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Precautions to take when travelling

Holidays should be fun, not painful - here are measures to deal with any ailments or situations which may arise during your trip

Travelling overseas for a holiday, especially to affordable and convenient neighbouring countries in South-east Asia, has become a quintessential part of many Singaporeans' lives, but they are not without health risks.

To avoid ending up with more pain than joy, here is what you need to know about common ailments and situations which may arise during a vacation and what necessary precautions and measures you should take.


Travellers' diarrhoea is the most common illness contracted abroad, affecting some 50 per cent of overseas travellers.

This infection is usually caused by bacteria in the majority of cases, while viruses and parasites make up the rest.

The prevalence of street food and less-than-satisfactory food-handling practices in some countries may present an increased risk. Symptoms may present as early as a few hours from exposure or a few days after, and can include stomach cramps, nausea, diarrhoea, bloating, vomiting, fever and malaise.

Avoiding raw foods, salads, ice and ice cream, and drinking bottled water or drinks instead of tap water are some ways to minimise your risk.

If you do get these symptoms, you can try some over-the-counter anti-diarrhoea medications such as charcoal or prescription medications such as loperamide for diarrhoea and buscopan for the cramps.

If you do have fever, body aches or headaches, some antipyretic medications like paracetamol can help you feel better.

The most important thing about the treatment of diarrhoea is hydration. Oral rehydration salts work better than isotonic drinks in this aspect.

If you are feeling extremely unwell, feel your symptoms are intolerable, or are unable to hydrate yourself due to continuous vomiting or diarrhoea, seek medical attention immediately.

There are some other more serious diarrhoeal diseases like typhoid and cholera, which may be life-threatening in some cases.


Over the counter medications can ease your common cold symptoms such as runny nose, sore throat, cough, fever and nausea, which usually abate within the week. The best thing you can do is to keep your immunity up and you will be less likely to catch a cold on a holiday.


Dengue is one of the most serious and endemic mosquito-borne diseases in South-east Asia.

Symptoms usually present within a week and can include high fever, headaches, flu-like symptoms and a skin rash.

Most cases are fairly mild and most people are able to get past the infection without any serious complications.

However, some may develop dengue haemorrhagic fever and dengue shock syndrome which may lead to a dangerous drop in blood pressure and death.

There is no real treatment for the dengue virus, but the purpose of the treatment is for symptomatic relief and supportive management.

Paracetamol and copious hydration are encouraged.

Should you start having bleeding gums or severe abdominal pain or are feeling very unwell, seek medical attention immediately.

Other infections like malaria, which can be life-threatening, are seen more frequently in travellers visiting forested areas, but you can still get the disease in cities.

Malaria usually causes a fever, headache, nausea and vomiting, muscle aches and fatigue. The fever may be high and start with chills and rigors. This may be followed by sweating as the fever declines. However, not everyone will follow this pattern.

Malaria can be prevented by chemoprophylaxis (taking anti-malarial medications) before travelling to the area. Check with your doctor if you are suitable for it.

It can also take a while for symptoms to show, sometimes a few weeks after the mosquito bite. If you are back from your travels and do develop such symptoms, tell your doctor about your travel history.

Other less common mosquito-borne diseases seen in South-east Asia include chikungunya, Japanese encephalitis and lymphatic filariasis.

Sandfly-borne disease (kala-azar) and snail-transmitted disease (like schistosomiasis) are possibilities as well.

Reduce your risk by using insect repellent with DEET or picaridin on exposed skin when you are outdoors, or wearing long-sleeved tops and pants.

Lemon eucalyptus oil can also provide protection similar to products with low concentrations of DEET.


Travelling to different countries exposes you to different cultures and foods, but the most common allergy is from food.

Food allergies can present with itching of the eyes, mouth and throat, puffy eyes, a rash (hives), swelling of the lips, face, tongue and throat or other parts of the body.

More serious food allergies may cause swelling of the throat, leading to difficulty in breathing, wheezing, giddiness, abdominal pain, diarrhoea, nausea or vomiting, or loss of consciousness.

Simple allergies can be treated with over-the-counter antihistamines, while more serious allergies have to be treated by a medical professional immediately as they can lead to death.

Environmental allergens may worsen pre-existing conditions like asthma and allergic rhinitis, so remember to bring your regular medications for your allergic conditions and your rescue therapy for asthma as well.

Bee and wasp stings may afflict travellers at the countryside and forested areas of South-east Asia. In most people, these stings result in pain and swelling for a few days. But for a certain group, a bee sting allergy can kill them.

If you see or hear a bee hive, avoid it. Should you already be stung and feel unwell, faint or short of breath, seek medical attention immediately.


While infectious diseases play a role in only 5 per cent of visitor deaths, half the visitor deaths in Asia are the result of road accidents. Avoid jaywalking and riding scooters or motorcycles if you are inexperienced, and always be aware of your surroundings.

Even if you are involved in a minor road traffic accident, it is still important for a doctor to assess you to make sure there are no injuries to the internal organs or injuries that are not visible to the naked eye.


Thirty per cent of the traveller deaths are due to heart attacks. If you have heart problems, get thoroughly evaluated if you are fit for travel before booking your flight and ensure you have your long-term medication and prescriptions with you.

Travel can be stressful on the mind and body, which can lead to an increased chance of a heart attack if you have existing cardiac conditions. If you have a history of fainting spells, low blood pressure or seizures, avoid water activities, hot springs and saunas, and activities in high and precarious places.

* The writer is a resident doctor at DTAP Clinic Holland Village.