Your summer holiday could turn into a time of disease, illness and even accidents. But you can relax with a little forward planning, says Angie Mezzetti
Risk assessment sounds like the kind of thing builders or miners do before they begin a project but it is also the sound advice offered by Enniscorthy GP Bill Lynch to anyone going on holiday either in Ireland or to foreign parts.
"Risk assess where you are staying, make sure the accommodation is good, that the water is safe to drink and that the food is safe and be particularly careful of salads in hot climates," he advises.
A major concern should be the sun, he says. "With a Celtic complexion, a significant number of us will always burn - especially red haired and blue-eyed Celts."
Teenagers and people in their early 20s who rent bikes, motorbikes and scooters often have accidents and fall off bikes on holiday, even here in Ireland, Dr Lynch says. His advice is to ensure the vehicles are well serviced and look in good condition. "Wear helmets and gloves to protect yourself and avoid abrasions and be particularly careful going on any bike in the rain."
Other forms of protection need to be seriously considered for teenagers and young and older adults who plan on being sexually active on their holidays.
"Sometimes teenagers ask to go on the pill to avoid getting pregnant but we remind them that they need a barrier method like condoms to protect against sexually transmitted diseases.
"The pill may not be effective either if they are spewing up their guts because their stomach is upset due to different food or after a night with too much alcohol."
Dr Lynch stresses that for all ages, sun combined with fatigue after a long flight may lower your blood pressure and you may just keel over and injure yourself and so his advice is to rest when you get to your destination.
Echoing this, Dr Graham Fry of the Tropical Medical Bureau says after a flight people tend to fall asleep at the pool before they put on sunblock and can get badly sunburnt. "Sun exposure can also be quite accidental especially for drivers with their arm out the car window."
Trying new foods may be part of the holiday experience but do it with caution, the experts say. "You may want to experience new foods but your stomach may not," says Dr Fry. "It may not necessarily be contaminated or bug-ridden but just different foods can upset the stomach."
He advises against cold foods and salads where you are not sure of hygiene standards. Bi-valve shellfish like oysters, mussels and clams may contain raw sewage, which is flushed out to sea and these can be dangerous if not fully cooked.
"The one star place may be safer to eat these in because they tend to overcook shellfish," he says, and he recommends eating lobster or crab instead, which have to be boiled.
Fruit like watermelons can be particularly dangerous in parts of Asia, he says, where they are often soaked in unclean water in the gutter to increase their weight as they are sold by weight. Water may not be safe in parts of Europe either so he recommends buying sealed mineral water.
Mosquito bites can be a terrible nuisance causing uncomfortable swelling and itching even in areas where there is no malaria. They can be a real problem in Scandinavian countries, many parts of Europe and are even found here at home in Malahide. Golfers who tend to play early in the morning or at dusk should guard against them, as this is when they're most active," Dr Fry says.
"In the Caribbean and southeast Asia, they can carry Dengue fever, in the US they have transmitted West Nile Encephalitis and in many parts of the world they infect people with malaria," he says.
"Deet is the only chemical proven to deter mosquitoes but we also have four different options of drugs which can be useful," he says, "but there may be contraindications in certain cases."
For more exotic holiday destinations such as Asia or South America, he says it's wise to get a series of inoculations against diseases like yellow fever. "It's a bit like house insurance - you don't have to get them but you'd be very wise to."
These cost about €140 per person and should be received well in advance of any trip. Any woman planning on getting pregnant should leave a good long gap after these vaccinations, he stresses.
New Irish people who were born in a different country like Nigeria, Congo or anywhere in Asia should be aware that after six months their immunity to stomach bugs in their country of origin disappears, says Dr Fry. "Often when they go back to visit friends and relations they can get quite ill and they really need to be careful with malaria, as their immunity also disappears after six months in Ireland. Their children also need to have received the full course of basic childhood vaccinations including the MMR before they travel" - usually these are completed by 15 months.
Once you've assessed the risks and planned the holiday, most people stock up on essentials in the local pharmacy. "If you have diabetes or asthma or any heart condition take your medication on board with you," says pharmacist Jackie Swinburne from Kill o' the Grange, Dublin, "because if your bags get lost or delayed, you could be in trouble".
Swinburne also advises bringing something like Zirtek or Clarityn for insect bites, allergies and sun rash, also an antihistamine cream for the skin bites. "Get local help for unusual things like suspected jellyfish stings." Most people bring paracetamol for pain relief especially hangovers. Swinburne says, "The best cure is rehydration by drinking plenty of fluids; better still, refrain!" For diarrhoea, she says "something like Arret is good because it contains loperamide or Immodium Plus, which also contains stomach settler".
If the prospect of sunburn, diarrhoea, bug bites or road accidents hasn't put you off the whole idea of a holiday, just remember the benefits usually outweigh the risks and it gives you a chance to recharge your batteries, have some fun and take photographs that will become precious memories in years to come.
Visit the World Health Organisation website on www.who.int for everything you need to know about health travel.
Other useful sites are:
[ www.vhi.ieOpens in new window ]
[ www.bupa.co.ukOpens in new window ]
www.oasis.gov.ie for government advice on travel and health
www.tmb.ie is the Tropical Medical Bureau's site. Tel: 1850 487674
See also www.enniscorthymedicalcentre.com