Health is the most important detail in planning one’s travel. Planning and staying healthy while travelling ensures an enjoyable trip and lessen the risk of adverse health consequences. It is important to ensure a comprehensive travel insurance that will cover all the overseas medical costs as well as repatriation of the body in case of death. Travellers must check their health plan about out-of-area coverage and should be aware of the circumstances and activities of the insurance policy. Insurance certificate, contact details, as well as copies of prescriptions should be carried out with other travel documents in the hand luggage.
Travellers also should visit their physician or travel health clinic 4-8 weeks before the trip. Doctors and travel health clinic are the best source of information about preventive measures, immunizations and disease outbreaks overseas.
The following are the commended vaccinations for Sri Lanka:
> Hepatitis A
> Hepatitis B
> Japanese encephalitis
> Routine (for fever, headache, muscle aches, malaise, soreness, diphtheria, etc.)
Note: A yellow fever vaccination certificate is required from travelers over a year of age coming from an infected area.
What to Pack
Here are suggested items that you may bring when you travel to Sri Lanka: adhesive tape; antiseptic wound cleanser; bandages; emollient eye drops; insect repellent and insect bite treatment; nasal decongestant; oral rehydration salt; scissors and safety pins; paracetamol and analgesic cream; sterile dress; clinical thermometer; lotion; antihistamines for allergy symptoms; antifungal powder; sunscreen (SPF 30 or higher) and sunglasses; and water disinfectant or iodine tablets.
Food and Water Precautions
Food and drinks should be considered as potentially contaminated. Water used for drinking, brushing teeth or making ice should have been boiled first or sterilized. It is safe to drink bottled water or mineral water which is available at most hotels and other establishments. It is advisable to get powdered or tinned milk, pasteurized or sterilized milk. Avoid unpasteurized milk or any dairy products that might have been made from unpasteurized milk. Eat only a well cooked meat and fish, vegetables or fruits should be cooked or peeled. Make sure to wash your hands often with soap and water, particularly before eating. Alcohol based hand gel (with at least 60% alcohol) is another alternative if soap and water are not available.
Travellers should bring along antibiotic or antidiarrheal drug. If diarrhoea occurs one should take loperamide or diphenoxylate to reduce diarrhoea and prevent dehydration. If diarrhoea is severe or bloody or accompanied by fever and shaking or abdominal pain and persist for more than 72 hours medical attention should be sought.
Insect and Tick Precautions
Diseases like malaria and dengue are spread through insect bites. So the best protection against these diseases is to prevent insect bites. Here are some suggestions to prevent insect bites: wear long sleeves, long pants, hats and shoes outdoors; use insect repellents containing 30-50% DEET or apply frequently 7% and 20% picaridin to the exposed skin; avoid sleeping with open window unless there is a screen; one should remain indoors in a screened or air conditioned area during the peak biting period for malaria (dusk and dawn); spray rooms with products effective against flying insects, such those that contain pyrethroid; when visiting a rural area or forest, perform a thorough tick check at the end of the day using a full length mirror or a help from a friend, removed ticks using tweezers, tick-borne illness can be prevented by prompt tick removal.
Malaria is a serious disease and usually occurs in many tropical and subtropical areas. Human acquire malaria through mosquito (infected with parasite) bite. In order to prevent malaria, travellers who are travelling to malaria risk areas in Sri Lanka should take an antimalarial drug where necessary and take precautions against mosquitoes, which include using insect repellant at all times.
Some of the common symptoms of malaria are fever, chills, sweats, headache, body aches, fatigue, nausea and vomiting. These symptoms usually occur for at least 7 to 9 days after bring bitten by the infected mosquito. If a traveller develops fever anytime during the first week of travel in a malaria-risk area he or she must see a doctor immediately. Travellers develop fever after their return from a malaria-endemic area should seek immediate medical attention.
There were reported outbreaks of Chikunguya fever in Kuruwita-Erathna and Ratnapura District in the province Sabaragamuwa province on the later part of the first quarter of 2008. In 2006 there were about 5,000 people who had been infected by the same disease in Colombo. Other affected areas were the district of Batticaloa, Jaffna, Kalmunai, Mannar, Puttalam, and Trincomalee.
Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Common symptoms are fever, joint pains, muscle aches, headache, and rash. Although the disease is not fatal it may be complicated by prolonged fatigue and malaise. Some protective measures to prevent this disease are wearing protective clothing, staying in areas with screen and using insect repellent.
At present, there is no specific anti-viral treatment for chikunguya fever. Symptoms like headache and fever can be treated symptomatically, while hospital care is indicated in severe illnesses or complications.
An outbreak of leptospirosis was reported from the Southern Province of Sri Lanka which resulted to the 41 deaths on first quarter of 2008. Leptospirosis is acquired by exposure to water, food or soil contaminated with urine from infected animals. Rodents are the principal carrier of the disease in the country; other animals that might carry the disease are cattle, deer dogs, cats, foxes and goats.
The symptoms last for few days to 3 weeks or longer, symptoms include high fever, chills, severe headache, muscle aches, vomiting, abdominal pain, diarrhea, red eyes, rash or even jaundice. Leptospirosis is treatable with antibiotics however if the disease is not treated patient could develop kidney damage, liver failure, meningitis or respiratory distress and may lead to death. In order to reduce the risk of acquiring the disease, travelers should minimize contact with fresh water, mud and vegetation that might be contaminated with the urine of infected animals; and also wear protective clothing when participating in recreational or work activities that might result in contact with contaminated water.
In 2006 around 7,000 cases of dengue fever were reported. Dengue fever is a flu-like illness which may be complicated by hemorrhage or shock. It is characterized by onset fever with intense headache, joint and muscle pain, pain behind the eyes, nausea, gastrointestinal disturbances and rash. The disease virus is transmitted to human by Aedes mosquitoes. In order to prevent the disease travelers must rely on preventing mosquito bites to combat infection; wearing long sleeved shirts and trousers is advisable, rest in well screened or air conditioned rooms, use insect repellents containing at least 20% DEET, carrying a portable bed-net and applying permethrin on the clothes are also useful.
Travellers are advised to have a medical examination on their return if they suffer from a chronic disease, if they experience illness in the week following their return, if they spent more than 90 days in a developing country and if they were exposed to a serious infectious disease while travelling.
It is also advisable to provide medical information to medical personnel about their recent travel, including destination, purpose as well as duration of the visit.