Advice for Travel to the Tropics

If you are travelling to the tropics you must allow 6 weeks to be fully immunised at your doctor’s surgery.

Water/Ice: Drink enough to keep your tongue moist and your urine pale. Avoid ice, drink only bottled water and use it for washing your teeth/dentures and for washing fruit and salads.

Fluid/Electrolytes replacement is essential for treating gastro-enteritis/food-poisoning and sunstroke; take rehydration sachets/imodium capsules (or dilute fruit juice with teaspoon of sugar and a good pinch of salt).

Food: Cook meat thoroughly, eat cooked food hot, don’t eat food cooked on market stalls, avoid ice-cream, pates and soft cheeses, beware of shellfish especially if raw. I.e. oysters in the Indian and Pacific Oceans. Avoid eating large carnivorous fish, especially if "longer than your forearm" (ciguatera toxin)


Cerebral Malaria can kill you in a matter of days.

Discuss malaria prophyllaxis with your GP/Practice Nurse and discuss side effects. Remember it is better to have an occasional nightmare than to die of malaria.

Take your anti-malarials regularly and for the recommended time before and after your time in the malarial areas.

Avoid Mosquito bites: wear long sleeves/trousers at dawn and dusk and in shaded areas. . Avoid perfume/ after-shave/perfumed soaps/shampoos: If you smell like a flower you will attract insects!

Use neat deet on back of towelling headbands in the Rain Forest and Jungle.

For expeditions and longer trips soak clothes and mosquito nets in permethrin solution

Sleep under nets or in screened rooms – close screens and doors prior to putting lights on, then spray with "knock-down" spray.

NB: Deet damages plastic. Anklets could cause swelling of feet, so pull them up your legs and then take them off, leaving a smear of deet on your legs.

Burn smouldering pyrethrum coils or use pyrethroid containing electric mats.

Always consult your GP if you are ill on your return from your holiday. Tell your GP your travel itinerary and dates.

Your Flu is Malaria until proved otherwise.

Other Insect Problems

Sand Fly: Avoid caves in Turkey; the bats transmit Leishmaniasis
Tombu Fly cause "living boils with maggot inside" (South America)

Ticks: in Europe can cause Lyme Disease and European tic-borne encephalitis. To remove, unwind the tick anti-clockwise (clockwise in the Southern Hemisphere). Lyme Disease also in the USA.

Scorpions: Shake your shoes out before putting them on!

Spiders in Australia – red back and funnel web. Ensure you always check under your loo seat!!

Leeches can be knocked off with a stone or stick or touch with a lit cigarette (only time you’re allowed to smoke!)

Schistosomiasis (Bilharzia) Avoid Rift valley/Nile Valley Lakes and Rivers in Africa – if there are reeds there will be snails and therefore a real risk of shcistosomiasis.

Dangers in the Sea.

Sharks: Do not urinate in shark-infested waters, don’t swim if menstruating, don’t spear fish. All these things might attract the shark’s attention!

Stone Fish: Don’t paddle on rocky foreshores in the Pacific. Wear reef-sandals or full-sole flippers.

Box Jelly Fish (Australia) Wear ladies tights, one pair as normal, one pair over the head with a hole cut in the crotch and your arms in the legs of the tights (would suggest investing in a new pair of tights) Jelly fish pneumatocyst cannot penetratenylon (that or the very look of you scares them off!)

Coral Grazes (Coral is a living organism and grows with salt water – so the wound is slow to heal). Remove coral from graze with cellotape, then apply bactroban ointment (available on prescription from your GP)

Scuba Diving: never alone, never after alcohol, never within 12 hours of airline flights

Going to High Altitude – ie Mount Kilabalu/Kilimanjaro/Andes: ask your GP for altitude sickness tablets.


Ensure you take your own medication and carry it in your hand luggage. Eg Insulin, asthma treatment, contact lens solution.

For Long Stay trips ie Back-packing

Consider purchasing sterile medical kits from M.A.S.T.A. or your local pharmacist.

Health Insurance:

For EU countries take the E111 (available at the Post Office) and always ensure you have adequate health insurance – seek advice from your travel agent.

Be careful not to drive under the influence of alcohol and ensure crash helmets are supplied with scooter hire; we can relax too much abroad!!!

Additional Tips:

Don’t get between a hippo and the water.

Sleeping Crocodiles are never asleep.

Think ahead and Come Back with Happy Memories!



Dr Adrian McCracken

Malvern, Worcs