Health problems of
travel abroad
S.K. Jindal,
MD (Medicine), FAMS,
FCCP, FNCCP
(Former Professor
& Head, Department of Pulmonary Medicine,
PGIMER, Chandigarh, India)
Medical Director
Jindal Clinics, SCO
21, Sector 20 D, Chandigarh, India 160020
There is an
enormous amount of information on health problems related to travel of western
tourists to the tropical countries, including to India. Whether travelers from India to the West are also
at increased risk of health problems, is a dubious question. Undoubtedly, the risk of infection related
health problems in the West is significantly lesser than that in India. There is a cleaner atmosphere and effective
implementation of health standards of available water and foods. There is lesser air pollution and almost nil
adulteration of edible items. One can
easily rely upon the labeled constituents of sold food items and believe most
of the vendors for the quality of the products being sold. Why then worry about the health problem? We Indians are conditioned to live and stay
healthy in more adverse conditions.
When
Columbus in 1492 discovered America, he is said to have brought back parrots
and spears, and syphilis to Europe. Syphilis,
being contagious, spread widely in Europe and the rest of the world through
human sexual contact. Similarly, plague
is known to have spread through trans-country travel and migration of
populations. The danger of spread of
infections in the modern times is much verse.
The enormity of travel these days is several thousand-time more and the
period of travel is rather short – only a few hours by air to travel to most of
the countries. In particular, the
chances of spread of infections due to viruses have tremendously
increased. We all have heard of many incidences
of respiratory infections in the last decade such as the Severe Acute Respiratory
Syndrome (SARS), swine-flu (H1N1) and avian flu (H5N1 and H7N9) etc. Fortunately, H7N9 influenza detected in China
has remained restricted to that country.
The latest in the series is the Middle East Respiratory Syndrome (MERS)
infection.
The
important points on which I wish to lay stress are related to an individual’s
allergic diathesis and to the availability of health-care for an alien
traveler. Patients of all types of
allergies need to be careful during travel.
The common belief that allergic problems will not be there in lesser
polluted Western countries is not true.
Allergic problems have no obvious relationship with levels of pollution,
they may get worse during travel. Many
forms of allergies including asthma, are rather more common in the least
polluted countries of Europe, Australia and America. The same is true for nasal, skin and eye
allergies.
It is also
true that allergic condition of an individual may sometimes get better during a
travel. An allergic patient may
temporarily feel better when removed from the surroundings in which he/she had
lived. But the effects during the period
of travel are unpredictable. It is
therefore, important to be careful. The
patient known to have allergies must be adequately prepared to deal with an
increased problem, in case that be so.
Availability
of health care is an important issue which must be addressed, especially in the
absence of known acquaintances in the region of travel. It is rather cumbersome for an Indian
traveler, accustomed to the easily available health advice in India, to seek
medical advice in a Western country. The
Western medical system is highly professional, costly and relatively difficult
to seek, especially for minor problems.
It is generally quite bothersome for a relaxing tourist to run to a
hospital for increased occurrence of sneezing, running nose, itching or
wheezing.
Health
insurance during travel is important to take care of severe problems and
emergencies. It is important to arm one-self
to handle a known problem, aggravated during a travel. One should therefore carry the extra and
additional medicine required for such a situation. It is always advisable to use an extra dose
or two in case of a need. It is however
important to seek local medical opinion in case of a persistent or a worsening
problem.
Travelers
are in no way immune to develop serious problems and/or accidents. Heart attacks, strokes, acute abdominal and
respiratory emergencies can happen during travel, to healthy individuals and
more so to patients with pre-existing chronic diseases such as hypertension,
diabetes or asthma. It is important to
seek early medical advice and/or hospitalization if necessary. The insurance cover to deal with such a
situation is almost mandatory.
There are a
few other area-specific problems which can be kept in mind. Sun burns are common in tourists to the Alps
in Europe in the presence of an intense sun-shine and unprotected skin. Similarly, the travelers to the African and
South American countries should be cautious about the regional kinds of insect
bites and endemic infection (e.g. yellow fever).
Constipation
is another common problem faced by Indian travelers. The food is usually deficient in fiber
content with a lot of junk food consumption.
Fluid intake is also poor and the regular schedule of eating and
exercising is missing. Though not
serious, the problem is quite troublesome.
Preventive steps are generally adequate for avoidance.
Awareness of
the possibilities of health risks and of the steps for their prevention will go
a long way to increase the joy of travel.
Non-essential travel should always be avoided during the periods of
epidemics in a particular country/ region.
Dr
Surinder K. Jindal, MD, FCCP, FAMS, FNCCP
(Ex-Professor
& Head, Department of Pulmonary Medicine
Postgrad
Instt of Med Edu & Res, Chandigarh, India)
Medical
Director, Jindal Clinics, SCO 21, Dakshin Marg, Sector 20 D,
Near
Guru Ravi Das Bhawan, Chandigarh, India 160020.
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