Travel Health

From organising travel insurance and vaccinations to preventing DVT and jet lag, here’s what to think about before you travel.

Travelling abroad is exciting, but with so many things to see and do when you get there, the basics of health and safety are often neglected.

Every year, people living in the UK go on more than
60 million trips abroad. Most have a safe trip, but some people get ill or have an accident and need medical treatment while they’re away. 

Travel vaccinations

Start preparing for your trip four to six weeks before you go.

Read the latest health advice for the country you’re travelling using NATHNAC’s interactive world map, and check the travel safety updates with the Foreign & Commonwealth Office.

You may need travel vaccines or, if diseases such as malaria are a risk, you may need to start protecting yourself well in advance.

Prepare a kit of travel health essentials, including sunscreen, medications, painkillers, antiseptic, insect repellent and anti-diarrhoea pills. These will be useful wherever you’re going.

Sexual health experts advise taking condoms with you to avoid the risk of buying fake, and potentially unsafe, brands when you get there.

“Make sure your vaccinations are up to date and check whether you need any extra travel vaccines depending on your itinerary,”

Says Lynda Bramham, senior nurse advisor for Medical Advisory Services for Travellers Abroad (MASTA). 

Travel kit checklist

• antiseptic
• sunscreen
• after sun lotion
• insect repellent
• condoms
• antihistamines
• anti-diarrhoea pills
• rehydration sachets
• first aid kit

For more on what to pack to stay safe and healthy abroad, go to Travel health essentials.

Sun protection

Skin cancer is one of the most common cancers in the UK, and it’s a growing problem. Each year, around 2,600 people die from skin cancer. 

Skin cancers are caused by damage from the sun’s ultraviolet (UV) rays. Protecting the skin from the sun can help prevent these cancers.

Whether you’re on holiday or at home, you can protect yourself by following Cancer Research UK’s SunSmart messages:

• Spend time in the shade between 11am and 3pm.
• Make sure you never burn.
• Aim to cover up with a T-shirt, hat and sunglasses.
• Remember to take extra care with children.
• Then use factor 15 or more sunscreen.

Report any changes to moles or any unusual skin growths to your GP.

Always take special care of children’s skin. The best way to do this is to cover them up and keep them in the shade. For more information, read the Sun safety Q&A.

TRAVEL INSURANCE

Whether you’re off on a six-month trek to the Himalayas or a family holiday in Spain, it’s vital to have the right travel insurance.

Make sure your policy covers your destination and the duration of your stay, as well as any specific activities you might do. For example, don’t assume your winter sports policy will cover off-piste skiing.

When travelling in Europe, make sure you have a valid European Health Insurance Card (EHIC). This will entitle you to free or reduced-cost medical care. However, the EHIC won’t cover you for everything that travel insurance can, such as emergency travel back to the UK.

DVT AND JET LAG

If you think you may be at risk of developing deep vein thrombosis (DVT), seek advice from your GP.

On long-haul flights, get up from your seat to walk around and stretch your legs whenever you can. Drink regularly but avoid alcohol. Wear loose, comfortable clothes. There is evidence to suggest that compression stockings are effective in reducing the risk of developing DVT.

To get over jet lag quickly, adjust to your destination as soon as possible.

“Set your watch to the time at your destination as soon as you board the plane and try to eat and sleep according to appropriate times in your destination,” says GP Dr Dawn Harper.

Get the right travel vaccinations and follow the advice below to reduce your risk of common infectious diseases.

Travel health experts advise preparing for a trip four to six weeks before you travel, especially if you need vaccinations.

“Vaccination is just one element of protecting yourself from infectious disease,”  Says Professor David Hill, National Travel Health Network and Centre (NaTHNaC) director.

UK residents visiting their country of origin should also be vaccinated as any immunity they may have built up previously in their native country will have reduced over time.

Water and food safety abroad

Many infectious diseases are transmitted through contaminated food and water, and insect bites.

You can reduce your risk of these diseases by following some basic guidelines:

• Don’t drink tap water or use it to brush your teeth in countries with poor sanitation. Use filtered or bottled water instead.
• Don’t put ice in drinks. Bottled fizzy drinks with an intact seal are usually safe, and so are boiled water and hot drinks made with boiled water.
• Don’t eat salads, uncooked fruits and vegetables unless you’ve washed and peeled them yourself.
• Don’t eat food that has been kept at room temperature in warm environments, or that has been exposed to flies.
• Don’t consume unpasteurised milk, cheese, ice cream and other dairy products, or raw or undercooked seafood.

“You should only eat freshly prepared food that is thoroughly cooked and served piping hot,” says Professor Hill.

Avoiding insect bites

• Try not to go to areas that are highly infested with biting insects. 
• Malaria mosquitoes bite between dusk and dawn, so being indoors during these hours can reduce the number of bites.
• Research shows that products containing the chemical DEET are the most effective insect repellents and are safe when used correctly.
• Mosquitoes can bite through tight clothing, so wear loose-fitting long trousers and long sleeves in the evenings in malaria hotspots.
• Sleep under a mosquito net to avoid being bitten at night. Carry a small sewing kit so you can repair any holes that develop. 

Travellers’ diarrhoea (TD)

Travellers’ diarrhoea is the most common illness in people travelling from the UK to developing countries. TD is caused by eating or drinking contaminated food or water. Foods most likely to cause TD are those that have not been thoroughly heated or that have been left out at room temperature.

You can reduce your risk of TD by following good food and water hygiene practices. If you develop TD, drink regularly to avoid dehydration. In most cases, TD will only last a few days but you may want to pack medications. 

Find out more about preventing diarrhoea.

Malaria

Malaria is a serious and sometimes fatal disease that is common in tropical countries. It is spread by night-biting female mosquitoes carrying a parasite called plasmodium. About 1,750 people a year return to the UK with malaria. Most of them catch it because they didn’t take any tablets or didn’t take the right ones for the areas they visited.

See your GP or go to a travel clinic for specific advice and the correct tablets for the country you’re visiting before you travel. Avoiding mosquito bites will also reduce your risk.

Traveller Alex Cheatle tells how he learned the hard way when he decided to stop taking his malaria tablets during a round-the-world trip. Read Alex’s story.

Find out more about preventing malaria.

Dengue

Dengue is a virus that is spread by an infected Aedes mosquito, which usually bites during the day. Dengue is a risk in areas such as Southeast Asia, the Caribbean and South America. The best way to avoid infection is to avoid mosquito bites.

Symptoms include fever, headache, muscle and joint pain and, in some cases, a rash. The illness usually lasts a few days and serious complications are uncommon. There is no specific anti-viral treatment. Symptoms such as fever and headache can be treated individually.

Find out more about dengue.

HIV and STIs

Unsafe sexual behaviour can expose travellers to HIV and sexually transmitted infections (STIs), such as gonorrhoea, chlamydia or syphilis. Drinking too much alcohol may decrease your inhibitions and make you more likely to have unsafe sex. 

Avoid sex with a new or unknown partner, and always use condoms. The condoms you can buy in developing countries may not be reliable, so buy them in the UK and take them with you.

Find out more about STIs.

Hepatitis A

Hepatitis A is caused by a virus. It is caught through food or water that has been contaminated by human faeces. Foods that grow close to the ground, such as strawberries and lettuce, are particularly risky. Crustaceans that feed on the seabed, such as oysters and clams, are also a risk.

Infected people can pass on the virus if they don’t follow proper hygiene practises. Early symptoms include weakness, loss of appetite, nausea and fever, followed by the onset of jaundice. Highly effective hepatitis A vaccines are available and should be considered by most travellers.

Find out more about preventing Hepatitis A.

Hepatitis B

Hepatitis B is caused by one of the most common viruses worldwide. It is a major cause of chronic liver disease and liver cancer. Symptoms include flu-like complaints, loss of appetite, nausea, diarrhoea, abdominal pains and jaundice.

The virus is spread through sexual intercourse, blood transfusions, contaminated needles (including tattoo needles) and poorly sterilised medical and dental equipment. High-risk regions include sub-Saharan Africa, Southeast Asia and the Pacific islands. A vaccine is available for those at risk of hepatitis B.

Find out more about hepatitis B.

Typhoid

Typhoid is a potentially fatal disease caused by the bacteria Salmonella typhi. Typhoid is acquired through contaminated food or water in areas with poor sanitation. The Indian sub-continent has the highest incidence of typhoid.

Symptoms include sudden fever, severe headache, nausea, abdominal pain, loss of appetite, constipation or diarrhoea. Vaccination is recommended for travellers visiting high-risk areas.

Find out more about preventing typhoid.

Yellow fever

Yellow fever is a viral disease that is transmitted by infected mosquitoes in tropical regions of sub-Saharan Africa and South America. Early symptoms include aching, fever, headache, loss of appetite, nausea and vomiting. In severe cases, this can lead to organ failure and death. The disease is preventable by vaccination and is rare in travellers. Some countries require you to be vaccinated against yellow fever as a condition for entry.

Find out more about preventing yellow fever.

Rabies

Rabies is caused by a virus that attacks the central nervous system. When it reaches the brain, it causes swelling, inflammation and death. The virus is found in the saliva of infected animals, including dogs and bats, and is passed to humans by bites or scratches.

Africa, Asia and South America are rabies risk areas. Vaccination is advised before you travel to high-risk areas. If you get a bite or scratch from a potentially infected animal, wash the wound with soap and water and seek urgent medical care.

Find out more about preventing rabies.

Meningitis

Meningitis is the swelling of the lining around the brain and spinal cord, which is caused by different types of germs. Early symptoms include fever, headache, nausea and vomiting, just like many mild illnesses. The germs, which are present in the nose and throat, can be passed from person to person by close and regular contact through coughing, sneezing and kissing.

Meningitis risk areas include sub-Saharan Africa, where there are annual outbreaks. Vaccines are available to travellers visiting high-risk zones, although the risk of meningitis for tourists is low. Vaccination against meningitis is a requirement for pilgrims attending the Hajj or Umrah in Saudi Arabia.

Find out more about preventing meningitis.

With expert advice on what to pack, including first aid essentials, you can stay safe and healthy abroad.

For every travel kit:

• Sunscreen
  Choose sunscreen with a sun protection factor (SPF) of at least 15. The higher the SPF, the better the protection. Buy sunscreen labelled “broad-spectrum”. This means that it protects against both UVA and UVB rays. Don’t use creams that are past their expiry date. Most sunscreens have a shelf life of two to three years.
• First Aid Kit
  For minor injuries, use antiseptic with gauze squares, non-adherent dressings, bandages, fabric plasters, adhesive tape, scissors, tweezers and safety pins and tick removers. You can buy bottles or sprays of standard antiseptic such as TCP from all major chemists, or get ready-prepared antiseptic wipes. A first aid kit may be useful if you’re going off the beaten track or taking part in high-risk activities.
• Insect Repellent
  Mosquitoes usually bite between dusk and dawn, and are attracted to humans by our body heat, smell and the carbon dioxide we breathe out. Research shows that products containing the chemical DEET are the most effective insect repellents and are safe when used correctly. DEET products are available in sprays, roll-ons, sticks and creams. Your GP or travel health clinic will tell you whether the area you are going to is malarial and what protection is advised.
• Condoms
  Condoms are recommended for everyone who is sexually active. Buy condoms with the CE mark on the packet. This means they have been tested to the high safety standards that are required in Europe. Condoms that don’t have the CE mark won’t meet these standards, so don’t use them. Condoms can be damaged by oil-based products, such as suntan lotion, baby oil and lipstick. Heat can also cause damage, so store them in a cool, dry place. For more information on using male and female condoms, see How to use a condom.
• Antihistamines
  Over-the-counter antihistamines can reduce itching and inflammation caused by allergies and insect bites. Antihistamines are available as tablets (oral antihistamines), creams (topical antihistamines) and nasal sprays. Antihistamines work by blocking the effects of a protein called histamine.
• Anti-diarrhoea Pills
  Anti-diarrhoea drugs, such as loperamide, can relieve symptoms of diarrhoea by slowing down the movement of bowel contents and sometimes by increasing water absorption from the gut. Loperamide can be taken once or twice a day, over a long period. However:
  • Do not take anti-diarrhoea drugs if there is blood in your stools or if you have a high temperature (check with your pharmacist). 
  • Do not give anti-diarrhoea drugs to your child.

Travel in the developing world:

• Rehydration Sachets
  Rehydration sachets help replace fluids and salts lost through diarrhoea, vomiting and too much sun. You can buy sachets of rehydration salts from your pharmacy and add them to water. They provide the correct balance of water, salt and sugar. Your doctor or pharmacist may also recommend rehydration drinks for your child, if you are worried they may become dehydrated. Do not use homemade salt or sugar drinks. Always consult your pharmacist.
• Mosquito Net
  A mosquito net is vital for sleeping in malarial countries. When buying a net, make sure it is impregnated with permethrin. Permethrin is a contact insecticide, which will kill insects landing on the net and, therefore, increase the net’s effectiveness. Generally, nets will need to be impregnated again with permethrin after six months of use. Carry a small sewing kit so you can repair any holes that develop in the net.
• Anti-Malarial Drugs
  Visit your GP, pharmacist or practice nurse four to six weeks before you leave to find out what malarial cover you’ll need. They will also have up-to-date advice about the cover you need, and which strains of malaria are resistant to which drugs.
• Emergency Medical Supplies
  Kits available from pharmacies, including sterilised and sealed syringes, sutures and needles, can be useful when visiting developing countries, where hospitals and dentists may not have properly sanitised equipment.

Many illnesses, including travellers’ diarrhoea, hepatitis A, typhoid and cholera are contracted through contaminated food and water.

Travellers’ diarrhoea is the most common illness contracted abroad, affecting 20-60% of overseas travellers.

In countries where sanitation is poor, you can reduce your risk of such diseases by following these basic guidelines.

DRINKING WATER ABROAD

In countries with poor sanitation, don’t drink tap water or use it to brush your teeth unless it has been treated. For information about sanitation levels in the country you are travelling to, visit the National Travel Health Network and Centre (NATHNAC).

Filtered, bottled, boiled or chemically treated water should be used.

Bottled fizzy drinks with an intact seal are usually safe, as are boiled water and hot drinks made with boiled water. Ice in drinks should be avoided.

The most reliable way to purify water is by boiling it, but this is not always possible.

Chemical disinfectants, such as iodine and chlorine, will usually kill bacteria and viruses and can easily be obtained from larger chemists or specialist travel shops.

However, some parasites are not reliably killed with iodine or chlorine preparations. Combining iodine or chlorine with filtration using a specialist filter (bought from a travel shop) should be effective.

Domestic water filters designed for use in the UK are not suitable.

FOOD ABROAD

Some developing countries use animal waste as fertiliser. Certain foods, especially those growing close to the ground, are particularly prone to contamination and should be avoided.

Foods to avoid

• salads, such as lettuce
• uncooked fruits and vegetables, unless they have been washed in safe water and peeled by the traveller
• fresh or cooked food that has be allowed to stand at room temperature in warm environments, or that has been exposed to flies, such as in an open buffet
• unpasteurised milk, cheese, ice cream and other dairy products
• raw or undercooked shellfish or seafood
• food from street traders, unless it is has been recently preparedand is served hot on clean crockery

Food served in good-standard hotels or restaurants may not always be safe as it may have been contaminated during preparation. Try to pick places to eat that have a reputation for serving safe foods.

As a rule, only eat freshly prepared food that is thoroughly cooked and served very hot.

Always wash your hands after going to the toilet and before preparing or eating food. See Health A-Z: preventing food poisoning for more information about food hygiene.

If you’re travelling on a long-haul flight, there are several ways you can reduce your risk of getting deep vein thrombosis (DVT).

Travel-related deep vein thrombosis was first reported in 1954 in a 54-year-old doctor who developed a blood clot following a 14-hour flight.

The condition was soon dubbed “economy class syndrome” by researchers, who believed that there was a link between DVT and long-haul air travel in cramped conditions.

The actual number of people who get DVT from travelling on long-haul flights is unknown and is difficult to determine, as the condition can be symptomless and may not occur for some time after travel.

However, there is some evidence to suggest that certain groups of people, such as pregnant women or anyone who has had a stroke, are at increased risk of developing DVT on flights of eight hours or more.

DVT high-risk factors:

• history of DVT or pulmonary embolism
• cancer
• stroke
• heart disease
• inherited tendency to clot (thrombophilia)
• recent surgery (pelvic region or legs)
• obesity
• pregnancy
• hormone replacement therapy

If you think you have a risk of developing DVT, see your GP before you travel.

DVT occurs when blood flows too slowly through the veins. The blood forms a clot that blocks up deep veins, usually in the legs. 

DVT doesn’t generally have any immediate symptoms, making it difficult to spot. However, typical signs include a swollen or painful calf or thigh, paleness and increased heat around the affected area.

If left untreated, people with DVT are at risk of developing a pulmonaryembolism, when part of the blood clot breaks away and travels to the lung, which can be fatal.

Read a traveller’s experience of getting DVT from flying.

BEFORE YOU TRAVEL

If you think you have a high risk of developing DVT, see your GP before you travel.

You may be prescribed blood-thinning drugs to lessen the risk of your blood clotting, or compression stockings (also called flight socks).

Studies have concluded that airline passengers who wear compression stockings during flights of four hours or more can significantly reduce their risk of DVT as well as leg swelling (oedema).

The below-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. Class 1 stockings (exerting a pressure of 14-17 mmHg at the ankle) are generally sufficient.

It’s vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT.

Flight socks are available from pharmacies, airports and many retail outlets. Take advice on size and proper fitting from a pharmacist or other health professional.

RECOVERING FROM DVT

If you have recently had DVT you are probably taking medication, such as warfarin, to prevent the formation of blood clots.

If that’s the case then your risk of developing DVT is low and there is no reason why you can’t travel, including long-haul.

However, if you’re still in the recovery phase, you should get the all-clear from your consultant before travelling. You should also follow the general DVT prevention advice for high-risk travellers listed below.

WHILE YOU’RE TRAVELLING

If you are planning a long-distance plane, train or car journey, ensure that you:

• Wear loose, comfortable clothes.
• Consider buying flight socks (compression stockings).
• Store luggage overhead so you have room to stretch out your legs.
• Do anti-DVT exercises. Raise your heels, keeping your toes on the floor, then bring them down. Do this 10 times. Now raise and lower your toes 10 times. Do it at least every half an hour (you can do it more often if you like).
• Walk around whenever you can.
• Drink plenty of water.
• Don’t drink alcohol or take sleeping pills.

Having asthma should not prevent you from travelling and enjoying your holidays.

Planning ahead is key to having a great time away and dealing with any potential problems with your asthma.

Health experts advise preparing for a trip four to six weeks before you travel.

Things to consider as part of your preparation include:

• health check
• asthma triggers
• air travel
• travel immunisation
• travel insurance

Health check

See your GP or asthma nurse before you travel to review your personal asthma action plan and to make sure it’s up to date.

If you don’t have a personal action plan, now is the time to get one. It will allow you to recognise deteriorating asthma and alter your treatment to stay well.

Find out how you can get medical help (such as a local ambulance or doctor) if necessary at your destination.

Take spare inhalers in case of loss or theft. These can usually be carried in your hand luggage.

Bring enough medicine to last throughout your trip plus a few extra days.

Take a print-out of your regular prescriptions, including the generic names of medicines, in case you need medical assistance during your trip or your medication is lost.

For information, read Asthma UK’s travelling with asthma.

Asthma triggers

If being exposed to feather pillows makes your asthma worse, you could bring your own non-feather alternative or ask your hotel for a pillow with synthetic filling.

If you’re sensitive to tobacco smoke, ask your accommodation provider whether you should book a non-smoking room as smoking rules vary from country to country.

Some holiday activities, such as scuba diving, may be hazardous to people with asthma, and special considerations may apply.

Ensure your asthma is fully controlled as exposure to allergens and viral infections in confined spaces, such as planes and ships, may make your condition worse.

Air travel

If you’re always short of breath, even when resting, you may need a special evaluation before you fly because of the reduced oxygen levels at high altitude.

Carry all your asthma medicines as hand luggage, in case your checked-in luggage goes missing or your medicines are damaged in the baggage hold.

Under current security restrictions, you cannot carry containers with liquids, gels or creams that exceed 100ml in your hand luggage.

You can carry essential medicines of more than 100ml on board, but you’ll need prior approval from the airline and airport and a letter from your doctor or a prescription.

All asthma medicines taken on board should be in their original packaging, with the prescription label and contact details of the pharmacy clearly visible.

For more information, read the British Lung Foundation’s advice on air travel with a lung condition.

Travel immunisation

Your GP or practice nurse can tell you what vaccinations and precautions you need to take for the country you’re travelling to.

You can have the usual travel jabs that are recommended for your destination, unless there are other health reasons for not having them.

Tell your GP or practice nurse if you have recently used high-dose oral steroids before you have any vaccinations.

Asthma and its treatment don’t usually interfere with malaria tablets.

Travel insurance

Take out travel insurance and check that it will cover your asthma. Many insurers ask you to get permission from your GP before you travel.

Shop around for the best deal. Travel insurance quotes vary depending on your age, medication and destination.

For travel in Europe, make sure you have a European Health Insurance Card (EHIC). This entitles you to reduced-cost and sometimes free medical treatment.

Take out travel insurance as well because an EHIC may not cover all the costs of your treatment. An EHIC doesn’t cover the cost of being flown back to the UK.

See the Asthma UK website for more information on finding travel insurance if you have asthma.

Travelling with a long-term condition such as cancer isn’t straightforward, but many difficulties can be avoided with good planning.

Discuss your travel plans with your doctor to assess whether you’re fit to travel.

Different types of cancer have different treatments and often require you to take specific precautions when you travel.

Health experts advise preparing for a trip four to six weeks before you travel.

Things to consider as part of your preparation include:

• air travel
• travel vaccinations
• travelling with medicines
• travel insurance

Air travel

Under current security restrictions, you cannot carry containers with liquids, gels or creams that exceed 100ml in your hand luggage.

You can carry essential medicines of more than 100ml on board, but you’ll need prior approval from the airline and airport and a letter from your doctor or a prescription.

All medicines taken on board should be in their original packaging, with the prescription label and contact details of the pharmacy clearly visible.

See the Directgov website for more information on air travel hand baggage rules.

Flying may not be advisable if you’re always short of breath, anaemic, at risk of brain swelling, have had recent surgery or have problems with your ears or sinuses.

Long-haul travel, especially by air, can increase your risk of developing a blood clot in your legs (deep vein thrombosis or DVT).

Some people with cancer, particularly some types of lung, stomach and bowel cancer, have a higher risk of DVT.

See your doctor before you travel and read our tips on preventing flight-related DVT, which include exercises and compression stockings.

Travel vaccinations

If your destination requires you to have vaccinations, check with your doctor before you book your trip whether it’s safe for you to have them.

Some travel vaccines cannot be taken or may be less effective if you have a particular type of cancer or cancer treatment.

If you’ve had chemotherapy and a stem cell transplant, you may have your lost immunity to diseases that you were previously vaccinated against. Therefore, you may need new jabs.

Travelling with medicines

Take enough medicines to last throughout your trip plus some extra in case of delays.

If you’re going on a long trip, check if you can get your medicines in the country you’re travelling to.

If you need to keep medicines cool, buy a small cool bag from a pharmacy for the journey. Check whether your room at your destination has a fridge.

Keep a list of all your medicines (including the generic names) and doses in your purse or wallet, just in case you lose any of them or you run out.

Travelling across time zones can affect when you take regular medicines. Your doctor or pharmacist can help you plan adjusting the times of your medicines.

Find out if you need a letter from your GP explaining to customs officers your need to carry certain medicines, syringes or portable medicine pumps.

Some GPs charge for writing a letter, so if you travel frequently, ask them to write it in such a way that it can be used more than once.

Travel insurance

Getting travel insurance when you have had cancer can be very difficult. It’s a good idea to start looking for cover before you’ve booked your holiday.

Get advice from your GP before purchasing an insurance policy. They will be able to help you answer the medical questions about your health. 

For travel in Europe, make sure you have a European Health Insurance Card (EHIC). This entitles you to reduced-cost and sometimes free medical treatment.

Take out travel insurance as well because an EHIC may not cover all the costs of your treatment. An EHIC doesn’t cover the cost of being flown back to the UK.

Macmillan Cancer Support has information about finding travel insurance if you have cancer.

Having diabetes should not prevent you from travelling and enjoying your holidays.

Planning ahead is key to having a great time away and dealing with any potential problems with your diabetes.

Health experts advise preparing for a trip four to six weeks before you travel.

Things to consider as part of your preparation include:

• diet
• medicines and travel vaccines
• travel insurance
• air travel

Diet

Whether you’re at home or abroad, make sure you still eat healthily.

You should be able to choose foods from local menus and still eat a balanced diet. Overseas travel is also an ideal time to try different foods.

If you’re flying to your destination, don’t order a special diabetic meal on board. These are often low in carbohydrate so they’re generally unsuitable.

On long-haul flights, take some healthy snacks with you as airline meals tend to be smaller than average meals.

In some countries, blood glucose is measured differently from the UK. See Diabetes UK’s blood glucose conversion chart.

Medicines and travel vaccines

See your GP or diabetes specialist for information on travel jabs and how the local weather and changing time zones can affect your condition.

Vaccines may disrupt your blood glucose control as your body makes antibodies to fight the disease that you’ve been inoculated against.

Carry a diabetes ID (either a card or jewellery) so that if you become unwell, people are aware that you have diabetes.

Bring twice the quantity of medical supplies you would normally use for your diabetes.

Travelling to a hot or cold climate may affect how your insulin and blood glucose monitor work.

Travel insurance

Most travel insurance policies exclude pre-existing medical conditions, including diabetes.

Make sure you declare all your medical conditions, including your diabetes. Making a mistake or omission could result in a claim being refused.

Diabetes UK recommends that everyone you’re travelling with is insured on a policy that covers pre-existing medical conditions.

For travel in Europe, make sure you have a European Health Insurance Card (EHIC). This entitles you to reduced-cost and, sometimes, free medical treatment.

Also take out travel insurance because an EHIC may not cover all the costs of your treatment. An EHIC doesn’t cover the cost of being flown back to the UK.

See the Diabetes UK website for more information on finding travel insurance if you have diabetes.

Air travel

Bring a letter from your GP explaining your need to carry syringes or injection devices and insulin.

Some GPs charge for writing a letter. If you travel frequently, ask them to write it in such a way that it can be used more than once.

Carry all your diabetes medicines as hand luggage, in case your checked-in bags go missing or your medicines are damaged in the baggage hold.

Diabetes UK advises against storing insulin in checked-in luggage as the freezing temperatures in the hold may damage it.

If you have to take insulin in your checked-in luggage, place it in an airtight container or in bubble wrap, then a towel, and pack it in the middle of your suitcase.

When you arrive, check that the insulin hasn’t been damaged in the hold. Look out for crystals and test your blood glucose levels more frequently.

Most people with a heart condition are able to travel, as long as they feel well and their condition is stable and well controlled.

If you’re recovering from a heart condition, such as a heart attack or heart surgery, it’s often best to wait until you’ve fully recovered before you travel.

Your GP or heart specialist can advise you on whether you’re fit enough to travel by air.

Health experts advise preparing for a trip four to six weeks before you travel.

Things to consider as part of your preparation include:

• your destination
• travel insurance
• air travel
• pacemakers and ICDs

Your destination

When you book your holiday, think about how to make your trip as convenient as possible. Stay in accommodation that’s easily accessible and close to any amenities.

Avoid destinations that are hilly, unless you’ve recovered enough and you’re fit enough for potentially strenuous activity.

Avoid travelling to high altitudes (over 2,000 metres) as lower levels of oxygen can cause breathlessness or angina. Get advice from your doctor.

Avoid countries where there are extreme temperatures, either very hot or very cold, as this can put an added strain on your heart.

Find out how to get medical help (such as a local ambulance or doctor) at your destination.

Keep an up-to-date list of all your medication (including the generic names) and doses in your purse or wallet, just in case you lose any of them.

Take enough medicines to last you throughout your trip plus a few extra days.

Travel insurance

Take out travel insurance and check that it will cover your specific heart condition.

Declare all your past and present health conditions. Making a mistake or omission could result in a claim being refused.

Get advice from your doctor before you purchase an insurance policy. They can help you answer the medical questions about your health. 

For travel in Europe, make sure you have a European Health Insurance Card (EHIC). This entitles you to reduced-cost and sometimes free medical treatment.

Take out travel insurance as well because an EHIC may not cover all the costs of your treatment. An EHIC doesn’t cover the cost of being flown back to the UK.

See the British Heart Foundation website for more information on insurance if you have a heart condition. They also have a list of insurers recommended by people with a heart condition.

Air travel

See your doctor before you book your flight for advice on whether you’re fit enough to travel by air.

If you have a heart condition or a history of heart disease, you may have an increased risk of deep vein thrombosis (DVT).

Get tips on preventing flight-related DVT, including exercises and compression stockings.

Consider arranging support at the airport terminal, such as help with your luggage and early boarding onto the plane.

It’s safe to use your glyceryl trinitrate (GTN) spray while you’re on the plane.

Under current security restrictions, you cannot carry containers with liquids, gels or creams (including medication) that exceed 100ml in your hand luggage.

You can carry essential medicines of more than 100ml on board, but you’ll need prior approval from the airline and airport and a letter from your doctor or a prescription.

Pacemakers and ICDs

If you have a pacemaker or an implantable cardioverter-defibrillator (ICD), bring your device identification card with you.

Tell security staff that you have a pacemaker or ICD as it can set off the security metal detector alarm.

Ask to be hand searched by security staff or checked with a hand-held metal detector. The metal detector should not be placed directly over your device.

From pool safety to sun protection, these simple steps will help your children stay safe and healthy on holiday.

Pool safety

Children need to be watched constantly. Don’t depend on a lifeguard, who may not be trained to UK standards.

What to pack 
Swimming aids, such as armbands, are great for playing in the water but can easily slip off. Therefore, you still need to keep an eye on your child.

Top tips

• Actively supervise all young children near water.
• Choose pools that are fenced with locking gates.
• Even if a pool has a lifeguard, make sure you know where your children are and what they’re doing in the water.
• Let children take swimming classes while on holiday. They’re a great way of gaining water confidence and learning essential water safety skills.

Take the RoSPA Water Wise quiz.

SUN PROTECTION

Studies have found that sunburn during childhood can increase the risk of skin cancer later in life.

What to pack
Use at least a factor 15 sunscreen and choose a “broad-spectrum” brand that has a four- or five-star rating. Apply it to areas that cannot be protected by clothing, such as the face, ears, feet and backs of the hands. Choose sunscreens that are formulated for children and babies’ skin.

Top tips

• Apply sunscreen before children go outdoors.
• Sunscreen can easily be washed, rubbed or sweated off, so reapply it often throughout the day.
• Keep babies in complete shade, such as under trees, umbrellas, canopies or indoors.
• Protect a baby’s skin with loose-fitting clothes and a wide-brimmed hat that shades their face and neck.
• Make sure children drink regularly.

TRAVEL SICKNESS

Children often get motion sickness more than adults. Early symptoms of motion sickness include hot flushes, dribbling and paleness.

What to pack
Several medicines are available to reduce or prevent symptoms of motion sickness. You can buy them from pharmacies or get them on prescription. Anti-sickness remedies containing hyoscine are the most effective medicines for motion sickness. There are several brands of medicines containing hyoscine and they come as a soluble form for children.

Top tips

• Avoid staring at moving objects, such as waves or other cars. Instead, look ahead a little above the horizon at a fixed place.
• Keep motion to a minimum. For example, sit over the wing of a plane or on deck in the middle of a boat.
• Avoid heavy meals before and during travelling. It may be a good idea to avoid spicy or fatty food.
• On long journeys, it may help to have a break and get some fresh air, drink some cold water and take a short walk.
• Ginger can improve motion sickness in some people. It can be taken in ginger biscuits, ginger tea or as tablets before a journey.