How to Prepare for International Travel: A Practical Health Guide for Hout Bay Travellers
International travel can be exciting, but unfamiliar climates, food, insects, long flights and infectious diseases may introduce health risks that are not part of everyday life in Cape Town. Preparing properly before departure can reduce the chance of illness, prevent interruptions to your trip and ensure that you have the medication and documents you may need while away.
Hout Bay Family Medical Clinic offers travel consultations, routine immunisations and personalised preventative-health advice for adults, children and families preparing to travel abroad. Because health risks and entry requirements differ between countries, your travel plan should be based on your destination, itinerary, length of stay, accommodation, activities and personal medical history.
Book a Travel-Health Consultation Early
Ideally, arrange a travel consultation four to eight weeks before departure. This allows enough time to review your vaccination history, receive vaccines that require more than one dose and begin preventative medication where necessary. A consultation can still be worthwhile when travel is booked at short notice.
Bring as much information as possible, including:
- Countries and regions you will visit;
- Departure and return dates;
- Planned stopovers and transit countries;
- Urban, rural or remote destinations;
- Accommodation and planned activities;
- Existing medical conditions;
- Current medication and allergies;
- Pregnancy or plans to conceive;
- Previous vaccinations; and
- Any history of serious vaccine reactions.
A business trip to a major city may require different preparation from backpacking, volunteering, visiting family in a rural area or travelling on safari.
Check Your Routine Vaccinations
Travel preparation starts with ensuring that routine immunisations are up to date. Depending on your age, health and vaccination history, this may include protection against:
- Tetanus, diphtheria and pertussis;
- Measles, mumps and rubella;
- Polio;
- Influenza;
- Hepatitis B;
- Chickenpox;
- Pneumococcal disease; and
- Other age-appropriate illnesses.
International travel can increase exposure to infections that may be uncommon locally. WHO advises that travel vaccines may be recommended because a disease occurs at the destination or required as a condition of entry or exit.
Travellers should not assume that childhood vaccinations still provide complete protection. Bring your vaccination record to the consultation where possible so that your doctor can identify missing doses or boosters.
Understand Destination-Specific Vaccines
Additional vaccines may be recommended according to where you are travelling, the season and the type of trip. These may include vaccines against:
- Hepatitis A;
- Typhoid;
- Yellow fever;
- Meningococcal disease;
- Rabies;
- Japanese encephalitis;
- Cholera; or
- Tick-borne encephalitis.
Not every traveller needs every vaccine. The recommendation may depend on whether you will be staying in cities, eating in informal settings, working with animals, camping, travelling to rural areas or remaining abroad for an extended period.
Entry requirements can change, so travellers should confirm the latest rules for every destination and transit country shortly before departure. Some countries require official proof of vaccination rather than merely recommending it.
Yellow Fever Certificates
Yellow fever vaccination may be recommended for travel to certain parts of Africa and South America. Some countries also require a valid yellow fever certificate from travellers arriving from, or transiting through, a country where yellow fever occurs.
The vaccine must be administered at an authorised yellow fever vaccination centre, which can issue the internationally recognised certificate. Whether you need vaccination depends on your exact itinerary, including airport transits, so this should be checked before travel.
Do not rely solely on advice from friends or previous trips, as entry rules can change. Travellers who cannot receive the vaccine for medical reasons may need formal documentation, but acceptance of an exemption remains subject to the destination country’s rules.
Consider Malaria Prevention
Malaria is a potentially life-threatening infection transmitted by mosquitoes. The risk differs considerably between countries and even between regions within the same country.
Travellers visiting malaria-risk areas may need preventative medication in addition to careful mosquito protection. NICD advises travellers to endemic areas to take measures against mosquito bites and to strongly consider suitable malaria-prevention medication.
Your doctor will consider:
- The specific destination;
- Time of year;
- Duration of the trip;
- Accommodation;
- Pregnancy;
- Age and weight;
- Current medication;
- Existing medical conditions; and
- Previous reactions to malaria medication.
Malaria tablets must be taken according to their exact schedule, which may begin before arrival and continue after leaving the risk area. Do not stop the medication early simply because you have returned home.
Mosquito precautions remain important even when taking tablets:
- Apply an effective insect repellent;
- Wear long sleeves and trousers after sunset;
- Sleep in screened or air-conditioned accommodation;
- Use mosquito nets where appropriate; and
- Follow local malaria advice.
No preventative medication provides complete protection. Fever, chills, headaches or flu-like illness during or after travel to a malaria area require urgent medical assessment. Tell the doctor exactly where you travelled, even if you used malaria medication.
Pack Enough Prescription Medication
Take enough regular medication for the entire trip, plus a reasonable extra supply in case of delays.
Keep essential medicines in your hand luggage rather than checked baggage. Where practical, retain them in their original labelled packaging together with a copy of your prescription or a doctor’s letter.
Before travelling, check whether your destination restricts medicines such as:
- Strong painkillers;
- Sleeping tablets;
- ADHD medication;
- Anxiety medication;
- Injectable medicines;
- Certain cold and flu remedies; or
- Medicines containing controlled substances.
Rules vary significantly between countries. Confirm requirements with the destination’s embassy, consulate or official authority before carrying restricted medication across a border.
Patients requiring refrigerated medication, injections or medical equipment should discuss storage, transport and airline arrangements in advance.
Prepare a Basic Travel Medical Kit
A practical travel-health kit may include:
- Regular prescription medication;
- Basic pain and fever relief;
- Oral rehydration solution;
- Appropriate diarrhoea medication;
- Antihistamines;
- Insect repellent;
- Sunscreen;
- Hand sanitiser;
- Plasters and dressings;
- Antiseptic;
- A thermometer;
- Motion-sickness medication where required; and
- Any condition-specific supplies.
The contents should be tailored to the traveller. Medication suitable for one person may not be safe for a child, pregnant traveller or patient with an existing health condition.
A travel consultation provides an opportunity to discuss whether standby medication is appropriate for your destination and circumstances.
Take Care With Food and Water
Traveller’s diarrhoea is one of the most common health problems during international trips. It is usually caused by contaminated food or water.
Reduce your risk by:
- Drinking sealed bottled water where tap water is unsafe;
- Checking that bottle seals are intact;
- Avoiding ice made with uncertain water;
- Eating food that is thoroughly cooked and served hot;
- Washing or peeling fruit yourself;
- Avoiding raw or undercooked meat and seafood;
- Being cautious with unpasteurised dairy products; and
- Washing or sanitising your hands before eating.
NICD advises travellers to reduce typhoid risk through handwashing, safe water, adequate sanitation and properly prepared food.
Seek medical care for persistent diarrhoea, blood in the stool, severe abdominal pain, high fever, repeated vomiting or signs of dehydration.
Prevent Insect Bites
Mosquitoes, ticks, sandflies and other insects can transmit diseases for which vaccines or preventative medication may not always be available.
Along with malaria, destination-specific risks may include dengue, chikungunya, Zika, tick-bite fever and other infections.
Helpful precautions include:
- Using insect repellent as directed;
- Wearing protective clothing;
- Sleeping under treated mosquito nets where necessary;
- Checking your skin for ticks after outdoor activities;
- Avoiding heavily infested areas where possible; and
- Following destination-specific public-health advice.
Pregnant travellers or those planning pregnancy should obtain individual medical advice before visiting an area with a risk of infections that may affect pregnancy.
Protect Yourself From the Sun and Heat
Travellers from Cape Town may still underestimate the effect of tropical heat, altitude or intense sun exposure.
Use broad-spectrum sunscreen, protective clothing, sunglasses and a hat. Drink water regularly and avoid strenuous exercise during the hottest part of the day.
Symptoms such as headache, nausea, weakness, dizziness, confusion or reduced sweating may indicate heat-related illness. Move to a cooler area, begin cooling measures and seek medical care when symptoms are severe or do not improve.
Prepare for Long Flights
Long periods of sitting can contribute to swelling, discomfort and, in some travellers, deep-vein thrombosis.
During a long flight:
- Move around periodically when safe;
- Flex your ankles and legs while seated;
- Avoid becoming dehydrated;
- Wear loose, comfortable clothing; and
- Follow your doctor’s advice if you have an increased clotting risk.
Speak to your doctor before flying if you have recently had surgery, a blood clot, major injury, serious heart or lung disease, a complicated pregnancy or another condition that may affect air travel.
Do not start aspirin, anticoagulants or compression therapy without appropriate medical advice.
Consider Altitude and Adventure Activities
High-altitude destinations can cause headaches, nausea, poor sleep, dizziness and shortness of breath. Ascend gradually where possible, remain hydrated and avoid pushing through worsening symptoms.
Scuba diving, climbing, remote hiking and other adventure activities may require additional preparation. Travellers should consider fitness, emergency access, evacuation arrangements and whether travel insurance covers the planned activity.
People with heart, lung, neurological or other chronic conditions should discuss demanding activities with a doctor before departure.
Travel During Pregnancy
Many pregnant women can travel safely, but the timing, destination and individual pregnancy must be considered.
Important issues may include:
- Vaccination suitability;
- Malaria and mosquito-borne disease risks;
- Risk of blood clots during long journeys;
- Food and water safety;
- Access to maternity care;
- Airline restrictions; and
- Travel-insurance exclusions.
WHO notes that pregnancy, breastfeeding, young age, older age and underlying medical conditions may require additional travel-health planning.
Pregnant travellers should obtain personalised advice from their doctor or maternity provider before making final arrangements.
Travelling With Babies and Children
Children may require adjusted vaccination schedules, weight-based medication and additional planning around feeding, hydration and fever management.
Parents should carry:
- The child’s regular medication;
- A vaccination record;
- Child-appropriate fever relief;
- Oral rehydration solution;
- Safe insect protection;
- Sunscreen;
- Basic first-aid supplies; and
- Copies of relevant medical information.
Children can become dehydrated more quickly than adults. Seek care promptly when a child has persistent vomiting or diarrhoea, reduced urination, breathing difficulty, unusual sleepiness or difficulty taking fluids.
Travelling With a Chronic Medical Condition
Patients living with diabetes, asthma, epilepsy, heart disease, kidney disease or other chronic conditions should ensure that their condition is stable before departure.
Your doctor may help you prepare:
- A medication supply;
- A written medical summary;
- Copies of prescriptions;
- An action plan for flare-ups;
- Advice about time-zone changes;
- Guidance on storing medication; and
- Emergency contact information.
Wear or carry medical identification where appropriate. Travellers with diabetes should pay particular attention to insulin storage, meal timing, glucose-monitoring equipment and changes in time zones.
Obtain Suitable Travel Insurance
Travel insurance should cover more than cancelled flights and lost luggage. Check whether it includes:
- Emergency medical treatment;
- Existing medical conditions;
- Hospital admission;
- Medical evacuation;
- Repatriation;
- Adventure activities;
- Pregnancy-related care; and
- Treatment in every country on your itinerary.
Read exclusions carefully and declare existing conditions accurately. Medical treatment and emergency evacuation abroad can be extremely expensive.
Keep policy details and emergency contact numbers accessible both electronically and on paper.
Know What to Do If You Become Ill Abroad
Before departure, identify reputable medical facilities near your destination, particularly when travelling to remote areas.
Seek medical help urgently for:
- Severe breathing difficulty;
- Chest pain;
- Confusion or loss of consciousness;
- Serious injury;
- Severe allergic reaction;
- Persistent vomiting;
- Bloody diarrhoea;
- High or persistent fever;
- Signs of dehydration; or
- Fever during travel in a malaria-risk area.
Avoid self-treating serious symptoms with leftover antibiotics or medication supplied by another traveller.
Monitor Your Health After Returning Home
Some travel-related illnesses only become apparent after returning to South Africa.
Consult a doctor if you develop fever, rash, diarrhoea, jaundice, persistent cough, unexplained fatigue or another unusual symptom after international travel. Tell the doctor:
- Where you travelled;
- The dates of travel;
- Rural or outdoor exposure;
- Insect or animal bites;
- Food and water risks;
- Medical treatment received abroad; and
- Vaccines or preventative medicine used.
NICD advises returning travellers to inform healthcare practitioners about recent travel because conditions such as malaria may present after leaving the affected area.
A fever after visiting a malaria-risk region requires urgent assessment, even if preventative tablets were taken.
Travel-Health Consultations in Hout Bay
Hout Bay Family Medical Clinic provides personalised travel-health guidance for individuals, families, business travellers and tourists preparing for international trips.
Travel and preventative services may include:
- Pre-travel medical consultations;
- Review of routine vaccinations;
- Destination-specific vaccine advice;
- Malaria-prevention guidance;
- Medication planning;
- Advice for chronic conditions;
- Travel-health documentation;
- Food, water and insect-bite prevention;
- Pregnancy and family-travel guidance; and
- Post-travel medical assessment.
Requirements and health risks can change, so arrange your consultation well before departure and confirm current destination rules shortly before travelling.
Contact Hout Bay Family Medical Clinic to arrange a travel-health consultation before your next international trip.