Travel Health for Children While Overseas

Dr Brian Gilbert of Travel-bug Vaccination Clinic in Adelaide has kindly prepared the following information to help us keep our kids healthy while away from home.

While overseas keep children away from animals, especially dogs and monkeys (these carry rabies). Take care with power plugs, motorcycle exhaust pipes (Asia), wires, balconies, crossing roads, oceans and swimming pools. Ensure children are restrained when travelling in cars and never leave them unattended. Care with babysitters is recommended.

Common problems while away:

Gastroenteritis, vomiting or diarrhoea

Children, particularly babies, are very susceptible to dehydration from fluid loss. Prevention of these issues involves attention to hygiene (hand washing, anti bacterial gel/wipes) and careful choice of food and water. Take care your children don’t drink the bathwater and use only bottled water for teeth brushing.

Treatment – replace lost fluids with an oral re-hydration solution. Gastrolyte sachets mixed with bottled water or boiled water (boiled for 10 minutes) OR juice/lemonades diluted in 1:4 water (bottled or boiled). Offer small amounts often.

Age Daily Fluid Intake
Babies - 2 Months 600 ml
3 - 6 Months 1000 - 1400 ml
6 Months + 1400 - 2400 ml

Breast feeding and formula (DILUTED) feeding should continue and be supplemented with clear fluids from a bottle, cup or spoon.

Avoid – dairy, fatty foods and wheat products.

If the child is hungry feed small amounts of rice crackers (toast or plain biscuits), steamed rice, bananas, papaya.

Emergency – if the child is listless, unexplainably drowsy, has a dry mouth, prolonged high fever and for a baby under 1 year of age; vomiting or diarrhoea for more than 24 hours – seek urgent medical attention. Do some research before you go so you know where to find help (hospitals, medical centres, ambulances).

Fever

A child with a temperature above 38C should be given a paracetamol dose as per weight/age (never exceed recommended dose). Undress the child to a nappy and keep cool, but do not chill. Rest and fluids are essential. If in a malarious area, seek medical advice within 24 hours after fever onset.

Malaria

Malaria is one of the world’s most dangerous diseases. It is a mosquito borne disease present in tropical and sub tropical countries. Malaria kills a child every 30 seconds somewhere in the world. Mosquitos spread the disease to humans by injecting tiny parasites into the blood when they bite. These parasites affect the liver and the red blood cells.

Symptoms of malaria include fever, chills, headache, vomiting, diarrhoea, muscle and joint aches, coughing. The possibility of malaria must always be considered in all cases of unexplained fever or flu-like illness. Unfortunately a young child may just be listless, or unwell.

The period between the mosquito bite and onset of symptoms is usually 1 – 3 weeks. Medication to prevent malaria is available, but you need to see a doctor for this. There are various medications which can do this, but it depends on where you are going, and the age of the children.

Rabies

Rabies has the highest known fatality rate of any infectious disease ( almost 100%). Rabies exists in every continent except Antarctica. The outlook for most rabies victims is certain death. The best protection for rabies continues to be prevention through vaccination. Rabies has no boundaries and continues to spread across previously rabies free countries (eg Bali). Rabies kills one person every 10 minutes – more than 55,000 people every year. Sadly, over 50% of these deaths are children under 15 years of age.

Preventative measures:

  • Prevention of possible exposures to rabies virus is best accomplished by avoiding bites from mammals (mainly dogs, monkeys, bats, and cats in some countries).
  • Licks from animals to fresh wounds or mucus membranes of humans are a risk of acquiring rabies.
  • Travellers should avoid approaching stray animals, be aware of their surroundings so that they do not accidentally surprise a stray
  • In addition to avoiding bite exposures, two strategies are available to travellers for the prevention of rabies: vaccination before travel OR the management of a possible rabies exposure after a bite or scratch.
  • Immediate and adequate medical care after an animal bite is critical to preventing rabies. Wash the wound with copious amounts of soap and water and iodine if available. Seek medical advice within 24 hours.

Regardless of whether or not pre-exposure vaccine is administered, travellers going to areas with a high risk for rabies should be especially encouraged to purchase medical evacuation insurance.

Make sure to also see Dr. Gilbert’s article on Pre-trip preparation

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