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Whatever their destination, whether they are jetting off to sunnier climes, exploring European cities or taking a ‘staycation’ in the UK, your customers need to be prepared for all manner of accidents and illnesses.

“When consumers think about ‘stocking up’ for their holidays, they will generally think about swimwear, sun cream, insect repellent and grooming before they come up with anything else,” says Michael Stewart, Numark’s information pharmacist. “However it’s vital that pharmacies ensure all their customers’ travel requirements are considered.”

The following A-Z travel health guide will help your pharmacy team ensure that customers are prepared for every eventuality.

Accident and health cover

If customers are taking out travel insurance, they should read the exclusions carefully. Standard policies may not cover pre-existing medical conditions or certain planned activities (e.g. extreme sports).

BBQs and buffets

Many harmful bacteria thrive in warmer climates, turning barbecues and summer buffets into potential health hazards. “Always wash your hands with soap and water or use alcohol hand gel before eating or preparing food,” says GP Dr Roger Henderson. “Avoid shellfish, undercooked meat and any food served in a buffet at room temperature. Avoid street vendors and don’t drink tap water; many people forget that tap water is also used for making ice cubes, washing salad and fruit.”

Condoms and contraception

Natika Halil, director of communications (health and wellbeing) at the FPA says it’s always a good idea to pack condoms as they are the only method of contraception that can protect against both pregnancy and sexually transmitted infections. Holiday stomach bugs can make the contraceptive pill or emergency hormonal contraception less effective, so condoms provide an essential back-up.

“It’s worth reminding people that condoms can be damaged by oil-based products such as moisturisers, sunscreen, baby oil and lipstick,” she says. “Heat can also be a problem, so if people are off to sunnier shores, condoms should be stored in a cool, dry place.”

Deep vein thrombosis

According to the Deep Vein Thrombosis (DVT) Awareness Campaign, around one in 2,000 people have a DVT each year in the UK. Typical symptoms are pain, tenderness and/or swelling of the leg, increased heat around the affected area and redness of the skin.

Research has shown that journeys of more than five hours by car, plane or train increase the risk of DVT four-fold. Customers can lower their risk by avoiding excessive alcohol intake, drinking plenty of water and exercising their calf and foot muscles regularly. Travellers at high risk (e.g. family history, previous DVT, heart or circulatory conditions or major surgery in the past three months) may be advised by their doctor to take anticoagulant medicines, in addition to wearing compression stockings.

Journeys of more than five hours by car, plane or train increase the risk of DVT four-fold

Eye protection

Polarised sunglasses (with a CE mark and/or the British standard BSEN 1836:1997) filter out harmful UV rays. If customers will be swimming, suggest they invest in a pair of swimming goggles to protect their eyes from water, chlorine, salt and UV rays.

Moisturising eye sprays can help to ease dry irritated eyes caused by air conditioning on long flights. If customers wear weekly or monthly contact lenses, they should ensure they take enough cleaning solution for their needs.

Foot health

During warm weather, feet are often exposed, leaving them vulnerable to irritation and injury. Cracked heels, which can be caused by open-backed shoes rubbing around the edge of the heel, can be prevented with a rich moisturising cream.

Athlete’s foot is a common fungal infection, spread easily in communal areas such as swimming pools and changing rooms. Most cases can be treated with OTC antifungal creams, sprays and powders. Customers with diabetes need to be especially careful if they are going barefoot, particularly if they have peripheral neuropathy (numbness or tingling in their feet), as they may not notice any damage. If they experience any foot problems, they should consult a podiatrist.

GI problems

When travelling abroad, the local delicacies, climate and stress can lead to digestive problems, such as diarrhoea, indigestion and constipation. “Diarrhoea is a common holiday illness, frequently caused by the food and drinks we consume while abroad,” says Dr Henderson. “It leads to the loss of body fluids and dehydration, which must be dealt with quickly.”

Customers should pack a selection of digestive remedies, especially if they are prone to certain symptoms. A laxative may ease acute constipation, but a high-fibre diet and drinking plenty of fluids will help in the long-term. Customers with diarrhoea may benefit from oral rehydration therapy. Medicines such as loperamide can be used for the short-term treatment of mild diarrhoea. (See also BBQs and buffets)

Hot weather advice

Most people welcome hot weather, but being too hot for too long carries health risks. Danger symptoms to watch out for in hot weather include feeling faint and dizzy, shortness of breath, vomiting or increasing confusion. Older people, especially those with chronic health conditions, and young children, are most at risk. Heatwaves can worsen air pollution, which may make asthma and hay fever worse. The Met Office Heat-Health Watch runs from June to mid-September every year.

Insect bites and stings

Mosquitos, midges and stinging insects such as wasps are a common holiday hazard, even in the UK, so it’s important that all holidaymakers pack suitable repellents (e.g. DEET-containing products) and bite and sting relief products. (See also Malaria)

Jet lag

Jet lag is worse when people move from west to east because the body finds it harder to adapt to a shorter day than a longer one. Alcoholic and caffeinated drinks (e.g. coffee, tea and cola) can disturb sleep and cause dehydration, which often makes jet lag worse. Customers who take medicines according to a strict timetable (e.g. insulin or oral contraceptives) will need advice on when to take these if they are travelling across time zones.

Kits – first aid and other supplies

Travellers should be advised to put together a basic holiday first aid kit containing items like plasters, bandages, tweezers, antiseptic creams/sprays and painkillers, as it may be difficult (or more expensive) to buy their usual brands at their destination.

Anyone travelling to a country with lower medical and hygiene standards is advised to carry their own needles and syringes in case they are admitted into a hospital that doesn’t have access to sterilised equipment.

Lyme disease

Transmitted by the bite of an infected tick, Lyme disease is rife in parts of the UK, Europe and North America. Although Lyme disease can cause flu-like symptoms, often the only sign is a distinctive rash, which gradually expands from the site of the tick bite to become a ring with a central clear zone, before spreading to other parts of the body. Most cases can be treated successfully with a course of antibiotics but, if treatment is delayed, the infection can spread to the joints, heart and central nervous system.

Malaria

There were over 1,300 imported malaria infections reported in the UK in 2012. This parasitic disease triggers fever, chills and flu-like illness. Symptoms usually appear seven days or more following the transmission of the infection from a mosquito bite.

In particular, malaria affects people travelling to visit friends and relatives, especially in Africa and Asia. In December 2013, travellers were reminded of the importance of taking antimalarial tablets before, during and after their trip after a British woman, who regularly travelled to the Gambia in West Africa, died, and her husband was taken seriously ill, as a result of failing to take their prescribed medication. (See also Insect bites and stings)

Travellers should be advised to put together a basic first aid kit

Nasal congestion (and ear pain)

Air travel is a common trigger of nasal congestion, which may be eased with conventional decongestants or natural saline sea water sprays. Flying with a blocked nose can make ear pain more likely. To relieve any ear pain, popping and discomfort during the take-off and landing, customers should be advised to chew gum, suck on hard sweets and/or use pressure-regulating earplugs.

Otitis externa

Otitis externa (swimmer’s ear) often occurs when water sits in the ear canal for long periods, providing the perfect environment for bacteria to grow. The ear becomes red, painful and swollen. While swimmer’s ear can be treated with medicated ear drops (containing antibiotics, antifungals and/or corticosteroids), it’s important to also wear a swimming hat or use ear plugs that stop water seeping into the ears.

Prescription medicines

Customers should pack plenty of their regular prescription medicines, even if they are only travelling within the UK. Air passengers should keep their medicines in their hand luggage, in case their checked-in luggage is lost or delayed.

“Taking prescription medicines abroad needs to be carefully planned well in advance because there are many countries that won’t allow certain medicines to be imported into the country,” says Numark’s Michael Stewart. “The obvious ones would be controlled drugs such as opiate-based painkillers – but it isn’t always as simple as that. If they find their medicine is listed, then it is essential they obtain a letter from their GP confirming that it has been prescribed for a specified medical condition and including formulation and dosage information to indicate what quantities the patient may need to carry with them.

“Some countries may require this letter to be translated and forwarded to the embassy prior to travel but it should also be carried on the person during travel.”

Quitting smoking

Holidays are an ideal time for customers to quit smoking, when they are out of their usual routine or can’t smoke on a long journey. Some countries have strict ‘no smoking’ laws in place, which can make it harder for people to light up while abroad. Nicotine replacement therapy can help to prevent withdrawal symptoms and make the quitting process more bearable.

Rashes and other allergic reactions

Allergies may occur when people are exposed to new insects, foods and pollens. Even strong sunlight can trigger an allergic-type reaction. Antihistamine tablets are effective against most allergies but customers should choose non-sedating products such as loratadine or cetirizine for daily use. Older antihistamines, such as chlorphenamine, provide immediate relief from acute mild allergic reactions. Anti-itch creams and emollients can help manage itchy skin rashes. If customers need to carry adrenaline injectors (e.g. for nut allergy), they should speak to their airline in advance and carry a letter from their GP.

Sun protection

According to Cancer Research UK, over 8 out of 10 melanoma skin cancers in the UK (around 11,100 cases every year) are linked to too much exposure to UV rays from sunlight or sunbeds. Customers should be careful about protecting their skin from sunburn during the hottest part of the day (usually 11am to 3pm). For instance: spend time in the shade; wear loose clothing, a wide-brimmed hat and good quality sunglasses; and regularly reapply sunscreen with a high SPF (15+). (See Sun Safety feature)

Travel sickness

If customers are prone to travel sickness, advise them to sit in the front seat of the car and focus on a non-moving object in the distance, such as the horizon. They should avoid reading or texting, as this will make them feel worse, and should dress in layers that they can take on and off depending on the temperature. Regular breaks to stretch the legs and get some fresh air are important.

Whatever the form of transport, travel sickness can be prevented with OTC remedies, such as antihistamines, but forward planning is essential as many remedies need to be taken before the journey. Some travel sickness tablets can cause drowsiness.

UK festivals

Music festivals are one of the highlights of the British summer, attracting hundreds of thousands of fans of all ages every year. Many festival-goers, especially teenagers, may not think of possible health hazards. Cuts and grazes, stomach upsets, hangovers, dehydration and viral infections can be common occurrences.

Vaccination

Customers travelling long-haul should think about their health needs four to six weeks in advance, especially if they need any vaccinations. They should call their GP or practice nurse to find out whether their existing UK jabs are up to date. Other vaccinations will depend on which country customers are visiting, as well as when they are travelling, where they are staying and what they plan to do during their travels. The latest requirements for different countries can be found at www.fitfortravel.scot.nhs.uk and www.nathnac.org. Some countries, especially in Africa and South America, require travellers to have an International Certificate of Vaccination or Prophylaxis (ICVP) before they enter.

World Cup 2014

The 2014 FIFA World Cup is scheduled to take place in Brazil from June 12 to July 13. According to Public Health England, there are 12 stadiums up to 2,000 miles apart and the risk of yellow fever and malaria varies between them. Measles has been reported in Brazil and large gatherings such as sporting events can encourage transmission. Customers must make sure they have a yellow fever vaccination before they travel if they are visiting the state of Amazonas [see Yellow fever]. They will also need to take antimalarials [see Malaria]. Dengue fever is rife in several states of Brazil, so practical measures to avoid mosquito bites (e.g. insect repellents and mosquito nets) are necessary.

e-X-ercise safely...

Some people exercise more regularly on holiday, visiting the hotel gym or taking advantage of water sport facilities. Oral and topical analgesics and hot and cold therapy products should be packed in case injuries occur. If customers are exercising in hot weather, it is important that they stay well-hydrated and eat snacks regularly to keep their strength up.

Yellow fever

Yellow fever is a potentially fatal viral infection that mainly occurs in sub-Saharan Africa, South America and parts of the Caribbean. It is the only disease for which countries may require proof of vaccination as a condition of entry under international health regulations. Vaccinations are only available from designated vaccination centres and must be given at least 10 days before people travel.

Zzzzzz..... sleep problems

An unfamiliar mattress, noisy hotels and too much alcohol or rich food can trigger temporary insomnia. If customers find it difficult to sleep, they will need to re-establish a regular sleep routine. OTC sleep aids, containing sedating antihistamines or herbs such as valerian, may help in the short-term.