Don’t Forget The Meds

Are you making these six travel health mistakes? EVELINE GAN shows you why they could ruin your family’s next holiday.

Portrait of Tammy Strobel

When you’re travelling with kids, something is bound to crop up and derail your best-laid holiday plans. For my family of four, the ultimate vacation bummer always involves a kid falling sick.

On our recent Batam getaway, a nasty tummy bug reared its ugly head. In Australia, it was the winter flu. Midway through our Taiwan holiday some years back, a mysterious skin rash made my toddler’s toes swell and itch for days.

My kids’ experiences with travel bugs are not unusual, given that families here are becoming increasingly adventurous.

“Once we step out of Singapore, the risk (of coming down with a holiday-acquired bug) opens up,” warns infectious disease expert Leong Hoe Nam of Rophi Clinic at Mount Elizabeth Novena Specialist Centre.

Singaporeans also tend to be nonchalant about hygiene when travelling, says Dr Leong.

“Many seem to assume that the Agri-Food and Veterinary Authority (AVA) ministry officials work around the world, and apply the same eating and lifestyle rules we have in Singapore to everywhere they go. That is a complete recipe for disaster,” he adds.

According to Dr Leong, the top three infections Singapore holidaymakers suffer are everything my kids have experienced: respiratory tract infections (like the flu), diarrhoea-related illnesses, and skin infections usually triggered by a cut or insect bite.

The list doesn’t end there. For instance, your kid may also pick up infections that are common in our neighbouring countries, like Hepatitis A and E, by taking a swig of contaminated water or tucking into improperly cooked food, he warns.

These viruses attack the liver and can cause symptoms like fever, nausea, vomiting, tummy pain and jaundice.

Travel infections aside, even seemingly minor health issues like motion sickness or jetlag can put a damper on holiday fun.

On one particularly bumpy flight, my 10-year-old puked her guts out thanks to a bad case of air sickness. Later that day, a long three-hour train ride left her miserable and green with nausea.

Don’t want to lose a chunk of your vacation to these spoilers? Avoid these six common travel mistakes to keep Junior – and yourself – healthy on your next trip.


You skip Junior’s optional vaccinations

Sure, your kid may be wellcovered by the vaccinations under the National Childhood Immunisation Schedule. But they may not cover other nasty infections that he may pick up beyond our shores.

For example, many developing countries around the region still have cases of typhoid fever, and Hepatitis A and E infections, says Dr Christelle Tan, a specialist in paediatrics at Raffles Specialists at Raffles Holland V, which runs a travel medicine service.

Outbreaks of chickenpox and measles have also been reported on cruise ships, where it is easy for infections to spread, adds Dr Tan. “Think of a cruise ship as a sardine can packed with people. One uncooperative person with the flu, for instance, will easily spread it throughout the ship,” says Dr Leong.

BEAT IT Before your trip, check that your kid’s vaccinations are up-to-date. You should also find out the required or recommended shots for your travel destination, advises Dr Tan.

Check out the United States’ Centres for Disease Control (CDC) and Prevention destination list ( which provides information on each country’s recommended vaccines, as well as travel health notices and what to do if you fall ill.

Plan your vaccination schedule at least a month in advance by consulting a doctor who is experienced in travel medicine, says Dr Tan.


You leave your medical kit behind

Even if your kid doesn’t have a medical condition or drug allergy, it is always good to bring along a travel medical kit in case of emergencies.

“Kids fall sick easily as they may be sensitive to weather changes and have a weaker immune system. Plus, it may be difficult to obtain medications that you are familiar with in a foreign country, so being prepared can be very helpful,” says Dr Tan.

BEAT IT Pack these into your travel first-aid kit, says Dr Tan:

• Basic first-aid supplies, including plasters, antiseptic cream and some gauze.

• Medication for fever, cough and colds, as well as diarrhoea and vomiting.

• Your child’s inhaler medications, if he has a history of asthma or has used an inhaler before.

• Anti-allergy medications, particularly for those who have allergies.

• Your child’s medical alert or an updated summary of his medical condition from his doctor, in case of emergencies.

• Syringes to measure and feed medication.

• Mosquito repellent, sunscreen, anti-motion sickness medications (depending on your destination).


You feed your kid “fresh” or undercooked food

Who doesn’t love runny eggs, sausages and a colourful cutfruit platter from the breakfast buffet line?

It’s safer to skip these items when travelling in less developed countries. Don’t take a chance with raw or half-cooked food or food that has been left uncovered or sitting in the open even if you’re dining at an upmarket restaurant, says Dr Leong.

“Many people will say ‘we eat only at five-star hotels’. But if there is a one-star cook or kitchen helper in the five-star hotel, your food safety is only as good as that in a one-star restaurant,” he says.

It is still possible for your kid to get food poisoning even in first-world countries. For instance, salmonella is still frequently found in the US and Europe, while there are cases of Hepatitis A and E in Japan, says Dr Leong.

BEAT IT When in doubt, only feed your kid food that is thoroughly cooked and served hot. Choose fruit that you can easily peel, like bananas. Remember to wash your hands before you tuck into your meal, too. If soap and water aren’t available, use a hand sanitiser containing at least 60 per cent alcohol. The CDC advises travellers to steer clear of:

• Food served at room temperature.

• Food from street vendors.

• Raw or soft-cooked (runny) eggs.

• Raw or undercooked (rare) meat or fish.

• Unwashed or unpeeled raw fruits and vegetables.

• Peelings from fruit or vegetables.

• Condiments (such as salsa) made with fresh ingredients.

• Salads.

• Unpasteurised dairy products.

• “Bushmeat” (monkeys, bats or other wild game).


Brushing your little one’s teeth with tap water

All it takes is an accidental swig of contaminated water for travellers’ diarrhoea to strike. Besides ruining your holiday plans, diarrhoea is also especially dangerous for young kids as they tend to become dehydrated more quickly than adults.

The CDC advises travellers to developing countries to avoid drinking or using tap water to brush teeth or rinse the mouth.

BEAT IT The CDC recommends disinfecting tap water by boiling it for about one minute. If you’re unsure, simply use bottled mineral water for drinking and brushing teeth, and when preparing formula milk or rice cereal for babies and toddlers, says Dr Leong.

Download the CDC’s Can I Eat This? app. It helps prevent travellers’ diarrhoea by pointing you to the right food and drink choices in different countries.


Passing your kid the iPad while on the road

Air and motion sickness usually do not affect babies, but it can hit older kids. Those aged two to 12 years old tend to be prone to nausea, vomiting, headaches and general discomfort while travelling, says Dr Tan.

This could be due to their developing balance centre, says Dr Tan. Babies don’t have this problem because they are usually on their backs.

BEAT IT To prevent motion sickness, Dr Tan suggests:

• Offer plenty of fluids to keep your kid hydrated.

• Get him to focus on the surroundings outside the vehicle instead of watching a video or reading a book, which may make matters worse.

• Travel during naptime.

• Avoid large meals and opt for light snacks before travelling.

• Distract your kid by playing some music or talking to him.

• Ask your paediatrician about anti-motion sickness medications. They can be used for kids above the age of two, but may cause drowsiness.


Cramming too many exciting activities in the first few days

You’ve reached your destination and are raring to go. But the kids have turned into cranky monsters who have trouble staying awake in the day and wake up at odd hours at night.

Like adults, kids can get jetlag, too, if they already have an established sleep-wake cycle and are crossing time zones. Expect jetlag to set in during the first few days, so try not to overschedule your holiday activities, advises Dr Tan.

BEAT IT Prevent jetlag with these strategies from Dr Tan:

• Ensure that your kid has sufficient sleep weeks before you travel.

• A few days before your trip, adjust his sleep schedule closer to the destination time, for example, by an hour or so every day.

• Set aside time to rest and recuperate. This means scheduling that theme park trip or other high-energy activities to a later date.

• Get enough sunlight to help the body adjust to the local time, and wind down in the evenings.

• If your kid needs a nap during the day, keep to only 15 to 30 minutes. Move naptime to an earlier time in the day. 

Get that jab

Your child is protected against certain diseases under the National Childhood Immunisation Schedule. But the vaccinations on the schedule may not cover other bugs that Junior may pick up outside Singapore. Infectious disease expert, Dr Leong Hoe Nam, says you may consider these optional vaccinations.

INFLUENZA This is a travel must-have, regardless of your destination. Update your flu jabs yearly so that you and your kid are protected against the current circulating seasonal flu strains. Kids aged nine and below will need two shots at least a month apart, says Dr Leong.

HEPATITIS A Get two shots at least a month apart before heading across the causeway or to other South-east Asian countries, which are Hepatitis A hotspots, advises Dr Leong.

There is currently no vaccine for Hepatitis E, which is typically spread via drinking contaminated water.

TYPHOID The vaccine, which can be given as an injection or orally, protects you from a nasty diarrhoea-causing bug called Salmonella Typhi that lurks outside Singapore’s borders. It only offers around 70 per cent protection, though, and you’ll need to top it up every two to five years, says Dr Leong.

MALARIA As a general rule of thumb, young kids and pregnant women should avoid malaria-prone areas, such as countries in the Sub-Saharan Africa and South America. If you’ve already planned a trip, see a travel medicine specialist to get the right type of anti-malaria medication.

JAPANESE ENCEPHALITIS Going on a rural getaway for more than four weeks or doing a farm stay in areas where there is pig farming? Get vaccinated, because there is no treatment if Junior gets this nasty brain infection that is spread by mosquitoes. About half of the people who get it will die from it or end up with serious lasting defects, says Dr Leong.