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Travel Health Matters

The Travel Health Matters series covers health topics pertinent to student life in order to promote a safe and healthy university experience.

Topics in this series include:

If there are topics of interest you would like to see in our Health Matters series, send us an health [dot] promotion [at] mcgill [dot] ca (e-mail) .


Click to download a pdf version. Travel Health Matters: Basic

Basic Travel Health

Bringing medication on board?

  • Always bring prescribed medication in its container, labeled with your name, the name of the medication, the dosage, and your doctor’s name.
  • Make sure that you filled all of your prescriptions before leaving and that you have enough for the length of the trip. It is usually not possible to fill a prescription in another country.
  • Bring all of your medication with you on the plane in case your checked baggage is lost. Also, it can sometimes be very cold in the luggage cabin. Some medications, such as asthma pumps, can be damaged when frozen.
  • If you need to carry syringes with you, make sure that you bring an official letter from a doctor. You can be arrested and imprisoned for carrying syringes.

Travel sickness

To prevent nausea, some find it helpful to eat a small snack before getting on a plane. Some medication can be bought over the counter to control nausea, such as Gravol or Transderm-V. If you suffer from flight anxiety, it is a good idea to discuss this with a physician before traveling. Also, try sitting in specific areas of the vehicle. On a plane, reserve a seat over the wings, in a boat stay in the middle sections (both vertically and horizontally), and in a bus/car, sit closer to the front or middle.

Jet Lag

Jet lag refers to difficulties adapting to time changes. Symptoms include: disturbance in sleep/wake cycle, malaise, headache, irritability, poor concentration and appetite disorder. Flights to the west are generally tolerated better than the flights to the east.

To alleviate symptoms, change the time on your watch to the time of your destination as soon as you board the plane. Eat and sleep according to that time during your flight. Limit your naps to 40 minutes in duration on the first few days. Try to stay in the sunlight, avoid alcohol and do not consume caffeine for 4-6 hours before bedtime.

To alleviate symptoms, change the time on your watch to the time of your destination as soon as you board the plane. Eat and sleep according to that time during your flight. Limit your naps to 40 minutes in duration on the first few days. Try to stay in the sunlight, avoid alcohol and do not consume caffeine for 4-6 hours before bedtime.

Tips for Traveler’s Diarrhea


Symptoms

A symptom of traveler’s diarrhea is loose, watery stools, usually lasting between 3-5 days. It is often accompanied by abdominal pain, nausea, and low-grade fever.


Prevention

Follow these tips to stay healthy while you travel.

  • Stay away from contaminated food and water, which causes diarrhea, typhoid, hepatitis A, and cholera.
  • Boil it, cook it, peel it or forget it! Don’t eat anything raw, unless it is a fruit or vegetable you can peel yourself. Otherwise, ensure that your food is well-cooked.
  • Only drink treated, bottled, or canned water. When you arrive in a hot country you might become thirsty right away. Bring a water bottle with you on the plane.
  • Avoid all ice cubes! They can be made from contaminated water.
  • Avoid creams, dairy products, pastries, and ice creams.

If you become ill...

  • Hydrate yourself with weak tea, or mineral water with some sugar in it.
  • Try to eat salty crackers. Avoid any greasy or spicy food.
  • Rest.
  • Avoid alcohol.
  • Get medical attention if you start to experience one or more of the following symptoms: violent vomiting, intense headaches, high fever, acute abdominal pain, or bloody stools.

General Travel Tips

  • Practice safer sex. Bring condoms with you. Inexpensive condoms are available at Student Health Services, suite 3312.
  • Never swim in stagnant water.
  • Be a cautious driver and pedestrian. The number one cause of death among travelers is road accidents.
  • Respect your limits. Don’t engage in dangerous sports or activities. Check the equipment that you are using. Security standards differ between countries.
  • Bring a first aid kit! Here are some ideas about what to include:
    • Antibiotic ointment (like polysporin)
    • Disinfectant, alcohol wipes
    • Adhesive tape (water proof)
    • Ace bandage (tensor bandage)
    • Sling
    • 2 safety pins
    • Gauze
    • Acetaminophen and/or Ibuprophen
    • Antacid medication
    • Anti-histamines
    • Scissors
    • Tweezers
    • Tourniquet
    • Ice pack
    • Small flash light
    • Small pack of sugar
    • Small face shield for CPR

Upon your return...

If you have been away for a long period of time, especially in an isolated rural region, it is recommended that you see your family doctor for a check-up. If you develop symptoms such as fever, swollen lymph nodes, heavy diarrhea, constant headaches, rashes or any other questionable symptoms, you should go to a medical clinic. It is important to inform the physician that you have just returned from a trip. If you are taking an anti-malarial regimen, make sure to continue taking the medication for 4 weeks after you return.

Websites

Here are some websites that you can visit to prepare for your trip. They can give you useful information about different diseases particular to your destination. Also, try to research the political situation in the country you plan to travel to. The more you know about your destination, the better your trip will be.

Health Canada: www.hc-sc.gc.ca
World Health Organization: www.who.int
Center for Disease Control: www.cdc.gov/travel
Department of Foreign Affairs Canada: www.fac-aec.gc.ca
Travel Health Online: www.tripprep.com





For more information about preparing for a healthy trip, make an appointment to see the Travel Nurse at McGill Student Health Services. Call 398-6017 to book an appointment– be sure to schedule it at least six weeks before your trip.

Click to download a pdf version. Travel Health Matters: Bugs

Travel Bugs

Annoying insects can put a damper on outdoor trips and travel. Certain insects transmit diseases that can make you really sick, like Malaria, Japanese Encephalitis, Yellow Fever, Dengue Fever and Lyme Disease. Some of these diseases can be prevented with vaccination or prophylactic medication. It is important, however, to protect yourself from insect bites. To do so, all you need is insect repellant, proper clothing and a bed net. Insects can transmit diseases any time of the day, and in urban as well as rural areas. Here is some information to help you protect yourself.

Bed nets

Bed nets should be treated with permethrin, which is a mosquito and tick repellant. If you already have a bed net, it should get the treatment with permethrin once or twice a year. The bed net has to cover the bed completely. Make sure there is no way a mosquito can get in. Before going to bed, check inside if anything got in! Don't get trapped with the enemy. Outdoor specialty stores usually sell bed nets (La Cordée, Baron Sport). It would be a good idea to give a permethrin treatment to bed sheets (if it happens that you are carrying your own).

Insect repellent

Now you need to protect your self directly from the bugs. First, your clothes should be sprayed with Permethrin. There is a product on the market called Duranon (which is good against mosquitoes and ticks) not commonly sold in Québec. Can be ordered on internet (3M cie) or one place where it can be purchased in Montreal is Clinique Voyage Medisys, 500 Sherbrooke West for $18.

  • Now you also need to protect the exposed skin. DEET lotion or spray has to be used. The concentration of DEET in the product varies from 10% to 95% you should get something with a concentration of more or less 35% (this recommendation is not applicable for children, verify with a pediatrician).
  • Sometimes it is difficult to find those products in a regular pharmacy, try outdoor specialty stores, even Canadian Tire might have some (according to the season!).
  • One good product is called Ultrathon or HourGuard 12. Concentration of DEET is 35%, but comparable to 95% and it is sold in a tube. Safe for pregnant women and children. Again, it is not easy to find in Montreal, but you can get it at Clinique Voyage Medisys ($24).

Clothing

Wear long sleeves and pants when you are in a risky area. Avoid wearing perfume and flower fragrances. You will attract some friends that will surely bug you.

  • Don't stand in the sand
    You might not realize it, but there are some bugs in the sand too. If you stand barefoot, not walking, or if you lie down directly on the sand, bugs can get through your skin and crawl under, making the area very itchy. The worst part is that you see the red stream and the bug moving! Not very pleasant. It can be removed by a physician or it will die on its own after a few weeks.

What do I do if I get an insect bite?

If you get bitten, there is no way of knowing if the bug had something or not. If you get a local reaction you can use some topical lotion/ cream like afterbite or calamine lotion to decrease the itchiness. You can also take some antihistamines. Watch for any symptoms, which can take weeks before they develop. Check for fever, enlarged lymph nodes, headaches, and/or rash. When you start to feel sick you need to seek medical attention.

What's under the sun?

  • Don't forget to protect your skin! You need SPF protection over 15 if you want to prevent sunburn and cancer.
  • Keep in mind when using DEET, increase the level of SPF. DEET decreases the effectiveness of the sunscreen.
  • Wear a hat and cover those sensitive parts of your body.

Click to download a pdf version. Travel Health Matters: Diarrhea

Traveler's Diarrhea

Causes and Symptoms

  • Traveler's diarrhea is most commonly caused by an infection with Escherichia coli. Most cases of traveler's diarrhea last 3 to 5 days and are accompanied by nausea, vomiting, abdominal cramps and low-grade fever. Bacteria are the cause of about 80% of the cases of traveler's diarrhea.
  • If you have bloody diarrhea or bloody/mucus diarrhea you need to see a doctor immediately.

What do I do if I have it?

  1. Hydrate yourself with 2-3 litres of fluids per day. Eat soups and crackers but AVOID DAIRY PRODUCTS.
  2. Pepto-Bismol (liquid form): Take 2 tablespoons (1 oz) immediately, and then another 2 tablespoons (1 oz) every hour. Don't exceed 8 oz in a 24 hour period. Pepto-Bismol works to reduce the amount of unformed stool by 50%. However, it can also cause blackening of the tongue and stool. If you are taking antibiotics, check with your pharmacist for any possible interactions. If you have any kind of chronic medical illness, check with your physician about the safety of Pepto-Bismol.
    DO NOT TAKE PEPTO-BISMOL IF YOU:
    • Have allergies or intolerance to aspirin
    • Have any type of bleeding disorder
    • taking an anticoagulant
    • a history of peptic ulcer disease or gastrointestinal bleeding


  3. Loperamide (Imodium): Take 2 capsules (4 mg) immediately and then 1 capsule (2 mg) after each loose or watery stool. Don't take more than 8 capsules over a 24 period. DO NOT TAKE IMODIUM IF you have bloody diarrhea or a fever greater than 101ºF.
  4. When you should consider antibiotics:
    • You have bloody diarrhea (dysentery), usually with a high fever, abdominal pain and tenderness.
    • You have taken Pepto-Bismol and seen NO improvement.
    • If you are taking antibiotics, the duration of treatment is usually about 1-3 days. You may still use Loperamide (Imodium) while taking antibiotics.

Chronic Diarrhea

Less then 2% of travelers develop chronic diarrhea, but it can last several weeks. Chronic diarrhea is usually caused by a parasite, and is often accompanied with abdominal pain, bloating, nausea, loss of appetite, fatigue, weight loss and low-grade fever. You should see a physician to get proper treatment.

Preventing traveler's diarrhea

“Boil it, cook it, peel it, or forget it!” Take food and water precautions when eating abroad; and remember that contaminated food causes more illness than contaminated water. If you are travelling to areas with poor hygiene, you should avoid raw vegetables, fruit you have not peeled yourself, unpasteurized dairy products, cooked food not served steaming hot, and tap water, including ice.

WASH YOUR HANDS BEFORE EATING!

Drug prophylaxis: Preventative drug treatment is recommended for people who cannot afford to be sick (i.e. important business trip) or immunocompromised travelers. Pepto-Bismol (tablet form is fine) is often used. Take 2 tablets, 4 times daily with meals and before bed.

Prophylactic antibiotics are not necessary; but you can get a prescription that you can use only if you develop traveler's diarrhea.

If you have any further questions, please see a doctor or nurse at Health Services.