It’s that time of year again. The long school holidays
are here and most of you will be packing your bags to head
off for the far and not so far places. Whether you are boarding
a 747 for a 26 hour flight, or hoping on a motor bike and
heading for the hills, certain precautions need to be taken
to ensure that your recreation does not end up in commiseration.
Here are few questions that have been thrown my way in the
lead up to this year’s break.
Q. I am 3 months pregnant and plan to go to the East Islands
for a weeks holiday. Is there any form of malaria prophylaxis
that is safe for pregnancy?
A. Unfortunately there are no malarial prophylactics that
are safe for pregnancy. Other considerations are that for
some reason pregnant women seem to attract the mosquito more
than non-pregnant women. This is possibly because pregnant
women have a higher metabolism (more body heat produced),
and are there fore more easily targeted by the mosquito. Aside
from being an easier target, pregnant women also seem to suffer
more severely and have a longer recovery time if malaria s
contracted. There is a high risk of miscarriage due to this
disease.
My advise is that if you really want to go on this holiday,
that you research the areas that you will be visiting before
hand, and find out if Malaria is currently an issue. Choose
accommodation that has a mosquito control program in place
(these will probably be the pricier resorts). Take all the
other precautions that you can such as wearing a repellant
late in the afternoon and at night; spray your room with a
good knock down spray before you retire; wear loose light
colored long sleeved clothing and avoid the use of perfumes.
If all this seems a little too daunting find somewhere else
for your holiday.
Q. I am a 65 year old mild asthmatic, and I will travel through
Europe with my grandchildren this summer. Do you recommend
that I receive the “flu” vaccine before I travel?
I had this vaccine only 9 months ago, should it not be still
effective?
A. As you are now in your senior years, and with your asthmatic
condition you should definitely get this vaccine before you
travel this year. The vaccine that you received last year
is likely not to be the same vaccine that is issued this year.
The influenza virus mutates and causes a new epidemic each
year. Better to check your vaccination to find out what kind
of flu vaccine that you had last year. If this years strain
is available here now I would certainly opt to protect yourself
before you leave. Once you have had the vaccine, it will take
several weeks for your antibodies to rise to a sufficient
level. Best then to get this vaccine at least a fortnight
before your travels.
Q. My flight to the States next month is a very long one,
and I am taking my two and a half year old son with me. My
friend told me that there is a sleeping syrup that I can get
to settle him during the flight. What is the name of this
syrup?
A. Hmmmm. Sounds attractive. A sound sleeping child on a
very long and tedious journey. Unfortunately the medication
that is commonly used for sedation (antihistamine syrups),
can often have the opposite effect. The child may react by
becoming hyper-active! Wouldn’t that turn your dream
flight into a nightmare journey! I suggest that you take a
lot of activities to do with him. Invest in some new games
or toys that will get his attention and bring them out one
at the time, not all at once as he will quickly become bored.
Don’t have unrealistic expectations about him sleeping
for 15 hour stretches. Children just don’t do that in
the air or on the ground. Flying, especially for the first
time is a very exciting adventure for a child and he is likely
to want to see and experience everything. Sleeping will probably
be the last thing on his mind. If you are lucky the cabin
staff may delight in taking this little fellow off your hands
for a short while.
Q.We are planning an African safari for the holidays this
year. One of the requirements before we are allowed to enter
the country is vaccination against yellow fever. I have asked
around at several clinics and no one seems to be able to help
me with this? What am I to do as the certificate of vaccination
must be shown on entry?
A.Yellow fever vaccine is only permitted to be administered
by centers that are authorized to do so. These are usually
government run health centers, and in Bali the airport clinic
(Kantor Kesehatan Pelabuhan, Ngurah Rai Airport) is the only
center that is authorized to issue this vaccine.
Q. I am going to Thailand for my holidays. What precautions
/ vaccines do I need to take?
A. More information please! To give the correct advice on
travel, a full medical history, as well as all aspects of
the intended travel needs to be taken into consideration.
How long will you be there? How old are you? Are you male
or female? Married or single? Do you travel overseas frequently?
What level of accommodation will you take? What activities
will you partake in? All these things will affect the advice
that your travel health consultant gives you. If you are not
asked these questions by the person that is advising you on
your travel health, then you are talking to the wrong person.
Some web-sites (cdc, traveldoctor) will do an on-line questionnaire
that may assist you.
Q. My 10 year old daughter seems to suffer terribly from
ear pain when ever we take off or land in a plane. My friend
says I should use nose drops before the flight to help prevent
this. I don’t understand why drops in the nose can help
pain in the ears? If my friends advise is correct, what kind
of nose drops should I use?
A. Your friend is correct in her advice that nose drops will
help ear pain during the flight. Pain in the ears is caused
by changes in the cabins air pressure as the flight ascends
or descends (pressure gets less as you ascend, and increases
as you descend). The pressure of the air in the middle chamber
of the ear (between the ear drum and the inner ear) is usually
adjusted by air escaping in or out of a fine tube that connects
the middle ear to the back of the nose. In children the size
and the angle of the tube can make it difficult for air to
pass freely in or out of the ear chamber. If the child (or
adult) has a head cold with thick mucous, this can also block
the tube.
Ways that you can encourage the ears to “pop”
are yawning, chewing (or if the child is an infant, breast
or bottle feeding during landing or take off), pinching your
nose and gently trying to blow out through the nose (valsava
manouvre), or sucking on strong mint candies. If your daughter
is known to have a problem, especially if head cold symptoms
are present, then using nasal decongestant drops to open up
the nasal passages about 20 minutes before the flight would
help. Your doctor or pharmacist will tell you which ones are
appropriate. Using a menthol inhaler (Vicks stick) may also
be of some assistance.
That’s all for this edition, have a safe and happy holiday,
where ever your travels may be, and remember...stay happy,
stay healthy and stay young!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
