Ask the doctor - travel health matters

Read expert medical advice with doctors' questions and answers from Prima, SHE and Good Housekeeping

Do I need to worry about malaria

I'm planning a trip to Goa next month and the practice nurse has told me that I need to take malaria tablets. I thought India was mostly safe?

 

You're in good company in taking off for warmer climes - travel to malarial areas has increased by nearly 200% in the past 10 years alone. Goa used to be a ‘low risk' area for malaria, but there's recently been a sharp rise in the number of people coming back to the UK with malaria from the area. This change just underlines the importance of talking to your practice nurse or GP every time you travel outside Western Europe, the USA or Australasia - because ‘at risk' areas for many infectious diseases do change over time. You'll need to start taking tablets before you leave the UK and finish the whole course (usually going on for four weeks after you get home). Don't be tempted to wait until you reach your destination to get cheap local versions - you won't be protected unless you start before you arrive. What's more, recent research has shown a huge proportion of malaria tablets available without prescription abroad are fakes. And of course, it's important to take precautions to prevent mosquito bites, too - the practice nurse can advise.
Dr Sarah Jarvis, Good Housekeeping

 

Is there a natural travel-sickness remedy?

We’re flying abroad for Christmas. Can you suggest any drug-free air-sickness remedies for my children, aged 12 and 16?  

The most common age for sufferers of motion sickness is around ten years old, so hopefully your children are over the worst. However, ginger has excellent anti-emetic properties – get them to drink ginger tea or ginger beer (the fizz seems to help), chew crystallised ginger or take ginger tablets. Stimulation of the PC6 acupuncture point on the inner wrist, two finger breadths above the wrist crease, is also effective, and elasticated wrist bands that press on this point work well (try Sea-Band, £7.99 from pharmacies or www.sea-band.co.uk). A few drops of Bach Rescue Remedy under the tongue often works wonders, too (£3.95 from pharmacies or www.bachshop.co.uk). Travel sickness tablets containing the antihistamine cinnarizine can control symptoms for at least eight hours, if you need something stronger.
Dr Sarah Brewer, Prima
 

Send travel sickness packing

I suffer from terrible travel sickness, which makes me dread foreign holidays. I've been invited to France this year, which means travelling by car and ferry. I really want to go but I can't face the headaches and nausea that I know I'll get. I'm 32 and have been suffering for as long as I can remember. What can I do to alleviate the symptoms?

Travel sickness affects 30 per cent of adults in the UK. Your symptoms are caused by the brain receiving conflicting messages from the eyes, and motion-detecting hair cells in the inner ear. You can minimise this by sitting in the front of the car or by the window on a ferry, getting lots of fresh air, only eating light meals before or during travel, and sleeping as much as possible during the journey. However, in the car, it helps to be the driver rather than a passenger as drivers seldom suffer from car sickness.

There are a number of medications you can take. Hyoscine is thought to be the most effective – try Boots Travel Calm Tablets, £2.49 (www.boots.com). The dose should be taken 30 to 60 minutes before travelling. It can cause drowsiness and blurred vision, so do not take this if you are going to be behind the wheel. Or try an antihistamine, such as cinnarizine (Stugeron 15, £2.99, www.boots.com), or cyclizine (Hayfever and Allergy Relief tablets, £7.79, www.boots.com). These can be bought over the counter and are not as effective as hyoscine, but have fewer side effects.

Ginger is a popular alternative remedy for motion sickness. Try taking a flask of ginger tea with you to drink on your journey. Some people also find motion-sickness wristbands helpful. These work by putting pressure on an acupuncture point to relieve nausea. Available from www.boots.com, £6.99.
Dr Louise Selby, SHE

 

Arranging travel vaccinations
Last week I went to see my GP to get some jabs because I’m off to Kenya in three months’ time. When I got there I was told they no longer do travel vaccinations, and I’d have to go to a private travel clinic. This sounds expensive – is it really necessary? 

Yes, it really is. Far too many people travel without the right vaccine cover, and suffer the consequences. But since 1 April 2004, all GP practices have had the right to opt out of providing travel vaccinations. The good news is that you can still get them on the NHS. Some of the most widely needed vaccines, like typhoid and hepatitis A, should still be available free of charge. Contact your Primary Care Organisation (the address is in the phone book); they should be able to tell you where to go.
Dr Sarah Jarvis, Good Housekeeping 

Preventing heat bumps

I always try to go away somewhere warm in January to escape the British winter. This year I went to Cuba, but I developed an extremely itchy rash. The local doctor told me it was heat bumps, but I didn’t understand much else of what he said. What can I do to prevent it happening on my next trip?

Heat bumps, as you have discovered, are clusters of red, intensely itchy lumps, often on your arms or legs, sometimes with tiny blisters on top. People often confuse heat bumps with prickly heat, which is caused by blocked sweat glands. Allowing air to circulate around your body will help prevent prickly heat, but it won't stop heat bumps. Despite the name, these are actually caused by the bites of insects that thrive in hot conditions, so covering your arms and legs with insect repellent or long clothing, especially in the evenings, may help. At bedtime, you should always use a ‘knock-down' insect spray in your bedroom and, to protect you while you sleep, try an overnight insect repellent cone or plug-in electrical attachment. Also, take a mosquito net away with you - and use it!
Dr Sarah Jarvis, Good Housekeeping

 

My malaria dilemma

Are there any alternatives to taking malaria tablets? I’m going to Africa and am worried about side effects.

Malaria is a disease that can cause serious complications and be fatal. Prevention is vital – you must strongly consider taking recommended anti-malaria drugs, using mosquito nets, insect repellents and covering up as much flesh as possible, especially at dusk. Complementary approaches should only be used as well as, not instead of, anti-malaria drugs to reduce the risk of being bitten. Garlic powder tablets taken daily work well – mosquitoes do not like the garlic scent in your sweat that results. You can get information on medicines, vaccinations and disease prevention from the Medical Advisory Services For Travellers Abroad (www.masta.org).
Dr Sarah Brewery, Prima

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk