The Ultimate Guide to Staying Healthy Whilst Travelling

 
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Nobody wants to get sick while travelling.  Holidays are supposed to be relaxing – and it is certainly not relaxing to be up all night with Bali belly, or sightseeing in Paris with mucous being forcefully ejected from your orifices.  And nobody wants to even think about contracting something even more sinister, like malaria.

Whilst getting sick on holiday sucks, it’s not uncommon.  Traveler’s diarrhea affects 20 to 50% of international travelers.  Airplane passengers have a giant 10-80% chance of getting sick, depending on where they sit.  This is before we mention those infamous news stories about norovirus outbreaks on cruise ships.  The truth is that wherever there are people, there are illness causing germs.

However, the chance of getting sick shouldn’t stop you from getting out and exploring the world!  With a few simple precautions, you can likely avoid illness, or at least reduce the severity and duration of your illness.  In fact, if everyone took these steps all the time, we could reduce the collective likelihood of getting sick altogether.


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Before you go

Make sure you visit your doctor early

Schedule a visit to a travel doctor for advice on the vaccinations you need prior to travel.  Certain countries carry risk of infectious diseases like malaria, zika virus, or other serious illnesses which are easily prevented with vaccinations or medication.  Some prevention regimes need to be started well before travel, so plan to see your doctor at least 6 weeks out from departure. 

Also talk to your doctor about prescriptions for your regular medications, in case you run out, or it is restricted in the country you are visiting.

Don’t forget to talk to your doctor before embarking on a long flight if you have risk factors for stroke e.g. history of Pill use, family history, smoking.  (Trust me from firsthand experience: nothing kills your travel buzz like a suspected blood clot in your leg after a flight.) 

Further, if you’re visiting a country where traveler’s diarrhea is common, or you’re concerned about motion sickness, your doctor may prescribe anti-nausea medication, or provide other helpful tips for keeping a happy tummy.

Take your vitamins

As a nutritional therapist I must emphasize that vitamins are not a substitute for a healthy diet.  Without eating healthfully, you might as well tip your vitamins down the sink.  That said, we take vitamins before a trip as an “insurance policy”, together with a nutritious diet, to give our immune system an extra boost.

Vitamin C: High strength vitamin C boosts immune system function, reduces the severity and duration of viruses, and is a powerful antioxidant.
Vitamin B Complex: Boosts immune system function and energy levels, and eases stress.  There’s also a theory that vitamin B repels mozzies.  Anecdotally, people I know who are mozzie magnets swear by it (myself included).  The science says this is codswallop.  I say definitely take vitamin B for its many health benefits, and it can’t hurt as an extra step to repel mozzies.  Just don’t use it as a substitute for malaria or zika vaccinations, wearing proper clothing, and using mosquito repellent.
Probiotics: Keep a balance of good bacteria in your gut and prevent or at least reduce the severity of traveller’s diarrhoea. 
Fish Oil: The long chain fatty acids found in fish oil enhance immune cell function.  They also reduce inflammation and lower the risk of developing DVT. 
Elderberry Extract: Contains strong antiviral and antioxidant compounds.  It boosts the immune system and prevents or reduces the severity of up to 10 strains of flu.  It also boosts digestive health, provides allergy relief, and prevents or reduces the severity of urinary tract infections.
Olive Leaf: Olives are a super food!  People have used olive leaf medicinally for centuries.  Olive leaf extract is full of antioxidants, phytonutrients and sterols which reduce inflammation in the body and fight infection.  It is also antifungal and antiviral.
Oil of Oregano: Oil of oregano has powerful antimicrobial properties.  It is especially effective against preventing bacterial gastrointestinal illnesses and viruses.  It is also antiseptic and antifungal.

Always chat to your doctor before starting vitamin supplementation, especially if you have pre-existing medical conditions, to make sure nothing will adversely interact. 

Eat nutritiously

A healthy diet is the best way to prevent illness while travelling.  Choose to mostly eat fresh, whole foods that are as unprocessed as possible. 

  • Eat fruit and vegetables in all the colours of the rainbow: leafy greens like kale and spinach, cruciferous vegetables like broccoli and cabbage, capsicum/peppers, oranges, pumpkin, bananas, apples, sweet potato, berries, tomatoes and legumes should make up the bulk of your diet.

  • Lean protein provides building blocks for the body to use in cellular repair.  Choose chicken breast, oily fish, tofu, legumes, dairy (if you can tolerate it), and lean beef or lamb cuts.

  • Nuts and seeds contain healthy fats, iron, zinc, and protein to aid immune system function and wound healing.

  • Wholegrains like brown rice, quinoa, corn, and oats are gentler on the tummy than wheat, and are high in fibre, promoting gut health.  The gut is the home of our immune system, so keeping it swept clean is important.

Exercise

Exercise positively impacts our immune system, though scientists aren’t certain why.  There is a theory that it flushes bacteria from the lungs and airways.  Another suggests that it increases the efficacy of antibody and white blood cells.  Still another theorises that the brief spike in our body’s temperature prevents bacteria growth.  Finally, exercise lowers the production of stress hormone cortisol, which inhibits immune system function.

Sleep

A good night’s sleep is vital for the immune system.  During deep sleep our bodies repair themselves, fight infection, boost immunity, and recharge energy.  Lack of adequate sleep actually suppresses proper immune system function, so you are more likely to fall ill after a lot of sleepless nights.

Get travel insurance

Despite our best efforts to be healthy travelers, sometimes getting sick or injured Just Happens.  In many countries, healthcare costs can be exorbitant and downright unaffordable. 

This is why it is important to take out travel insurance before you go, so that if something does happen, you’re covered.  We always buy it and touch wood never use it, but having it there gives us peace of mind.  We like to use Tick Travel Insurance for comprehensive, fuss free cover.

On the plane

By design, those little tin cans we fly in tax our bodies.  The air pressure at high altitudes causse pressured breathing.  In addition, there is reduced oxygen in the cabin.  This means that our bodies get less oxygen into the bloodstream than usual.  There’s also the risk of DVT from being cramped in one place for too long, and the drying low humidity in the cabin wreaks havoc on our immune system.  But there are ways to prevent plane travel from knocking us. 

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Keep warm

Airplanes are icy cold, and bone dry, and often in that harsh immunity lowering environment we are trapped with people from all over the world carrying viruses we’ve never been exposed to.

Keeping warm and well hydrated counteracts this, protecting your immune system (and helping you feel super cosy and comfortable).

  • Avoid drinking ice cold water – stick to bottled room temperature water.

  • Choose hot liquids, preferably decaffeinated like herbal tea, as caffeine is drying. 

  • Avoid “cold” foods like ice cream, yogurt, or salads and favour cooked, hot foods.  You might also bring ginger tea or ginger biscuits (ginger has warming properties, and – added bonus – prevents turbulence sickness).

  • Wear warm clothing on board, even if it is warm outside.  Keep your neck and face warm with a thick knit scarf and cover your feet with a pair of your fluffiest bed socks. (Wear shoes to the plane bathroom though, those things are germy AF.)

  • Bring a Pashmina shawl to use as a blanket.  It doubles as a fashionable scarf whilst travelling.

Wipe down your plane seat and surfaces

I’m not ordinarily a fan of sanitising the shit out of everything, but I do recommend wiping down your seat, arm rests, entertainment screens, window shades and dining tray with antibacterial wipes before sitting down.

Studies show that tray tables on airplanes have 2000 bacteria per square inch.  By comparison, your mobile phone, one of the filthiest surfaces in your home, has 27 bacteria per square inch.  Flight staff admit that tray tables are infrequently cleaned, and that it’s more common to see dirty diapers sitting on them than food.

Yeah.  Think about THAT the next time you lay out your cheese and crackers right on the tray.  E.coli and staphylococcus aureus were also found on armrests and window shades.  Give your seating area a good wipe down to prevent catching something untoward – or, at least you’ll feel better.

Bring your own blanket and travel pillow

Why bring a blanket and pillow when the airline supplies them on long haul flights anyway?

Because airline supplied pillows and blankets only get washed before the first flight of the day.  After that, they’re just folded and handed out on the next flight.  You’re essentially sharing a blanket and pillow with a bunch of strangers.  Bring a Pashmina, or Turkish towel, and a travel pillow instead.  Both things are worth the space they use in your luggage.

Consider wearing compression leggings

These pants compress the legs, core and ankles.  This aids circulation, keeps limbs from swelling, and helps to prevent blood clots.  They’re also a versatile travel item.  They’re comfy to wear sightseeing as well as when exercising. 

Of course, if you’re concerned about your risk of developing DVT you should talk to your doctor and follow his or her recommendations.

Stay hydrated

Staying hydrated is one of the most effective ways to stay healthy.  Dehydration impairs mmune system function.  Unfortunately, a plane’s cold and dry environment combined with high altitude is the perfect recipe for dehydration.  This is why you often disembark a plane with a sore throat, feeling groggy, a little bit nauseous, light headed, and dry eyed. 

Drink a minimum of 250 mL of water for every hour you are in the air, taking small but frequent sips.  Don’t wait until you’re already thirsty before you start – thirst is actually a dehydration symptom!  Sachets of Hydralyte give your electrolytes a boost without sugary sports drinks.

Keeping your belly full of water also gets you up to use the loo more often, circulating your blood and preventing DVT.  It also minimises jetlag AND keeps your skin moisturised, so you won’t look like you’ve aged 1000 years on arrival.

Walk around the aisle when you can

When the seat belt sign is off and the plane is in the air, get up and walk around as often as possible, but at least every two hours. 

Unless you’re on the aisle seat there is, unfortunately, no way to do this without disrupting your row mates.  As an introvert, I once resisted doing this on a 14 hour flight, because I had to actually WAKE two people whenever I wanted to get up. 

I spent the entire flight crammed behind someone with his seat extended the whole way back (so I sat almost cross legged in my seat).  The unfortunate result? Ending up at the doctor instead of on the beach with a suspected blood clot in my leg.  Not fun.  It would have been more convenient to ask people to move, in hindsight.

While you’re up, go to the bathroom and, without obstructing others, wander up and down the aisles, perhaps even doing a few lunges or squats for extra movement.

Drink Berocca

Containing vitamin B and C, Berocca gives your immune system a powerful boost and keeps you hydrated too. 

While you’re there

Wash your hands, or use hand sanitiser

The most important thing you can do to avoid catching any sort of bug or parasite is to practice proper hand hygiene.  It’s estimated that 95% of people who use public toilets don’t wash their hands properly.  Most people spend only six seconds washing their hands, which is hardly at all effective for removing germs. 

The CDC recommends washing your hands for 15-20 seconds.  That is, you should be able to sing Happy Birthday twice through as you lather your hands.

After you’ve washed your hands, dry them properly with paper towel or an air dryer.  Avoid sharing cloths, which spread germs.

 Pay particular attention to palms and fingertips when washing your hands, and underneath your fingernails

Pay particular attention to palms and fingertips when washing your hands, and underneath your fingernails

You should wash your hands:

  • After using the toilet, changing diapers, or helping your child use the toilet

  • After touching garbage

  • After touching high traffic items, like elevator buttons, ATMs, handrails, or money

  • Before you eat, handle, or prepare food

  • After contact with animals

If soap and water aren’t available, the next best thing is hand sanitiser at preparations of over 70% ethanol.  (In Australia, I like Aqium Gel.  I hear Clorox hand sanitiser in the US is great too.)

Just like washing your hands, applying hand sanitiser the wrong way negates its effectiveness.  Use a good sized dollop, scrub it into your hands and fingers thoroughly (it should take the same time as hand washing), and ensure your hands are completely dry before touching anything.

I don’t recommend relying on hand sanitiser, or ever choosing it over washing hands, but rather only if hand washing facilities are not accessible.

Wipe down hotel room surfaces

For the same reason you would wipe down your airplane seat, wipe down high traffic surfaces in your hotel room.  This includes things like your bedside table, countertops, door handles, coffee tables, toilet handles, and faucets.

You could go overboard here.  We’ve read people don’t use the bathtubs, get rid of the bedspread, and never walk around the hotel room barefoot.  Personally, we feel like that’s overkill.  As long as the room looks and smells clean, we’re not too picky, but a quick going over of common surfaces provides good peace of mind.

Avoid putting your hands in your mouth or face

The average person touches their face every 20 seconds.  This spreads germs to your eyes, mouth, and nose, where they can enter your body and make you ill.  Touching your face often also leads to skin breakouts because bacteria get stuck in your pores.  Wash your hands first.

Check out the drinking water situation

In some countries, like Bali and Thailand, the water is not safe for foreigners to drink.  This is the most common cause of traveller’s diarrhoea.  Most people know to only drink bottled water, but inadvertently slip up elsewhere.

Research drinking water quality before you go. If it is an issue, follow these tips:

  • Always use bottled water for drinking and brushing your teeth.

  • Avoid getting water in your mouth whilst showering, swimming, or bathing

  • Avoid eating thin skinned or no-peel fruits (like berries), cut fruit, or raw salads.  These are washed with tap water which is unsafe.

  • Order drinks, like cocktails, soft drinks, smoothies, juices, or iced coffees, without ice.

  • Avoid desserts like Sno Cones or soft serves made with crushed ice.

  • Make sure the plates and cups your food is served with are completely dry, as they are washed in tap water.

  • If buying local fruit and vegetables, wash them thoroughly in bottled or boiled water before eating, and peel them if possible.

  • I learned this tip from an old colleague who used to travel frequently: if in doubt, buy a sealed bottle of Coca Cola.  Coca Cola’s stringent quality testing is uniform worldwide.  You can always be sure that it’s safe to drink (well... somewhat... in the short term, anyway).

We’ve heard that many people get traveler’s diarrhea the first time they visit a location, but after a few visits they can even order iced coffees and not get ill.  Everyone’s microbiome is different, and some are more tolerant to bacteria than others.

Handle buffets with caution

If you’re worried about catching a virus whilst abroad, beware the buffet. 

The spoons and tongs people use to ladle food onto their plate are rife with bacteria – remember that 95% of people don’t wash their hands properly.  This means if they were recently ill, you could be next!

However, telling me to avoid a buffet is telling a fish not to swim.  Greg eats from a buffet at work every day (I know, right), and has become an expert at avoiding sickness from buffets.  Here’s what he taught me:

  • You don’t make friends with salad.  Avoid eating salad from a buffet as the food isn’t kept at a warm enough temperature to kill errant bugs, and bacteria grows quickly.  Salads are often served with tongs which get tossed back handle first into the food tray.  Instead choose hot dishes, where the bain maries keep food temperatures at 95 degrees Celsius. Even if germs do make their way into the food, there’s a greater chance bacteria won’t survive in there.

  • Don’t eat from dishes where the ladle handle is or clearly was in the food.  I’ll never understand why people carelessly drop the ladle into the food, handle and all, after they’ve finished loading their plates. 

  • Choose a buffet where there is high food turnover.  If staff are constantly around switching out trays, there’s less likelihood the food isn’t fresh, and that they’ll switch out food contaminated from aforementioned servers.

  • Clean your hands before entering the buffet, and then again before eating. 

Eat at the busy places

We don’t think you should be missing out on local street food unless you have a weak stomach.  What better way to try the most authentic cuisine? 

Our advice?  Eat at places where you notice a lot of foot traffic.  Where there are lots of people, there is a high turnover of food and hence a greater likelihood that the food is fresh.  Also, choose places where the food is being cooked, hot and fresh, in front of you and avoid places where the food is sitting at room temperature or for long periods in the hot sun.

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Swim with caution

Hotel pools, public swimming pools, and water parks, were responsible for 27,219 infectious diseases, 493 outbreaks, and 8 deaths in 2014.  Almost a third of these occurred in hotel swimming pools.

Whilst we would never discourage availing yourself of that divine swim up bar at your hotel, be aware and practice good sense around public swimming areas.

  • Brown water, green water, cloudy water, or slimy water is probably not good for swimming in

  • Are there showers close by?  Because you know you should be showering before you get into the pool, right?  If there are no facilities to do this, you’re basically just sharing a bath – and a lot of fecal matter - with strangers.

  • Look for signs the pool filter is healthy: the filter should be unobstructed and have strong jet streams

  • Don’t drink the water: for obvious reasons.  Try to avoid swallowing it or getting it in your mouth.

  • Ensure the inspection code is up to date

  • Does the pool smell like chlorine?  It shouldn’t.  Chlorine doesn’t smell at all until it interacts with impurities like fecal matter, bacteria, and sweat. 

  • Avoid pools with animals, diaperless infants, or anything without voluntary control of its bladder or bowel in the water.

  • Are there things in the pool that don’t belong in there?  Like poop, for instance?  Believe us, from unfortunate firsthand experience, you want to make sure the pool is poop free before you get in.  I swear I heard Jaws music as I evacuated.  Michael Phelps wouldn’t have beaten me that day.

Doodie in the pool… Hilarious in Caddyshack. Terrifying when it’s real life… and it’s not a Babe Ruth bar.

If you do get sick, keep yourself isolated

If despite it all you got sick, remember one thing: just like you didn’t want to get sick, nobody else wants to get sick.  If you’re unlucky to be struck with Bali belly, or bring a stowaway cold with you from the airplane, do your best to keep the virus to yourself.

It really sucks, but if we all did our bit to keep ourselves contained whilst sick, we could drastically reduce the spread of viruses and bacteria.

  • If possible, stay in your hotel room and avail yourself of the pay-per-view movies and a hot tub soak.

  • Wipe down surfaces in the hotel room that you touch with antibacterial wipes when you are well.  Pay particular attention to door handles, faucets, the remote control and the toilet.

  • Don’t swim in a public pool for two weeks after you’ve had diarrhea.  It can take up to 10 days for chlorine to break down diarrhea-causing bacteria, and your poo can contain those bacteria for up to two weeks.

  • If you sneeze or cough, use a tissue, throw it away, and then wash your hands thoroughly.

  • Keep isolated until you’ve been symptom free for 24 hours. 

 

Whilst getting sick on holiday isn’t ideal, with a little know how and common sense, there are steps you can take to reduce the likelihood. At the end of the day, use your common sense and forget the rest. You’re more likely to ruin your holiday stressing about getting sick than you are actually getting sick, so with these tips in mind, get out there and enjoy your holiday!



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