Careful planning needed to protect against disease

Business people, often at short notice, need to travel to foreign lands

Business people, often at short notice, need to travel to foreign lands. What can they do to protect their health and wellbeing during business travel?

Dr Nancy Gallagher, a lecturer in tropical medicine and medical director of the travel health centre at the Royal College of Surgeons in Dublin, recommends that people who travel six or seven times a year receive "baseline vaccinations" which give long-term protection. These need to be planned and may involve a few visits for vaccinations over some weeks. But they are less stressful than turning up "two days beforehand", when less protection can be offered.

Dr Gallagher's advice on food while abroad is: "Boil it, cook it, peel it or forget it." Stick to hot, freshly cooked food, bottled water and don't take ice. Avoid rare meats (to prevent tapeworms) and salads (which can cause dysentery). Don't buy from street vendors and, above all, don't eat shellfish, like mussels, oysters and clams.

Where malaria is endemic, "avoid being out after dark" and don't sit on the veranda, she says. "If you can't avoid it, cover up," even if that means tucking trousers into socks. "The less you're bitten, the less likely you are to get malaria."

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She says it's 100 times easier to pick up HIV in the tropics than in Ireland. Some 75 per cent of heterosexuals with HIV in Britain contracted it while travelling abroad. Hepatitis B must also be avoided, which is "a lot more infectious than HIV".

Rabies is also a threat, especially in rural areas in India, Thailand, Vietnam and in central and south America because of the number of stray dogs. Dr Gallagher advises: "Don't approach animals. Wash any wound and get medical help immediately."

Dr Martin Hogan, an occupational physician in Cork, says food-borne diseases like typhoid and hepatitis A should be vaccinated against "at least two weeks or even four weeks before travel".

The typhoid vaccination is available in oral or injectable form. The oral form lasts one year while the injection protects for three years.

He explains the hepatitis A injection lasts only one year but, if given a booster one year later, it will cover you for 10 years. Tetanus and polio vaccinations should also be up-to-date.

Specific areas like central Africa or tropical south America may require vaccination against yellow fever "and proof of vaccination may be a requirement of entry", he says. Yellow fever vaccinations can only be given at registered centres but most others are available through GPs or medical advisers.

You should always check if the area you intend travelling to is free of malaria. If not, you should take tablets "ideally two weeks before going, for the duration of the stay and for up to four weeks after leaving", he says.

Dr Hogan says diphtheria can be a problem even in parts of eastern Europe and the former Soviet Union and vaccination may be required.

Dr Tom Donnelly of the Health and Safety Authority says it's important that older people on long transcontinental flights perform stretch exercises to prevent blood clots forming in the calf. If such a clot was dislodged, it could have serious health implications.

He says that in planning long trips, try to travel around the globe in a westerly direction, especially if a business meeting is to take place the following day. Moving west is more in accord with the body's diurnal rhythms and will reduce jetlag.

On this point, Dr Graham Fry, a lecturer in tropical medicine at Trinity College, Dublin, who practises at the Tropical Medical Bureau in Grafton Street and Dun Laoghaire, adds: "Try not to make any major decisions within the first 24 hours."

Dr Fry says the drug, melitonin, can be taken to alter the diurnal rhythm. But, as with any drug, there are concerns about its use and it should only be taken with caution.

He says business travellers can also be susceptible to eye and ear infections from swimming pools. So check if the pool is clean and that it is neither under nor over-chlorinated.

For further information contact the Tropical Medical Bureau 01 671 9200 or the Travel Health Centre of the Royal College of Surgeons 01 402 2337.