There is an enormous amount of information on health problems related to travel of western tourists to the tropical countries, including to India. Whether travelers from India to the West are also at increased risk of health problems, is a dubious question. Undoubtedly, the risk of infection related health problems in the West is significantly lesser than that in India. There is a cleaner atmosphere and effective implementation of health standards of available water and foods. There is lesser air pollution and almost nil adulteration of edible items. One can easily rely upon the labeled constituents of sold food items and believe most of the vendors for the quality of the products being sold. Why then worry about the health problem? We Indians are conditioned to live and stay healthy in more adverse conditions.
When Columbus in 1492 discovered America, he is said to have brought back parrots and spears, and syphilis to Europe. Syphilis, being contagious, spread widely in Europe and the rest of the world through human sexual contact. Similarly, plague is known to have spread through trans-country travel and migration of populations. The danger of spread of infections in the modern times is much verse. The enormity of travel these days is several thousand-time more and the period of travel is rather short – only a few hours by air to travel to most of the countries. In particular, the chances of spread of infections due to viruses have tremendously increased. We all have heard of many incidences of respiratory infections in the last decade such as the Severe Acute Respiratory Syndrome (SARS), swine-flu (H1N1) and avian flu (H5N1 and H7N9) etc. Fortunately, H7N9 influenza detected in China has remained restricted to that country. The latest in the series is the Middle East Respiratory Syndrome (MERS) infection.
The important points on which I wish to lay stress are related to an individual’s allergic diathesis and to the availability of health-care for an alien traveler. Patients of all types of allergies need to be careful during travel. The common belief that allergic problems will not be there in lesser polluted Western countries is not true. Allergic problems have no obvious relationship with levels of pollution, they may get worse during travel. Many forms of allergies including asthma, are rather more common in the least polluted countries of Europe, Australia and America. The same is true for nasal, skin and eye allergies.
It is also true that allergic condition of an individual may sometimes get better during a travel. An allergic patient may temporarily feel better when removed from the surroundings in which he/she had lived. But the effects during the period of travel are unpredictable. It is therefore, important to be careful. The patient known to have allergies must be adequately prepared to deal with an increased problem, in case that be so.
Availability of health care is an important issue which must be addressed, especially in the absence of known acquaintances in the region of travel. It is rather cumbersome for an Indian traveler, accustomed to the easily available health advice in India, to seek medical advice in a Western country. The Western medical system is highly professional, costly and relatively difficult to seek, especially for minor problems. It is generally quite bothersome for a relaxing tourist to run to a hospital for increased occurrence of sneezing, running nose, itching or wheezing.
Health insurance during travel is important to take care of severe problems and emergencies. It is important to arm one-self to handle a known problem, aggravated during a travel. One should therefore carry the extra and additional medicine required for such a situation. It is always advisable to use an extra dose or two in case of a need. It is however important to seek local medical opinion in case of a persistent or a worsening problem.
Travelers are in no way immune to develop serious problems and/or accidents. Heart attacks, strokes, acute abdominal and respiratory emergencies can happen during travel, to healthy individuals and more so to patients with pre-existing chronic diseases such as hypertension, diabetes or asthma. It is important to seek early medical advice and/or hospitalization if necessary. The insurance cover to deal with such a situation is almost mandatory.
There are a few other area-specific problems which can be kept in mind. Sun burns are common in tourists to the Alps in Europe in the presence of an intense sun-shine and unprotected skin. Similarly, the travelers to the African and South American countries should be cautious about the regional kinds of insect bites and endemic infection (e.g. yellow fever).
Constipation is another common problem faced by Indian travelers. The food is usually deficient in fiber content with a lot of junk food consumption. Fluid intake is also poor and the regular schedule of eating and exercising is missing. Though not serious, the problem is quite troublesome. Preventive steps are generally adequate for avoidance.
Awareness of the possibilities of health risks and of the steps for their prevention will go a long way to increase the joy of travel. Non-essential travel should always be avoided during the periods of epidemics in a particular country/ region.
(Ex-Professor & Head, Department of Pulmonary Medicine
Postgrad Instt of Med Edu & Res, Chandigarh, India)
Medical Director, Jindal Clinics, SCO 21, Dakshin Marg, Sector 20 D,
Near Guru Ravi Das Bhawan, Chandigarh, India 160020.