Plan Ahead before Travel

Dr. KWONG Wing Hun

Resident Medical Officer

Specialist in Family Medicine

No matter how eager you want to travel after three years of pandemic, you still need to plan ahead and prepare for your trip with extra care. A consultation with your doctor will definitely help you prepare well for any possible emergency.     

Advice for Travellers before Travel

1. Vaccination

While routine vaccinations are important, you may need more than influenza and COVID vaccines, e.g. those for hepatitis A, Japanese encephalitis and typhoid fever. You are advised to consult your doctor before travel for vaccine recommendations based on the travel destination, travel plan and other risk factors, as preparation differs widely with the hygiene condition and where you stay, i.e. rural areas or big cities. Doctors will also give advice based on such guidelines as the travel advice of the Department of Health (https://www.travelhealth.gov.hk/english/index.html）and the US’s Centers for Disease Control and Prevention (https://wwwnc.cdc.gov/travel/destinations/list）.

As some vaccines take time to take effect, you may need to get vaccinated well in advance of your trip. Vaccines like the hepatitis A and hepatitis B combined vaccine in accelerated schedule are given at 0, 7 days, 21 days and 12 months instead of 0, 1 month and 6 months to speed up the process.

2. Medication

Most travellers have standby medications at hand for common conditions like a cold, flu and diarrohea. Oral preventive medications may also be prescribed to those with chronic conditions depending on the destinations and infection risks.

Preventive medications for malaria may be needed if you are planning to go to the high-risk areas. Start taking the medications 1 or 2 days before leaving Hong Kong, and continue for a week after return. If you have access to high altitude during your trip and worry about altitude sickness, your doctor will also prescribe some anti-altitude sickness medications, which should be taken on the first day of ascent until 2 days after reaching the target altitude.

Medications are especially important for patients with chronic conditions. Check thoroughly (better with assistance from other family members) as to what medications you may need, and make sure you have more than enough before travel.

For those in need of treatment for their chronic illnesses, such as insulin injections for diabetes or renal dialysis, please consult your own specialist on medications for travel and their storage. Ask your family doctor or specialist to prepare a medication list or a simple medical record in case of medical consultation during travel. Mobile apps like “HA Go” of Hospital Authority are available to show the medical history and current medication. They are valuable sources of information in medical consultation in foreign countries. It is important for both patients and their companions to get familiar with the app before travel.

Advice for Travellers during Trip

1. Beware of Economy Class Syndrome

Economy class syndrome often occurs when one has to sit in the same position for a long time, i.e. long-distance plane or car travellers, resulting in reduced blood flow in the lower limbs and even deep vein thrombosis. Other high-risk factors include old age (over 60), overweight, pregnancy, cancer, blood clotting problems, etc. Patients may present with symptoms such as redness in the lower legs, fever, even a lethal pulmonary embolism if severe.

To prevent economy class syndrome, don’t forget to stand up, walk the corridor or go to toilet from time to time during long-haul flights or car travels.   Wear loose clothing and avoid consumption of too much alcohol or caffeine. Do not use sleeping pills during long-haul flights, as it encourages lower limb immobility and thus increases the risk of economy class syndrome.  

2. Beware of Traveller’s Diarrhoea

Common in places with poor hygiene, traveller’s diarrhoea is characterised by more frequent bowel movements and watery stools.

Generally speaking, traveller’s diarrhoea is often acquired through consumption of food and water contaminated with faeces. Examples of high-risk food are uncooked food, unboiled water and ice cubes. While mild symptoms can be treated by replacing the fluid and electrolytes lost, we should seek immediate medical attention in case of severe dehydration or fever, especially for babies and those with chronic illnesses.  

Another rule of thumb is to take good care of personal and food hygiene. Consume properly cooked food , and drink only boiled water or branded bottled/canned beverages. Also refrain from eating at street stalls or areas with poor hygiene.

3. Beware of Bedbugs

Now raging in countries such as France, the UK and South Korea amidst the post-pandemic tourism boom, bedbugs can lead to hives, itchy skin and even  allergic reactions in some patients with their bites. They can also travel and spread with luggage and clothes.

As bedbugs are less likely to attach themselves to rigid materials than to fabric, it’s better use hard-cased luggage during travel. Put your clothes in re-sealable vacuum plastic bags. After you check in, place your luggage on the table or the luggage rack in your hotel room. Do not open it on the floor, sofa or bed. Make a quick check of the mattress, sheets, headboards, pillows, bed frame, drawers and upholstered furniture in your room for shed skin pieces, eggs, blood spots and dead bedbugs. If you find any signs of bed bugs, call the hotel reception immediately for follow-up or simply demand another room. Do not scratch a bedbug bite as it may break the skin and increase the risk of infection. Try to clean it with cold water and soap, or use anti-inch cream for relief. Seek immediate medical attention if severe. You may be prescribed with a steroid-containing cream and oral antihistamine if necessary.