Here are four things you should warn your patients about before they head off on their adventures.
Traveller’s diarrhoea isn’t usually serious, but it can be very unpleasant and ruin a holiday. A digestive tract disorder that commonly causes loose stools and abdominal cramps, it is caused by eating contaminated food or drinking contaminated water. Without treatment, most patients improve within a day or two and recover completely within a week. It is however a good idea to encourage patients to pack medications that can alleviate symptoms in case the diarrhoea persists or gets worse. “The vast majority of stomach infections are viral, which means that antibiotics are not needed to treat them. Often, symptoms can be managed with rest and oral rehydration solutions,” said Dr Rene Leitch, who practises at Netcare Alberlito Hospital’s emergency department. “OTC medications for stomach cramps and diarrhoea can also provide some relief.”
Caused by too much exposure to ultraviolet (UV) light from sunshine or artificial sources, such as sunbeds, sunburn is red, painful skin that feels hot to the touch. Depending on the intensity of the sunburn, small fluid-filled blisters may form on the exposed skin. In severe cases patients may experience headache, fever, nausea, and fatigue. A cold compress or cool bath can soothe the skin. There are also several after-sun creams and gels that can help relieve the pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve sunburn swelling and pain all over the body.
Regular sun exposure leading to sunburn increases the risk of skin damage and other skin diseases, including cancer. Because of the lasting effects of sunburns, prevention really is key. Encourage patients to use broad-spectrum sunscreen with SPF 30 or higher when outside and to reapply it often – particularly after swimming. They should also wear sunglasses with UVA and UVB protection, a wide-brimmed hat, clothing with ultraviolet protection factor (UPF) when possible, and ideally avoid sun exposure between 10am and 4pm when the sun rays are strongest.
Anybody can get motion sickness, but it’s most common in children and pregnant women. A very common disturbance of the inner ear often caused by repeated motion from a vehicle, motion sickness can strike quickly. Symptoms can include cold sweats, dizziness, fatigue, headache, irritability, inability to concentrate, increased saliva, nausea and vomiting, pale skin, and rapid breathing or gulping for air.
Motion sickness management focuses on prevention. While home remedies and natural herbal treatments are effective for some, there are also several OTC and prescription medications for patients to consider. These come in the form of tablets, patches, and wristbands. Commonly used to treat allergies, first-generation OTC antihistamines can also prevent motion sickness and ease symptoms. Scopolamine, an anticholinergic, is a prescription transdermal patch the patient wears behind the ear. It’s important to make sure patients know how long in advance motion sickness medicines need to be taken to be effective.
When it comes to malaria, the focus is on prevention. Most travellers who develop malaria do so because they do not adhere to an effective chemoprophylactic drug regimen. As a pharmacist you have a key role to play in educating patients in the importance of preventing malaria. For example, Dr Leitch highlighted that it’s important to make patients aware that some antimalarials needs to be taken well before entering a malaria area.
While no regimen is 100% effective, the combination of preventive measures will give significant protection against the potentially severe consequences of malaria. The two key elements in prevention are barrier protection and chemoprophylaxis. Taken correctly, antimalarial tablets can reduce the risk of malaria by about 90%, add to that the use of mosquito repellent at all times, clothing that covers arms and legs, and mosquito bed netting at night, and patients will be well protected during their holiday.
American Family Physician advised that patients should be warned that malaria symptoms can present up to one year after a mosquito bite. “Symptoms are vague, and may include fever, chills, arthralgias, and headaches. Travelers experiencing symptoms should seek prompt medical attention.”