A- A A+
NCID > For General Public > Travel Health

Travel Health

Travel Health

Health Information for Travel

By the Traveller’s Health and Vaccination Clinic

Travellers’ diarrhoea is the most common infectious problem encountered by travellers. Follow these tips for safe consumption of food and drink:

  • Wash your hands often with soap and water, especially before eating. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol).
  • Drink only bottled or boiled water (1 minute at full boil), or canned drinks. Avoid tap water and ice.
  • Make sure food is well-cooked and at a hot temperature.
  • Do not eat or drink unpasteurized dairy (milk) products.
  • Fruits which can be peeled are safer. Avoid uncooked vegetables, including salads.
  • Avoid food purchased from street vendors.

Diseases from food and water cause diarrhoea, vomiting, as well as fever in severe cases. Most cases of travellers’ diarrhoea will improve after 2-3 days without needing antibiotics. Severe diarrhoea includes more than 5-10 loose stools per day, bloody stools or with fever. 

Treatment consists of:

  • Replacing fluids and electrolytes (salts and sugars) that are lost by diarrhoea. Oral rehydration salts are available at most pharmacies – follow package instructions.
  • Bring all anti-diarrheal medicine with you so you can treat mild cases yourself. Pepto-Bismol, Lomotil or Imodium can be used to treat diarrhoea.
  • Ciprofloxacin / Azithomycin (antibiotic available by doctor’s prescription). Ciprofloxacin 500mg twice daily for up to 3 days (or Azithromycin 1000mg as a single dose) may be effective for treating severe traveller’s diarrhoea.
  • If you have severe or prolonged diarrhoea (lasting more than 7 days), it is advisable to seek medical attention.

Stool tests may be required to check for bacteria or parasites.

Animal bites and scratches may cause wound infections or transmit rabies. Humans who develop rabies uniformity die as a result. It is important to understand how to reduce your risk, and what to do if you do get bitten or scratched.

  • Avoid feeding or touching animals, especially stray dogs. Even animals that look healthy may have rabies or other diseases. Bats may transmit rabies via close contact alone.
  • Help children stay safe by supervising them when around animals, and instructing them to report any animal bites/ scratches immediately.

    *** If you are bitten or scratched, wash the wound immediately with soap and water for 15 minutes.  Call a doctor immediately for rabies post-exposure prevention. This consists of a series of 4-5 rabies vaccines, given over 21-28 days. If you have never had a rabies vaccine before, you may also need rabies immunoglobulin (RIG). RIG must be administered as soon as possible (but no later than 7 days after starting rabies vaccines).

  • Be sure to inform your doctor and/or state health department of any rabies exposure.

Vaccinations you receive may cause pain, redness or swelling at the injection site. Occasionally, fever, headache or muscle aches also occur. Most of these side effects are mild, and resolve over 1-3 days. You may take paracetamol to relieve these symptoms. If uncommon side effects occur (rash, fits, numbness, weakness, etc.) please contact the Traveller’s Health and Vaccination Clinic. We will assess and advise if you should avoid that vaccine in future. If the reaction is serious (swelling of the lip, tongue or face, difficulty breathing, loss of consciousness), please proceed to the nearest hospital emergency room. If the reaction is serious and related to the vaccine, we may also have to notify the health authorities.

Specific Vaccine Precautions

If you received MMR, Yellow Fever or Varicella (chickenpox) vaccines, avoid pregnancy for 1-3 months.  Persons who receive yellow fever vaccine should avoid donating blood for 10 days.

Malaria is a serious illness, transmitted by Anopheles mosquitoes. Symptoms include fever, chills, headache (may be mistaken for “the flu” or “a stomach virus”). In certain cases, death results within a few days. Malaria risks vary in different countries (and in areas within the same country). If you develop fever (>38.3 C or > 101F) during your visit in malarious areas, or within 12 months such a visit, notify your doctor.

You can reduce your risk of catching malaria by using personal protective measures.

  • Use insect repellant containing DEET on exposed skin after dusk
  • Wearing long pants and long-sleeved clothing
  • Using insecticide-treated bednets, or sleeping in a mosquito-free setting

Anti-malaria medications can be used for prevention, and are usually 80-90% effective.

Drugs used for preventing malaria (Prophylaxis)

Malarone (atovaquone
(Doctor’s prescription needed)

Adult tablets
1 tablet daily

1) To start 1-2 days before travel to malarious areas
2) Every day during travel
3) 7 days after leaving malarious area
Avoid for persons with severe kidney problems

(Doctor’s prescription needed)

100 mg daily

1) To start 1-2 days before travel to malarious areas
2) Every day during travel
3) 28 days after leaving malarious area
Avoid for pregnant women and children < 8 years


250 mg once a week

1) To start 1-2 weeks before travel to malarious areas
2) Every week during travel
3) 4 weeks after leaving such areas
Avoid for persons with seizures, depression or other psychiatric disorders, cardiac condition (heart rhythm) abnormalities or previous intolerance to mefloquine

Altitude illness refers to the symptoms experienced due to lower oxygen pressure at higher altitudes, typically above 3000m. This can worsen to severe acute mountain sickness (AMS), high altitude pulmonary edema (HAPE) or high altitude cerebral edema (HACE). Be familiar with the symptoms of these conditions prior to travel. You can reduce your risk of serious altitude illness by:

  • Ascending gradually and allowing your body time to acclimatize
  • Being well hydrated and avoiding alcohol at high altitudes
  • Immediate, rapid descent if symptoms develop (urgent medical care for severe disease)
  • Diamox (accetazolamide) 250mg twice daily (or 125mg 4 times daily)
    (Doctor’s prescription needed)
    starting 24 hours before ascent until return to lower altitude can help reduce altitude illness. Avoid if allergic to sulfa drugs. (Dexamethasone 4mg 4 times daily may be useful in immediate treatment of HAPE/ or HACE)

  • Iodine tablets and portable water filters to purify water if bottled water is unavailable
  • Insect repellent with _ 20% DEET on exposed skin. Re-apply every 4-6 hours
  • First aid kit, or travel kit (may be purchased at the pharmacy)

Last Updated on