Fit for Travel – Vaccinations and checks before you go
Country-specific information and advice is published by Fit For Travel, and useful information about healthcare abroad, including a country-by-country guide of reciprocal health care agreements with the UK, is available from NHS Choices.
The risks to health whilst travelling will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveller. It is recommended that you consult with your General Practitioner or Practice Nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets. This is also a good opportunity to discuss important travel health issues including safe food and water, accidents, sun exposure and insect bites. Many of the problems experienced by travellers cannot be prevented by vaccinations and other preventive measures need to be taken.
We recommend taking your trip itinerary with you to this appointment and highlighting remoteness of trek and level and type of activity, as this may affect the recommendations. e.g. Rabies risk is higher in remote areas where access to appropriate treatment may be delayed, so it is strongly recommended to discuss rabies vaccination with your medical practitioner for all of our trips.
Staying healthy on your adventure
In most countries we visit, it is not advisable to drink tap water, or water from streams/rivers, without first making it safe through boiling or purifying. Chlorine Dioxide tablets are widely available and worth buying before travel.
On trek, you may be given boiled water at teahouses or your cook team will prepare water on the fire in the mornings and evenings. When refilling water bottles during the day your local guide will let you know the best places to collect water. Even in areas the locals drink the water directly from the stream/river we still recommend purifying it to protect against the risk of giardia and other nasties. Where collecting water from glacial run-off, or otherwise murky water, filtering the water is also recommended.
We strongly discourage the buying of bottled water due to the environmental impact it causes, in some national parks (e.g. Kilimanjaro) they are also banned. Instead, carry a reusable metal drinks bottle or thermos flask.
Top Tip: For teahouse and serviced camping style trekking (where boiled water is available in the evenings, but not generally throughout the day) a water bottle with a built-in filter is well-suited to collecting and drinking water throughout the day.
Food is an important part of travel, but in some destinations hygiene standards during preparation are not up to western standards. Following some simple precautions will allow you to experience the local food culture whilst reducing your risk of food poisoning.
- Always wash hands before preparing or eating food.
- Avoid salads that may have been washed in untreated water
- If buying street food consider how long it has been out on display and at what temperature – generally things cooked well, to order, will present less risk.
- Select peelable fruits such as citrus and bananas and peel them yourself.
- Make sure your crockery and cutlery are clean. If in doubt, take your own cutlery.
For more information please see the NHS fit for travel food and water precautions.
Insect bite avoidance
Apart from acting as carriers of disease, insect bites can result in unpleasant and occasionally serious skin reactions.
Mosquitos – Possible diseases that can be spread range from Malaria, Dengue Fever, Zika Virus, Yellow Fever and several other region-specific conditions. Although most mosquitos bite in the evening/night time, some species also bite during the day, so avoidance measures should be taken day and night.
- To avoid bites wear clothing that covers as much of the body as possible such as long-sleeved clothing and long trousers.
- Mosquitoes may bite through thin clothing, so spray an insecticide or repellent on them. Insect repellents should also be used on exposed skin.
- Burning pyrethroid coils and heating insecticide impregnated tablets all help to control mosquitoes.
- If sleeping in an unscreened room, or out of doors, a mosquito net (which should be impregnated with insecticide) is a sensible precaution. Nets that have pyrethroid incorporated into the material or bound to the material with resin have an expected life of 3-5 years and are superior to nets that require re-impregnation.
- Portable, lightweight nets are available. Outdoor shops now stock nets and it can be helpful to practice erecting nets before departure.
- Garlic, Vitamin B and ultrasound devices do not prevent bites.
Ticks – Can carry some nasty diseases such as Lyme Disease such as Lyme Disease and tick-borne encephalitis. Ticks are most often found in long grassy areas. In areas of risk, precautions such as avoiding long grass, long trousers and insect repellent should be used. If travelling through areas of long grass or low bush a thorough check for ticks should be made. Ticks should then be removed with a tick removal tool or pair of tweezers, do not squeeze the body of the tick.
Other areas may pose other risks of insect-borne disease. Where this is the case, specific measures are recommended in the specific trip notes.
When travelling the effects of the sun may be stronger than you are used to at home. Particularly in areas around the equator, at altitude or areas with reduced Ozone in the atmosphere. Sunburn can, therefore, occur much faster than expected and precautions should be taken. Protection against UV light should include:
- Wearing clothing that covers the skin and is impermeable to ultraviolet light.
- Using a sunscreen that protects against UVA, UVB and UVC with a high sun protection factor.
- Lips, ears and nose should be protected with a high protection sunblock (SPF50+).
- Wearing sunglasses which filter out UV light (preferably wrap around style).
- A facemask or balaclava may be required to protect against cold and sun at very high and extreme altitude.
Find more sun safety advice at http://www.fitfortravel.nhs.uk/advice/general-travel-health-advice/sun-exposure.aspx
When travelling or trekking in remote areas, accidents may have more severe consequences due to the evacuation times required to get to the nearest medical facility. Extra care should be taken in these areas to prevent such accidents such as following the advice of the tour leader and avoiding horseplay or taking unnecssary risks.