Travel health before you go

Most travel health problems are either preventable or manageable, and the preparation has to happen weeks before departure rather than days.

The timeline

Six to eight weeks before, ideally.

Some vaccines require multiple doses over several weeks, and some require time to become effective.

Travel health clinics and general practitioners can advise on what is recommended for a specific destination, and the recommendations depend on the region within a country, the season, the type of travel and the traveller's own health.

Four weeks before, for prescriptions, insurance and any documentation.

The week before, for practical assembly.

Vaccinations

Two categories worth distinguishing.

Routine vaccinations, which should be up to date regardless of travel — the standard childhood and adult schedule, including tetanus and measles.

Outbreaks of measles occur in many countries, and susceptible travellers are at genuine risk.

Travel-specific vaccinations, which depend on destination.

Hepatitis A and typhoid are commonly recommended for travel to many regions.

Yellow fever is required for entry to some countries and recommended for others, and proof of vaccination may be demanded at borders.

Rabies, Japanese encephalitis, meningococcal and others are recommended in specific circumstances.

National public health agencies publish destination-specific guidance that is updated continuously, and it is the authoritative source rather than general advice.

Malaria and other vector-borne disease

Where the risk is real and the prevention is effective.

Malaria prophylaxis is recommended for travel to areas with transmission, with the appropriate medication depending on the region, on resistance patterns and on the traveller's own health.

Some regimens must start before arrival and continue after departure, which is why the timing matters.

Bite avoidance is equally important and works against diseases for which no prophylaxis exists — repellent containing an effective active ingredient, covering clothing at dawn and dusk, and treated bed nets where appropriate.

Dengue, chikungunya and Zika have no prophylactic medication, which makes bite avoidance the only prevention.

Prescription medication

Several practical points.

Carry enough for the whole trip plus a margin, in original labelled packaging.

Split it between hand luggage and checked luggage where possible, keeping the essential portion in hand luggage.

Carry a letter from a prescriber listing medications by generic name, which helps at borders and if a replacement is needed.

Check whether any medication is restricted at the destination — several common prescriptions, including some for pain, attention disorders and anxiety, are controlled or prohibited in certain countries, and travellers have been detained for carrying them.

Embassy websites for the destination country generally publish this information.

Insurance

The item most often skipped and most consequential.

Medical treatment abroad can be extremely expensive, and medical evacuation from a remote area can run to very large sums.

What to check in a policy: the medical cover limit, whether repatriation and evacuation are included, whether pre-existing conditions are covered or excluded, whether the activities you intend to do are covered, and the excess.

Adventure activities — diving, climbing, motorcycling, skiing off piste — are commonly excluded from standard policies and require specific cover.

Reciprocal healthcare arrangements between some countries cover state treatment and generally do not cover repatriation, so they are not a substitute for insurance.

The kit

A basic assembly that covers most situations.

Rehydration salts, which are the single most useful item for travellers' diarrhoea.

Simple analgesia, antihistamine, and any personal medication.

Plasters, antiseptic and blister treatment.

Sun protection appropriate to the destination.

Insect repellent.

And a copy of prescriptions and insurance details, stored both digitally and on paper.

The health conditions worth planning around

Anyone with a chronic condition should discuss the trip with their clinician specifically.

Altitude, long flights and clotting risk, diabetes and time zone changes affecting medication timing, and access to specific treatments at the destination are all worth addressing in advance rather than improvising.

General information about travel health, not medical advice. Consult a travel health clinic or qualified clinician about your own circumstances and destination well before departure.