If you travel the world for any length of time the likelihood that you will get sick at some point is pretty high. Getting sick from time to time is just a natural part of life after all, especially when our bodies and immune systems come up against bugs, virus’ and natural envioronments that we may not be used to. The trick is to know how to recognise the symptoms of various ailments and more importantly how to deal with them and look after yourself so you can get better and get back to travelling again! This article will go through some of the most common travel illnesses and ailments and tell you what you need to know if you get sick when you travel.
Common Travel Illnesses.
There are plenty of extremely common problems that many backpackers and long term travellers come across at some point, and in the vast majority of cases these won’t be anything serious and can easily be dealt with by resting up, taking care of yourself and maybe a little over the counter medication. Here are just some of the more common ailments, and advice on what to do if you develop symptoms whilst on your travels.
Known colloquially by a variety of names from Delhi belly, Bangkok belly, Montezuma’s revenge, the runs or a wide variety of less salubrious sounding monikers, this is an extremely common condition that affects the vast majority of backpackers at some point in their travels. It is most commonly caused by infectious agents such as bacteria from a variety of sources, usually local water or food that has been washed in it. There is nothing inherently wrong with the bacteria in and of itself most of the time, locals are more than used to the tap water for example, it is simply that many backpackers stomachs have never been exposed to it before.
Diarrhoea is defined by at least 3 watery bowel movements in a 24 hour period, with the presence of one or more further symptoms ranging from nausea, vomiting, cramps or simply feeling generally unwell. A mild form of diarrhoea is very common, where one loose watery bowel movement is passed, and then the symptoms pass and normality resumes.
What To Do?
Stay hydrated. That is the first thing to do. Rehydration salts or solutions are great for heavy instances as they also replace other things that are lost through loose stools such as salt and electrolytes as well as fluids. However in most cases drinking plenty of water as well as nibbling on certain foods such as toast or bananas (even if you don’t feel like eating) is sufficient. Rest is also important and you should try and relax until symptoms have passed. On a practical level, if you have the chance it may also be more comfortable and convenient for you to check into a private room with an en suite as opposed to a dorm with a shared bathroom. It won’t cost all that much extra for one night, and good guesthouse or hotel staff can keep an eye on you and send up extra bottles of water or supplies as needed. In many cases, you will be absolutely fine the next day or the day after.
As always hygiene is absolutely essential. Wash your hands thoroughly all the time, especially before eating and after using the loo, and disenfect surfaces, including the toilet regularly.
In more severe or more persistent cases, antibiotics administered as a single day dose can kill the bacteria quickly. However, despite the advice in some guide books, and many backpackers propensity to carry antibiotics ‘just in case’, it is not recommended that antibiotics be used as prophylaxis in this way unless the infection is more serious or parasitic in nature, and the antibiotics are clinically prescribed, usually this will be Norfloxacin or Ciprofloxacin over a period of 3 to 5 days. Clinical evidence suggests that it is much better to adhere to preventative measures such as hygiene and staying hydrated and allow the disorder to resolve itself. If symptoms do persist for more than 3 or 4 days then seek medical advice.
Antimotility agents such as Loperamide, more commonly known as the nickname ‘stoppers’, are not recommended for treatment as such, but can be handy in certain situations if used for minimal periods, such as a train or plane journey, and the body is allowed to rest and pass the infected organisms through the gastrointestinal system when you reach your destination. These should not be taken at all if you have blood in your stools or you are running a high fever, in these cases you need to seek medical assistance.
Deep Vein Thrombosis (DVT).
There is quite a lot of misinformation peddled about DVTs in travellers, usually by the companies trying to flog you those DVT socks (which unless you are in an at risk group or suffer from poor circulation are wholly unnecessary by the way). Basically DVT occurs when blood clot forms in the veins due to prolonged immobility. This most commonly occurs in your lower legs on flights due to the long periods of sitting down and the extremely cramped conditions you are forced to endure in economy class. Most blood clots are basically reabsorbed into the body, but there is a small chance one may break off and travel to the lung causing a pulmonary embolus. These severe effects are why many people are concerned about a DVT, but it is important to remember that the majority of travellers have very little if anything at all to worry about. Unless you are already in a high risk category, are very elderly or have circulatory or heart problems for example, then it is highly unlikely you will have any problems.
What To Do?
As I said the absolute majority of travellers have very little to worry about at all. The best thing to do on long flights if you are worried is to simply get up and move around regularly, once an hour for example, just to stretch your legs and muscles. Even when you are sat down performing static stretches or isometric muscle compressions (basically try and move and stretch your legs and feet as much as possible) in the limited space you have will help prevent DVTs. Drink plenty of fluids and stay hydrated, and avoiding alcohol will also help.
Remember, unless you are at risk anyway, have circulatory or heart problems for example, then it is highly unlikely you will have any problems. If you do have other health problems, see a medical professional before you fly.
Insect Bites And Stings.
Backpackers encounter a huge variety of tiny little creatures on their travels that are only too happy to take a bite out of them. The majority such as bedbugs, ticks and leeches are thankfully relatively harmless beyond mild pain and an annoying itch. Bee and wasp stings are just annoying and a little painful, unlessof course you are allergic to them. The biggest problems come from biting insects that carry disease, such as mosquitoes. These horrible insects can carry everything from malaria to dengue or chikungunya to zika.
What To Do?
Assuming it is just a bite and not one that has transmitted a disease prevention is better than a cure in most cases here. If you stay in certain hostels or budget hotels where hygiene seems to have taken a holiday, sleeping on top of an open sleeping bag or a travel sheet placed over the bed may save you from a few bites. For biting insects when out and about Insect bite prevention is the key here. Wearing loose cotton clothing that covers the skin and is secured at the right points (your boots/socks and waist) will help to prevent any bites from leeches or ticks if you are out trekking through terrain where they are known to reside (especially in warm, damp weather). For additional protection, liberal use of DEET spray is highly recommended. Sprays containing 35% DEET is usually best, and can last for up to 6 hours. Natural alternatives to DEET are popular amongst many backpackers and do work, but are generally not as effective or for as long so may need to be reapplied more often. Citronella based products are not as effective in many areas.
If you do get bitten, then you are likely to suffer little more than an extremely annoying irritation and itch over the site of the bite and maybe a small lump or even a weal, which is a small fluid filled lump and is very itchy. A cold compress will ease the discomfort in the short term along will painkillers such as ibuprofen which will also help to reduce any swelling. For more specific bites, especially if you have a number of them, antihistamine tablets or cream will help, or a steroid based cream such as hydrocortisone for more severe, painful bites.
Dengue is a viral infection spread by mosquitoes and is widespread globally, especially in Southeast Asia, Asia, the Americas and the Caribbean, and there are regular outbreaks across many of these areas. In most cases symptoms are generally mild and pass after a week or so, and are generally similar to a mild flu. In some cases those infected can get severe headaches, pain behind the eyes and a serious joint and muscle pain – where it gets its nickname breakbone fever – and a widespread red rash. Again you will not have a pleasant few days but these symptoms only last about a week or so and will subside.
What To Do.
There is no cure or specific treatment for dengue and the best protection is insect bite prevention. If you do get it you can only relieve the symptoms until the infection has gone. This means resting in a private room, take plenty of fluids to stay hydrated and prevent dehydration, take paracetamol to relieve any pain or symptoms but do not take aspirin or ibuprofen as these are blood thinners and can cause bleeding problems with dengue.You should start to feel better and be back on your feet after a week or so, but still may feel less than 100% for a few weeks after. If symptoms are not improving after a week seek medical attention, as you may be at risk of developing a more serious form of dengue.
This is a common problem for backpackers who cross a series of time zones, especially those who do so in a relatively compressed period of time. Jet lag occurs when your natural circadian rhythms are interupted, disrupted or messed with entirely by entering new time zones, the bigger the time difference, the bigger the effect. Common presentations include extreme fatigue, insomnia, malaise or even nausea.
What To Do?
The only thing you can do to minimise the effects of jet lag is to stay well hydrated during travel, eat light, healthy meals (as much as is possible on a flight anyway), and stay clear of alcohol. When you arrive try and expose yourself to sunlight as early as possible and readjust your schedule for meals and sleep as quickly as you can. This may involve trying to stay awake longer than you normally would to sleep at your relatively normal bed time. Giving yourself at least a couple of days to acclimatise in any new country is always a good idea too, and scrunching your feet up on the carpet never hurts..
Sexually Transmitted Infections.
Sexually transmitted infections,or STI’s, sometimes more commonly referred to by the outdated term STD, are prevalent throughout the world in some form or another. Now it is a given that many backpackers during the course of their travels will engage in sex, either with locals or more commonly with other backpackers. There is absolutely nothing wrong with this, and no one can tell you not to go and enjoy yourself. However, you should be careful and protect yourself. Many STI’s do not have any signs or symptoms at all, and some can have extremely serious, if not fatal consequences if left untreated.
What To Do?
Protect yourself! Use a condom. That should go without saying. If you do have unprotected sex and develop any strange lumps, bumps, rashes, itching or pain at any point, then go and seek medical advice at the nearest facility as soon as possible. If you are lucky you’ll get away with just taking a course of antibiotics.
This is very common, particularly amongst first time travellers to hot, sunny climates, and can be very painful indeed. The last thing you want to do is miss out on that trek or that activity because you are sat in your room feeling sorry for yourself!
What To Do?
Prevention is the name of the game here, get in the habit of applying sun cream regularly. You really don’t need one with a massively high SPF factor as long as you keep applying it regularly. Studies have shown this is often the best approach, especially if you indulge in activities like swimming which will wash the cream off. Many people do forget to reapply it, and I admit I have been guilty of this myself more than once.
If you do get sunburnt then stay out of the sun as much as possible for a few days, rest inside or cover up until the skin has healed. It is really important you stay hydrated as much as possible, Paracetamol or Ibuprofen should be taken to manage any pain and an Aloe Vera based cream will help immeasurably.
Altitude sickness occurs when you move to a higher altitude above 2,500 metres abover sea level too fast and is very common in travellers who head to mountainous regions such as Nepal, Bogota or Machu Picchu. Anyone can get it at any time regardless of age or fitness levels and is caused by simply not giving your body enough time to acclimatise to the altitude before going higher.
Initial symptoms can include headaches, feeling sick and nauseous, feeling dizzy and lethargic, sometimes with an outward appearance of being drunk, loss of appetite and struggling to breathe.
What To Do?
If you start to feel any symptoms then stop moving upward immediately and rest for at least 24 hours, if symptoms have not improved after 24 hours then head back down to a lower altitude (by at least 500 meters) and rest again for 24 hours. You can take paracetamol and anti emetics to help with the symptoms. If symptoms improve then rest for 2 or 3 days to let your body acclimatise and then start moving upwards very slowly again. If symptoms show no sign of improvement or get worse, including hallucinations, then seek medical attention as this could easily turn into an High Altitude Cerebral or Pulmonary Oedema (HACE or HAPE) if symptoms are left too long, which is considered a medical emergency.
A combination of often much hotter climates, strenuous activities and not staying hydrated enough can be a serious and often underestimated threat to travellers health. Heat exhaustion in particular is really common in many travellers who may not be used to the change in climates and either not drink enough or over exert themselves in tropical or desert climates. Heat exhaustion occurs when your levels of body fluids and salts run low after a prolonged period of time in the sun or intense heat and dehydration. The resulting decrease in blood pressure and volume will lead to symptoms such as hot/flushed skin, extreme tiredness or fatigue, a headache or dizziness, a rapid heartbeat and even nausea.
Children, pregnant women and the elderly as well as anyone with kidney or heart problems or diabetes are more at risk.
What To Do?
Heat exhaustion can be treated very easily. Anyone displaying these symptoms in the heat or sun should get into the shade or somewhere cool as quickly as possible and should drink plenty of water to hydrate themselves again. Use a cold compress, a towel or cloth soaked in cool (not cold) water on their skin, especially the back of their neck. Symptoms should disappear after half an hour or so and is not serious as long as it is caught in time.
Heatstroke on the other hand is a the most serious form of heat exhaustion and happens when heat exhaustion is ignored and allowed to continue. It considered a medical emergency and should be treated as soon as possible.
It can develop over time and extended periods of heat exhaustion, or very quickly if you are exerting yourself hard in the heat. Initial symptoms are more severe versions of symptoms of heat exhaustion, but will also include a higher temperature of over 40 degrees, heavy sweating that stops suddenly because your body doesn’t have the fluids to produce sweat, a rapid heartbeat and breathing and muscle cramps. Secondary symptoms such as dizziness, confusion, anxiety, communication difficulties and even hallucinations can be caused when the nervous system is affected.
What to do?
Anyone suspecting heatstroke should also seek medical attention as soon as possible. Whilst waiting initial treatment of heatstroke is the same as heat exhaustion, cool the patient down, get them in the shade or somewhere cool and fan them if possible, push fluids and get them to drink as much as they can if they are conscious. If possible shower them with cool water, or apply a cool flannel or facecloth to the forehead and neck and remove excess layers of clothing.
These are just a few of the more common illnesses, ailments and health concerns that plague travellers. There are of course many more. If you need advice on anything that isn’t covered here then please feel free to check out my extensive travel health section on the blog, or have a one to one chat with a qualified nurse in my online travel clinic.
Have you read all the information but still need a little more specific advice? Is there a travel health issue that you are worried about and need a little reassurance on? Need some information on malaria, or which vaccinations you will need? Is there a travel health issue you would like to ask about in complete confidence?
Well I am here to help.
Apart from being an experienced backpacker with over 20 years travel experience, I am also a qualified nurse who specialises in emergency nursing and travel medicine.
The Bemused Backpacker Travel Clinic is an indispensable online resource for you to gain a one on one consultation with a medical professional giving you personal reassurance, expert information and qualified advice for any and all of your travel health related questions. To head into the Travel Clinic, click here