We often think we're safe when travelling surrounded by others or sharing facilities, but there's a world of hidden dangers. Dr Jane has all the top tips for staying healthy when away from home...
Joining in at a street festival brings you into close contact with lots of people. Fortunately, apart from the obvious risks of getting lost or squashed, the chances of catching an infectious disease are minute. Diseases acquired by living in confined, poor accommodation, including tuberculosis and leprosy, are not spread through fleeting contact of the sort travellers experience. There may be risk of meningococcal disease or influenza, for which there are excellent vaccines.
Busy markets and other dizzying presses of humanity can have you imagining there is a huge risk of infection. I have certainly been guilty of over-thinking risks during disease outbreaks. This is one excellent reason to be as fully immunised as possible – check www.fitfortravel.nhs.uk for all outbreak information.
It is also crucial to ensure you have good travel insurance that includes a travel assistance helpline number. Buying a local SIM card allows easier access to a local ambulance service, if one exists, and it is also a good idea to travel with a thermometer. If you fear you have acquired a nasty tropical disease, you can then check your temperature; if it is below 38°C, you can be confident that this is unlikely to be anything serious.
There are a few things for travellers to consider when using shared accommodation. Bedbugs can be an issue. The bites of these insects can cause a nasty reaction and infestations can be unexpected, as they are often imported by travellers on their clothes and luggage. They make for a miserable night but don’t transmit infection.
Accommodation owners are often armed with the chemicals to eradicate bedbugs, but just avoiding contact is best. Bring a torch to scan for any white eggs in the furniture or your bed. Look, too, for tiny black spots (bedbug poo) on your mattress, or mottled shells where bedbugs have shed their skins. If the building is basic, with cracked wall plaster, move your bed away from the wall – bedbugs often hide in crevices. If you find signs of infestation but have no other accommodation options available, wrapping yourself in an impregnated mosquito net should protect you. The next morning, spread your clothes out in direct sunshine to disperse bedbugs and fleas.
In homestays, your assailants are more likely to be flying insects, so if you are suffering bites, reconsider how you are keeping mosquitoes away, especially at dusk. If your route to the outside toilet is through lush vegetation, you might ask your hosts if you or they could cut this back, to discourage insects, leeches and snakes.
Whether using homestays or more conventional hotels, it is important to be aware that toilets are places for picking up undesirable hitchhikers and microbes. Your own intestinal microflora will do you no harm but the flush mechanism and toilet door handles are likely to be seething with faecal bacteria.
Be sure to wash your hands with soap and water after using any toilet. Alcohol gels do not cleanse hands nearly as well, so carry soap on your travels. Try to also keep a headtorch with you, so that you can see how sanitary the facilities are even if the power is off or non-existent.
Train travel is generally the safest method of communal transport, although on some routes you can find yourself really crammed in with other passengers, breathing the same air. Theoretically, this could give microbes a chance to colonise you, but as long as you are fully immunised, this is unlikely to result in much more than a cold.
In some destinations it is still possible to ride on the roofs of trains (and buses). As well as the risk of falling off, sunburn is highly likely. Even when riding inside the carriage, there are some routes where it would be easy, despite being surrounded by people, to tumble off the train through open doors, so take care. The most dangerous I’ve experienced are the bucking trains in Myanmar where accidents are very common.
Finally, there are some train routes (in Peru and China) that take you to serious altitudes. If this is a part of your itinerary, investigate how high you will be going and consider whether you have any issues with your lungs or heart that might make you more susceptible to mountain sickness.
Travelling by local bus is a great part of the travel experience but can be bad for your health. To these drivers, time is money, and often road safety and survival seems less important than arriving as fast as possible.
Motion sickness can be a particular issue in buses, especially if the route is winding and other passengers are also ill. Travellers who think they may be susceptible should take a good travel sickness tablet, such as Stugeron (cinnarizine), three or four hours before travel; you can take this eight-hourly if on a long journey.
Finally, closed air-conditioned buses (and cruise ships) can often facilitate the spread of vomiting virus. If people are being very ill around you, try to find a well-ventilated seat to yourself. Unfortunately, masks are not protective in these cases.