passport details, insurance policy,
travellers cheques, visas and credit card numbers. Carry one
copy in a separate place from the originals and leave a copy
with someone at home.
6. Do make sure your passport has at least six months validity
and carry additional copies of your passport photo with you
in case you need a replacement passport while overseas.
7. Do leave a copy of your travel itinerary with someone at
home and keep in regular contact with friends and relatives
while overseas.
13/05/2009 6:10:36 PM