With a week of sunshine and winter well behind us our thoughts quickly turn to our summer holidays. Each year throughout the summer months I and my colleagues see patients who have developed illnesses on holiday which have caused much anxiety, destroyed everyone’s pleasure and often been costly in terms of traveling home early and medical bills. Many of these simple illnesses can often be avoided by a little planning before and by simple preventative measures.
The simple problems of sunburn, mosquito bites and traveler’s diarrhoea are often enough to ruin a holiday and are usually easily avoided and treated. Start slowly in the sun using a good factor suntan cream for the first few days and take a long break over lunch to avoid the mid-day sun. Particularly protect young children from the sun as they can become more seriously ill and dehydrated from sunburn, get them to wear hats and spend a lot of time cooling in the sea. Treat sunburn with a local anaesthetic cream, keeping cool and drinking plenty of water, remember also to take a little salt and rest until you are comfortable. Sun exposure is implicated in the very serious skin cancer called melanoma and the risks are thought to be higher in those with pale skin and those with freckles who should take special care not to be overexposed.
In some seaside areas and near any water mosquitos can be a particular problem especially in the evening. Use a good repellent and if troublesome wear long trousers and sox to minimise exposure. Smokers could be excused for smoking a strong french cigarette, but one in an ash tray also works well! High frequency emitters also work well. Take an antihistamine cream to sooth any bites and a simple antihistamine tablet such as clarityn to stop the allergic reaction and itching. Occasionally itched bites get infected and do need a course of antibiotics, certainly keeping childrens’ nails clean help minimise this risk.
Traveler’s diarrhoea is again common, often caused by poor water or poor food preparation in busy resorts. Always use bottled water and be careful of food kiosks and cheap ice-creams. Treat any symptoms of vomiting with motillum and diarrhoea with smekta – both worth having in your travel bag, rest and keep well hydrated giving children frequent small sips of rehydron fluid, when recovering eat carbohydrates – bread, pasta, rice and potatoes for the first few days. Sea quality is a factor in gastrointestinal illness and has often been in question in Crimea. I am pleased to see that Yevpretoria has this year been graded as a blue flag beach and I hope this will set a challenge to other resorts.
Whilst we should perhaps use holidays to restore our bodies we can often, especially when young, use holiday times to abuse our health and take risks. Alcohol mixes badly with nearly all activities and most deaths in the sea are linked with its abuse, as are car and bike accidents and other injuries. Research shows that many people, indeed women more than men, also take sexual risks on holiday unaware that holiday resorts are often high risk areas for sexually transmitted diseases. Sex education in Ukraine is neither universal nor very informative and Ukraine is a long way from say Holland where frank messages are given about the risk that people take on holiday. HIV is prevalent in holiday areas and whilst doing project work south of Zaphorizja I came across several HIV positive women who had contracted the disease whilst in Crimea.
Car hire is easy but do remember to use a seat belt at all times and a helmet on motorbikes, both are clearly shown to reduce serious and often disfiguring injuries if you meet bad luck on a busy road. Once again resist the temptations of drinking and driving.
Always pack a simple bag of essential medicines, creams and bandages so you can manage minor illnesses yourself without wasting time and the expense of finding a doctor. Don’t forget travel sickness tablets if your children are prone to this problem. If going abroad always have some travel insurance and have the documentation to hand, I always keep it with a copy of our passports in a small medical bag. Its useful also to keep the telephone number of your physician in Ukraine and that of your consulate abroad who can help you if you have serious problems.
Not everybody holidays by the sea and Ukraine has some beautiful countryside in Transcarpathia and elsewhere, whilst many people spend holidays in forests and mountains most are unaware of a serious illness called tick borne encephalitis. Small ticks attach themselves to the skin burrowing in and infecting the blood with a small parasite that causes serious problems. Ticks are most common from April to October and my wife and I both recently got attacked after an enjoyable shashlik! They should be removed by suffocated them with any sort of gel which eventually makes them release their vice like grasp. Occasional forest hikers should wear hats and long trousers and always have a rigourous whole body inspection! For frequent hikers there is a vaccine (currently the only one available in Ukraine is manufactured in Russia) and 3 shots over 6 to 12 months gives a 3 year immunity. If you are ill after being in a forest area do seek prompt advice and tell the doctor about this.
For those lucky to travel outside Europe do get good health insurance and check what it covers especially in terms of getting you back home if you are seriously ill, and whether your family can travel with you. Keep mobile and well hydrated on the flight and avoid too much alcohol. Aspirin for 3 days surrounding the flight reduces the risk of deep vein thrombosis. Eat lightly on the plane and wear light clothing and take time to recover the next day after a long flight. In general children seem to cope with travel as well as, if not better, than adults. In tropical areas talk to a physician before traveling to discuss immunisations and prevention of malaria and remember to take anti-malarial tablets when you return home as directed. I wish you all happy and very healthy summer holidays.
Dr Richard Styles FRCGP
American Medical Centre