Holiday Traveller

By Tonia Buzzolini, National Operations Manager, Travelvax Australia.

I still take my turn on the ‘front lines’ of Travelvax Australia.
By ‘front lines’ I mean our free over-the-phone travel health advisory service (1300 360 164), where I join other medical professionals providing country-specific advice. We all share a passion for travel medicine and enjoy helping Australians prepare for healthy holidays, or to work or live overseas.
However, as a nurse and mother of two primary schoolers, it still surprises how often kids seem to be something of a travel afterthought – only mentioned at the end of the conversation.
Fortunately, the Travelvax doctors and nurses who see them during their pre-travel medical consultation regard them as little VIPs – very important patients.
It’s true that destinations once considered ‘remote’ or ‘exotic’ are much more accessible and child friendly these days. But, parents still need to be ready for the health and safety issues that can occasionally crop up.
I’d like to offer parents some tips on some of the main ones.

TIP 1 – Don’t get behind the wheel

It’s probably not surprising that the experts agree that car accidents are probably the greatest threat to kids travelling overseas. After all, they’re a leading cause of injury and death at home, too. In the developing world in particular, roads are often in poor condition, hire cars may not be fitted with seatbelts, while unfamiliar signs and road rules may be incomprehensible. And, then there’s mum or dad’s jet lag… Driving yourself is just not worth the risk. Kids should not ride bikes unaccompanied on local streets – even on footpaths – either.
My advice: Take taxis or public transport – especially in developing countries. It’s safer and stress free.

TIP 2 – Give all animals a wide berth

Rabies is a travel disease that is actually more of a risk for kids than adults. International data shows kids are more susceptible: Nearly all of the estimated 55,000 deaths each year occur in Asia and Africa, and most of the victims are children. Rabies is present in most countries of the world (Australia is among the lucky few without the deadly virus!) and kids are naturally drawn to animals and vice versa. Kids eating food make a tempting, eye-level target for hungry dogs or monkeys, and having been lectured about rabies by mum or dad, they may be reluctant to admit they were bitten. Rabies is nearly always 100% fatal and parents need to know what to do if they or their kids get bitten. You should also discuss with your travel doctor or GP whether you should consider having rabies vaccinations.
My advice: Firstly, warn your kids not to pat, feed or even approach any animals, especially dogs and monkeys. Continue to remind them, if necessary. Secondly, don’t eat food around animals.

TIP 3 – Ensure everyone has travel vaccines

Like their parents, kids need travel vaccinations too. In fact, kids are more susceptible to some germs and infections. Diseases like measles, meningitis, polio, and hepatitis A are more prevalent in the developing world and your children are likely to come into contact with them through contact with other kids. So, it’s important to ensure routine childhood vaccinations are up-to-date for the whole family (travelling babies as young as 9 months can get an early measles vaccine to keep them safe). While some of the vaccines recommended for travel require an occasional booster, others like hepatitis A and B usually last a lifetime of overseas travel once the course is completed. They are a sensible health ‘investment’. And, it’s a reassuring thought for parents, knowing that when young children suddenly turn into young adults and head overseas without you, that they are protected.
My advice: Take a long-term view on travel immunisation. See your travel clinic or GP 4-6 weeks before departure so your vaccines are at full strength.

TIP 4 – Get kitted out for every trip

Even in exotic places, the illnesses your kids are most likely to get overseas will be pretty familiar – a rash, a tummy ache, ear ache, or sore throat. If you don’t have a travel first-aid kit, buy one or assemble your own (see my suggested list below). Small is better, but your kit should include items to treat the more common ailments and the minor cuts and grazes that can occur at home or away. If you already have a travel first-aid kit, check expiration dates. Once you are overseas, pharmacies may be difficult to find and medication may be of questionable quality, so ask your travel doctor or GP for advice on any medication you may need and get scripts filled before you leave. 
FIRST-AID ITEMS: Protective gloves, antiseptic wipes, tweezers, safety pins, scissors, sterile gauze swabs, cotton tips, iodine swabs or other disinfectant, normal saline 30ml, curved sterile irrigation syringe, elastic gauze bandage (5cmX4m), elastic gauze bandage (7.5cmX4m), crepe bandage 10cm heavy, flexible active strips – steristrips, knuckle dressing, absorbent non-adherent dressing (7.2X5cm), triangle bandage, burn-aid gel sachet, open weave adhesive dressing (10X25cm), alcohol-based disinfectant hand gel, oral rehydration solutions, topical first-aid antiseptic burn cream, throat lozenges. Medications: Paracetamol or Ibuprofen, antihistamine.
My advice: A smartphone is part of a modern first-aid kit. Load yours with your doctors’ business and after-hour contact details, and those of a reputable clinic that provides western-style service medicine at your destination. It saves valuable time if you’ve documented your child’s recent medical history, including immunisations, any routine medication, and their weight (many medications are dosed by weight). Have your health insurance provider’s contact number handy, too.

TIP 5 – Make smart food and water choices – every time

Like rabies, kids are also more susceptible to stomach complaints than adults. Although most tummy bugs disappear in a day or so, they can leave littlies washed out. It’s food rather than water that is generally the cause. When it comes to preparing or buying food, I try to follow the adage: ‘boil it, cook it, peel it, or forget it’. One way to reduce the risk of gastro illnesses is to order food delivered to the table ‘piping hot’. If it’s too hot to eat immediately food is less likely to have been contaminated by insects or unhygienic surfaces or hands. In developing countries in particular, it’s just as important for everyone to get into the habit of washing their hands after visiting the toilet and before eating. If diarrhoea strikes, treat kids with a powdered electrolyte solution, such as Hydrolyte or Gastrolyte, mixed with safe water. (Follow the dosage directions on the pack for the child’s age or weight). Small, frequent sips of an electrolyte solution will help restore salts and maintain hydration. But, if vomiting or diarrhoea becomes continuous, seek prompt medical attention. Read more about safe food and water.
My advice: Be wary of buffet food – especially outdoors. If you must, try to be at the head of the queue, while the food is still fresh. And, avoid garden salads and anything stored in or on ice. And, if in doubt, order from the menu instead.

TIP 6 – Be well-armed against biting bugs

Insects are smart: You have to outsmart them – especially in tropical countries, where biting bugs carrying dengue fever, malaria, and Chikungunya may be present. If your accommodation won’t be air-conditioned or the windows aren’t screened, kids and adults alike should sleep under bed nets – ideally, treated with a contact insecticide such as permethrin. When you are outdoors, a bassinette or stroller should be well covered with a permethrin-impregnated net. Your next line of defense should be topical insect repellent – one with an effective active ingredient. DEET-based products to a maximum strength of 30 are appropriate for kids aged 6 months or older. Those containing picaridin and IR3535 are also kid-safe. Mosiguard, which contains extracts of lemon eucalyptus, is officially licensed for children over 12 months, but I’ve found it effective on my own kids from 8 months. Read more on protecting your family against biting insects.
My advice: This is when your smart phone comes in handy again. Program it to remind you when to reapply insect repellent and a separate sunscreen. Make sure the repellent is fresh if your family is outside around dawn and dusk: that’s when biting insects are at their hungriest!

Read more on Travelling with Children and call us on 1300 360 164 (toll-free from landlines). We’ll help you keep your little VIPs healthy and safe overseas.