Your ultimate passport to a perfect healthy holiday: Everything you'll ever need to know about staying healthy abroad



21:03 GMT, 7 July 2012

No one imagines spending their hard-earned holiday convalescing in some godforsaken hospital ward. But, with alarming regularity, it happens.

More than 3,700 British tourists need hospital treatment while abroad each year and many thousands more find their annual trip blighted by accidents or illness.

As a freelance repatriation doctor for the insurance industry, I bring sick Britons home every summer, before returning to my day job in a hospital.

From anti-bug creams and 'just-in-case' antibiotics to the insurance policies that actually work, Britain's leading travel health experts give their advice

From anti-bug creams and 'just-in-case' antibiotics to the insurance policies that actually work, Britain's leading travel health experts give their advice

I’ve seen people who have broken their
hip falling off cruise ship bar stools, dived head-first into the
shallow end of swimming pools and come a cropper on jet-skis.

far more common is a flare-up of a pre-existing condition. Run out of
asthma medicine and you can quickly end up in serious trouble – and
without the right cover, footing a hefty medical bill. Even minor health
issues such as sunburn can quickly get serious.

Many of these problems are preventable or can be remedied with advance planning. Here is what I recommend…

6-8 weeks to go

1 month to go

1 week to go

In a crisis


At best, a mosquito bite is uncomfortable and unsightly – at worst, they can transmit all sorts of nasty infections.

Even if you are taking malaria drugs you should not become complacent about insect repellent if you’re visiting a country that carries a risk of the disease as tablets are only 90 per cent effective.

Here DR JAMES LOGAN, of the London School of Hygiene and Tropical Medicine, gives his recommendations.


The type of mosquitoes that cause malaria are most likely to bite at dawn and at dusk so you should be particularly careful to wear mosquito repellent and protective clothing, such as long-sleeved shirts and long trousers, at these times.


I recommend a repellent containing DEET, a strong chemical proven to repel mosquitoes.

For high-risk tropical areas (with mosquito-borne disease), the level of DEET should be above 30 per cent. For low-risk tropical areas, choose DEET level below 30 per cent.

For Europe, it is not necessary to use a high percentage of DEET, so use whatever safe or natural alternative works for you.


Many people tend to reach for hydrocortisone cream for itch relief but doctors prefer a more effective, targeted antihistamine such as Piriton.

This over-the-counter cream or pill has none of the side effects associated with topical steroids, such as thinning of the skin.


Brewers Yeast, 7.89

Yeast supplements cause the body to
emit a subtle odour that mosquitoes and other biting insects are said to
find offensive. Take for the duration of your stay abroad.

Zap-It, 6.19

Creates a harmless static charge that
inhibits histamine release to stop the urge to scratch. It also reduces
swelling. The charge feels like a light pinch to the skin and the
device claims to treat more than 1,000 bites with no battery required.

Malibu Soothing After Sun with Insect Repellent, 3.99

Rich hydrating lotion contains
effective repellent Merck 335, which cools down and soothes overheated
skin. Contains an effective repellent against biting insects and smells
nice and fresh.

Bugging out: At best, a mosquito bite is uncomfortable and unsightly - at worst, they can transmit all sorts of nasty infections

Bugging out: At best, a mosquito bite is uncomfortable and unsightly – at worst, they can transmit all sorts of nasty infections

Electronic Mosquito Deterrent 9.50

A battery-powered ladybird-shaped
device that clips to clothes or the duvet and makes a sound which mimics
that of dragonfly wings – the dragonfly is the mosquito’s mortal enemy
so this may see them off.

Lifesystems Mosquito Coils, 3.50

Burn these coils, which contain
d-Allerthrin repellent, to ward off mosquitoes, midges and other biting
insects. Each coil lasts up to eight hours and they come in packs of

Smidge, 7

Formulated by the Scottish Midge
Forecast scientists, this water and sweat-resistant formula contains
picaridin, a chemical that can effectively repel midges and horseflies.

Nosi-Life Insect Repellent Clothing from 25-50

Impregnated with pyrethroids – a
man-made pesticide – this range of clothing includes T-shirts, hoodies,
floral dresses, skirts, socks, trousers and underwear for children and
adults in anti-bacterial and lightweight fabric. The insect repellent
treatment will not wash out as it is woven into the fabric.

ProtectiShade for Buggies, 9.99

A breathable sunshade that protects
babies in buggies with a closely woven mesh covering the whole buggy to
keep out creepy crawlies and biting insects.


Avoid excessive alcohol as it leads to dehydration

Avoid excessive alcohol as it leads to dehydration

Thousands of Britons every year suffer a deep vein thrombosis – a potentially fatal blood clot – as a result of prolonged inactivity during travel.

Almost all cases are preventable. Here vascular surgeon JOHN SCURR gives his guide to reducing your risk.


It is a blood clot that usually forms in a leg vein which can break away into the circulation and travel to the lungs, causing a fatal blockage. If you are unable to move for a long period, your blood collects in the lower parts of your body, increasing the risk of this happening.


Cancer patients on chemotherapy and radiotherapy have increased risk, as do those suffering from heart and lung disease, hepatitis, inflammatory conditions such as rheumatoid arthritis and anyone who is pregnant, on the contraceptive pill or overweight – or those who have had a DVT previously. Consult your GP before embarking on a plane, train or car journey of six hours or more.


Ninety per cent of people will be fine but those who may have chronic heart disease or had numerous blood clots in the past may need blood-thinning medication.


Drink water. Avoid excessive alcohol as it leads to dehydration, with the blood more likely to clot, and avoid taking sleeping pills as it can cause immobility. Do leg exercises and wear compression stockings.


Replace lost fluids by drinking lots and taking rehydration tablets

Replace lost fluids by drinking lots and taking rehydration tablets

If the dreaded traveller’s tummy strikes, Dr Ron Behrens, of the London School of Hygiene & Tropical Medicine, says: ‘As many as 60 per cent of travellers to tropical climates suffer diarrhoea.

'Many also suffer nausea and vomiting and it usually lasts two or three days.

Ensure you replace lost fluids by drinking lots and taking rehydration tablets.

'Patients usually self-treat, but experts say cases can be cleared up much quicker if sufferers take antibiotics.’

Your hotel should be able to recommend a local doctor but ring your insurer as soon as possible to tell them what you’re doing and make sure you keep receipts for any treatment and medication.

Use hand-sanitising gel regularly. The most common way of catching bugs is by touching a dirty surface, then your mouth.

Help! It's 3am, Oscar is gushing blood… and I don't speak Italian

It is every parent’s worst nightmare. There is blood pouring from our five-year-old son’s face and dripping on to the stone floor.

Oscar has fallen out of his bed and needs medical attention but it’s 3am, we’re in the middle of the Italian countryside, and my grasp of the language extends to booking a restaurant and asking for directions to the swimming pool.

I like to think I’m good in a crisis, but on this occasion I have absolutely no idea what to do.

Once I had managed to stop Oscar’s chin bleeding by applying pressure with a clean towel, we could see that his cut was under an inch long. However, I had just three SpongeBob SquarePants plasters stuffed into my washbag.

Unprepared: Alice, husband Justin, and their children (from left to right) Archie, Lara and Oscar

Unprepared: Alice, husband Justin, and their children (from left to right) Archie, Lara and Oscar

When my eldest child Archie was born, I did a first-aid course for children. I’m convinced this meant I was calmer and able to staunch the blood to ascertain the damage.

We suspected Oscar might need stitches, but he had calmed down and seemed quite happy so we decided to make him comfortable until we could more easily find a doctor or pharmacy.

Before we set off, I called our insurers, Lloyds TSB. Staff said that all our costs would be met as long as we kept receipts, including the one for taking a taxi to the hospital.

Our villa company had helpfully provided a list of medical centres in a folder of information. But as I tried to work out the relevant phrases from my Berlitz phrase book, I realised I was going to struggle to make myself understood and didn’t stand a chance of comprehending the answers.

Luckily for me, the villa owner, Cesare Garzetti, whose number we had been given, happened to be in the area and kindly escorted me and my tired, but reasonably cheerful son to the nearest hospital in Ancona, a 20-minute drive away.

Oscar was assessed immediately by a doctor, who was horrified I hadn’t brought him in straight after the accident.

It was now too late to stitch his already healing chin and the scar was going to be more severe because we had delayed finding treatment. It was bandaged up and we were given stern instructions that he stay out of the swimming pool for a week.

I have since discovered that, according to a Post Office survey, three per cent of British children who go on holiday end up in hospital.

It pays to be prepared, says Clive James, a trainer for voluntary organisation St John Ambulance. ‘You never know when accidents might happen, or what the consequences may be,’ he says.

He points out that in the event of an accident you are likely to be stressed but ‘some training will give you the confidence to deal with the situation’.

St John Ambulance runs essential first-aid courses lasting three hours (25 plus VAT,

If this isn’t feasible, text FREE GUIDE to 70099 and staff will send a booklet outlining basic first-aid procedures, including how to deal with choking, bleeding and resuscitation. There is even an iPhone app available.

Mr James recommends always carrying a basic first-aid kit, whether you’re in the UK or further afield.

‘Plasters, dressings, rubber gloves, cleansing wipes, diarrhoea treatment, aftersun and painkillers for all ages are invaluable and won’t take up much space. If in any doubt, especially with small children, just call an ambulance.’

Upset as I was, I was impressed at the speed of treatment we received and next time, I hope, we will be a bit better prepared.