MEDICAL MATTERS Charles Daly Hundreds of thousands of Irish holidaymakers go to sunny climates every summer, traditionally to the Mediterranean area but increasingly to more far-off places like the Caribbean, south-east Asia and South Africa.
Most of these holidays are uneventful, but every year brings a handful of tragic stories of drownings in pools and on beaches, road accidents and fatal accidents such as falls from balconies. Most of these traumatic events have a common theme of young men, too much alcohol with impaired ability to react, foolhardy behaviour in dangerous places, and ignorance of water depth and local conditions.
For others, the holidays can be ruined by illnesses such as vomiting and diarrhoea, too much sun, exposure to insects and lack of preparation. Insecurity, language difficulties and illness in children can compound problems. Nevertheless, a small amount of preparation and anticipation, allied with basic cop-on, can take the sting out of most minor holiday medical crises. The Ten Commandments of Holiday Health are as follows:
1. Drink plenty of water. Drink it all day long and all night long. Avoid tap water unless you are absolutely certain that it is safe and palatable. Bottled water is cheap, reliable and widely available. The risk of developing dehydration can never be stressed enough, especially for children and older people. Who could have predicted more than 5,000 deaths during last year's French heatwave?
2. Drink alcohol sensibly. It is very tempting, even for moderate drinkers, to drink more when a pint of beer is cheaper, the spirit measures more generous, and when a good bottle of wine in a top-class restaurant can cost as little as €6. Unfortunately, alcohol is a diuretic and large amounts can lead to dehydration, especially in a hot climate. The best form of damage limitation when drinking is to drink a glass of water between each glass of wine or beer.
3. Learn to swim. At least learn to float. Lie on your back, inflate your lungs and paddle with your feet and hands. It may keep you afloat long enough to save your life. If you can't swim, stay out of the deep end. If you can swim, don't swim alone, swim within your depth and parallel to the shore. Don't swim after a large meal or after drinking alcohol. Don't let children float on lilos or rings at the beach.
4. Avoid sunburn. Although sunshine has beneficial effects on bone and calcium metabolism, we Irish are attracted to it like flies to a dungheap. Despite repeated warnings every year, Irish GPs treat patients who look like they have had a close encounter with a blowtorch or who appear to have been in a barbecue instead of at one. However desirable a tan looks, medically it is a sign of skin damage. Again it's a case of damage limitation. Cover exposed areas with strong sunblocks, never stay in the sun for more than two hours at a go, stay indoors during the hottest times, and keep children covered. If you do get sunburnt, take plenty of fluids and analgesics and take your punishment - only time will cure.
5. Stay away from insects. Bites can be a pain in the neck and elsewhere, and are hard to avoid. Mosquitos are very common in southern Europe but fortunately are not carriers of malaria. Some people are more prone to bites than others, which may be due to pheromones (chemical attraction). Insect repellent sprays, creams and lotions are available but unpredictable in efficacy. Candles at night can also repel insects. Try not to scratch the bites as they can become infected.
6. Bring your own mini-pharmacy. Motilium for nausea and vomiting, Imodium for diarrhoea, paracetamol for pain and anti-histamines for bites and allergies will cover most situations.
7. Bring adequate medication if you are on long-term treatment. You may not be able to get your drugs abroad in the same formulations or preparations or you may get incorrect treatment because of communication problems.
8. Bring the E111 card with you (available from the local health board). If you holiday in the EU, this will entitle you to free treatment or reimbursable expenses. If you travel further afield, you may be covered by VHI or other travel health insurance. Sod's Law dictates that the time you forget to bring these documents is the only time you will actually need them.
9. Get your vaccinations on time. Hepatitis A and B, typhoid, cholera and yellow fever are endemic in some of the more exotic package holiday locations in Africa and the Far East. These vaccinations must be given four to six weeks before departure to become effective. It is no use coming to your doctor for vaccination three days before you leave - a common occurrence - as in these circumstances the vaccines will offer you no protection during your holiday. Remember too, if your destination is an area where malaria is endemic, you must take your anti-malarial treatment for a number of weeks both before and after your trip.
10. Be sexually discreet. If you can't, be careful and take precautions. Exposure to HIV or Hepatitis C is a high price to pay for a one-night encounter. Young women can also contract chlamydia and gonorrhea which can lead to difficulties with future fertility.
Like the original Commandments, it is almost impossible to stick to these rigidly, but attention to some of them may lessen your holiday health problems. Bon voyage!
Muiris Houston is on leave.