Travel Health: How to Stay Healthy Abroad and What to Do When You Get Sick

Why Travel Health Preparation Matters

The excitement of planning a trip abroad can make health preparation feel like an afterthought. Vaccinations, travel health appointments, and packing medicines are not the glamorous part of planning. But the travellers who end up in difficult situations most often are those who skipped the preparation, not those who spent an hour with their practice nurse and three hours at a travel pharmacy before they left.

Being seriously unwell in a foreign country carries a different weight to being unwell at home. You may be dealing with an unfamiliar healthcare system, a language barrier, the absence of your normal social support, and the practical complications of being far from home while also feeling very ill. Good preparation does not prevent all illness, but it significantly reduces the likelihood of serious illness and ensures you know what to do when your body surprises you.

Before You Go: Travel Health Appointments

Book a travel health appointment at your GP surgery or a travel health clinic ideally six to eight weeks before departure. This lead time allows for vaccinations that require multiple doses or that need time to take effect. Some vaccinations, such as yellow fever, require a certificate that is only issued at designated clinics, so check whether your destination requires specific certificates before you book.

The vaccines commonly recommended for international travel, depending on your destination, include hepatitis A, typhoid, hepatitis B, meningitis ACWY, rabies, Japanese encephalitis, and cholera. Some of these are available free on the NHS for certain destinations; others require payment. Your travel health appointment will advise on which are recommended for your specific itinerary.

Ensure your routine UK vaccinations are up to date, including tetanus, diphtheria, and polio. These are often overlooked in focus on travel-specific vaccines but remain relevant, particularly for destinations with limited healthcare infrastructure where a wound infection could become complicated.

If your destination is in a malaria-endemic area, antimalarial tablets are likely to be recommended. There are several types, and the right choice depends on your destination, medical history, and duration of travel. Start taking them at the correct time before departure (which varies by type), continue during your trip, and complete the course after returning.

Food and Water Safety

Travellers' diarrhoea, caused by consuming contaminated food or water, is the most common travel illness. In many parts of the world, tap water is not safe to drink, and this includes the water used to brush teeth and to make ice. The rule of thumb is to drink bottled water (with an intact sealed cap) or water that has been boiled. Carbonated drinks in sealed bottles are generally safe. Ice in drinks is only safe if it has been made from safe water, which cannot be guaranteed in many destinations.

Eating at busy, established restaurants where food is cooked to order and served hot significantly reduces food safety risk compared to street food that has been sitting for an extended period or food from establishments with limited customers. Fruit and vegetables that have been peeled by you are safer than pre-prepared salads. The phrase "boil it, cook it, peel it, or leave it" is a useful rule of thumb, even if strict adherence in every situation is not always practical.

Washing hands thoroughly before eating and after using the bathroom is basic but important, and in areas where hygiene facilities are limited, carrying an alcohol-based hand sanitiser provides an alternative.

Stomach Illness When It Happens

Despite precautions, stomach illness during travel is common. In most cases it resolves within a few days without requiring medical treatment. The priorities during stomach illness are hydration and rest. Oral rehydration salts, which replace fluids and electrolytes lost through diarrhoea and vomiting, are significantly more effective than water alone and should be carried as part of your travel medical kit.

Seek medical attention if: illness persists beyond five to seven days, there is blood or mucus in stools, there is a high fever (above 38.5 degrees Celsius), symptoms are severe, or you are unable to keep any fluids down for more than 24 hours. In areas with high cholera risk, symptoms of severe, watery diarrhoea with rapid dehydration should be treated as a medical emergency.

Antibiotics for travellers' diarrhoea are sometimes prescribed by travel health clinics as a standby treatment for use only in specific circumstances; discuss this with your travel health practitioner if you are visiting higher-risk areas.

Mosquito Protection

Mosquito-borne illnesses including malaria, dengue fever, Zika virus, and yellow fever are major causes of serious illness and death in travellers. The first line of defence is avoiding mosquito bites, which requires a combination of approaches used consistently.

DEET-based insect repellent applied to exposed skin is the most effective repellent available. Concentrations of 30 to 50 percent DEET are recommended for adults in high-risk areas. Apply it after suncream, not before. Reapply after swimming or excessive sweating. Covering exposed skin at dawn and dusk, when mosquitoes are most active, significantly reduces bite frequency. Sleeping under mosquito nets, particularly insecticide-treated nets, in areas where malaria or dengue is endemic is important.

Dengue fever deserves specific mention because there is no vaccine widely available for travellers (one exists for people who have previously been infected) and no specific treatment. Symptoms typically appear four to ten days after a bite and include high fever, severe headache, pain behind the eyes, joint and muscle pain, and rash. Dengue is usually self-limiting but can progress to severe dengue in a small proportion of cases, which is a medical emergency.

Altitude Sickness

Altitude sickness, also known as acute mountain sickness, occurs when people ascend to altitude faster than their bodies can acclimatise. It typically affects people travelling above 2,500 metres and is not related to fitness or previous high-altitude experience; anyone can be affected on any trip.

Symptoms of acute mountain sickness include headache (the defining symptom), fatigue, loss of appetite, nausea, dizziness, and difficulty sleeping. The single most important treatment is descent. If symptoms develop, do not ascend further; descend until symptoms resolve. Most people improve rapidly with even modest descent of a few hundred metres.

More serious forms of altitude sickness, high altitude pulmonary oedema (fluid on the lungs) and high altitude cerebral oedema (fluid on the brain), are medical emergencies requiring immediate descent and emergency medical care. Symptoms of these conditions include extreme breathlessness at rest, confusion, loss of coordination, and cough producing pink frothy sputum. Do not wait to see if these improve; descend immediately and summon emergency help.

The drug acetazolamide (Diamox) is prescribed preventatively for altitude-related journeys; discuss this with your travel health practitioner before travel to altitude destinations such as the Himalayas, Andes, or African mountain ranges.

Your Travel Medical Kit

A sensible travel medical kit for most destinations includes oral rehydration sachets, pain relief (paracetamol and ibuprofen), antihistamine, antiseptic cream and wound dressings, water purification tablets (as a backup), thermometer, any prescribed medications in adequate supply plus a copy of the prescription, and travel insurance documents including the emergency assistance number.

Your travel insurance emergency number is as important as any medication. This number connects you to the insurer's assistance team who can help arrange medical care, hospital admissions, and evacuation if needed. Store it separately from your insurance documents so you can access it if your bag is lost.