Summer is just starting, and many of us are planning for long vacations. I often hear sad stories from patients who had their vacations ruined from diarrhea or other illnesses, so I think it’s important for travellers to bring along a do-it-yourself travel first aid kit. Every kit should have the basics, most of which are over the counter (OTC), although a couple are prescription-only. Here’s my choice:
1. Diarrhea medicines. I think the number one cause of a ruined vacation is being stuck on a toilet for days with diarrhea. My favorite OTC medicine for this is loperamide (immodium), which is generally effective after age 2 to slow down most people’s watery (non-bloody) diarrhea. It doesn’t cure the infection but it does cut down the frequency of bathroom visits, which can be a godsend if you are on a long plane or bus ride. Also, a couple other healthy OTC medicines can help you recover more quickly, including the charcoal powder Smecta as well as probiotic pills such as Medilac. Both are also available for infants and toddlers.
In southern Asia, many bouts of diarrhea are caused by bacterial infections, so you should seriously consider carrying along some antibiotics as well. For example, many travel doctors now prescribe azithromycin with instructions on how to use as soon as diarrhea symptoms start. You would need a doctor’s visit to get antibiotics; oftentimes a local pharmacy will sell these to you but this isn’t legal and their instructions often are incorrect, or their choice may be dangerous for children.
2. Pain and fever medicines. It’s very common to get a headache or pain during vacations, whether from a sunburn, altitude sickness or any myriad reason. To help with this, you should bring along some child and adult versions of pain medicines, as you never know what your local pharmacy will have. Tylenol (paracetamol) and Motrin (ibuprofen) are the two most common OTC medicines, and both are very safe at the proper dose. I prefer ibuprofen due to its anti-inflammatory properties, although it can cause more stomach problems. Most children’s syrups come in sizes under 100 ml and thus are good for carry-on luggage.
3. Your DIY first aid kit should also include: small bottles of alcohol hand sanitizer; bandaids; an antibiotic ointment; chewable antacid pills to cure heartburn; anti-itch cream such as hydrocortisone; and good anti-mosquito spray — DEET 10-30% and picaridin 5-10% are by far the most effective and are considered safe for children over 2 months of age by the American Academy of Pediatrics.
4. Prescription medicines. If you take daily medicines for chronic diseases, don’t forget to bring enough to cover your trip — and maybe a bit more in case an elephant tramples on them. Also, keep a detailed list of your medicines somewhere safe, in case you lose your luggage and need all new medicines.
Don’t forget that you may need special vaccines or other prescription medicines, depending on where you travel. Many southeast Asian countries have malaria, so you may need to take prescription anti-malaria pills as prevention during and after your trip. If you go to Tibet you may want to bring medicine to prevent altitude sickness, a common illness which has ruined many people’s long-planned vacations. In all these cases, you need to plan at least one month in advance as you may need to receive a series of vaccines (such as rabies or japanese encephalitis), or your local clinic may need a few weeks to reorder malaria medicines, which frequently run out just before national holidays.
No matter where you travel, I always recommend that you first check out the U.S. CDC’s travel website, at http://www.cdc.gov/travel. They provide detailed information for every country regarding which vaccines you need as well as other health and security concerns.
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