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Play it safe and plan ahead when travelling abroad with children

Play it safe and plan ahead when travelling abroad with children

PUBLISHED : Monday, 02 December, 2013, 9:02pm
UPDATED : Thursday, 12 December, 2013, 4:52pm

A long time ago, I carried two seat belts in my luggage. The car we rented in Turkey had no rear seat belts, as my husband and I had been warned, so we paid a body shop to instal the two I'd brought, and strapped our children in.

For years, when I counselled families about travel, I would mention those seat belts. What's dangerous for children at home will be dangerous on a trip.

Travelling safely with children comes down to taking familiar precautions in unfamiliar settings.

Many children on the road during the holidays fall into a category known in travel medicine as VFR (visiting friends and relatives).

They are "the group of patients that carry the highest risk of contracting medical problems while travelling abroad", says Dr Stefan Hagmann, a paediatrician who is based in the US.

Yet as parents, we don't always see where the dangers lie. "The degree of expertise that families have in preparing for a trip is variable," says Dr John Christenson, director of the paediatric travel medicine clinic at Riley Hospital for Children in Indianapolis, in the US.

Talking about healthy travel, he says, can involve "what type of clothing they should have, what type of insect repellent they should have, what do they know about the country and how safe it is".

For small children travelling to developing countries, it's important to be vigilant about animal bites, especially where rabies is still a problem.

"I talk to the children about how animals in many countries are not pets the way they are here," says Dr Elizabeth Barnett, a US-based professor of paediatrics.

I remember lying awake during a holiday, worrying because my three-year-old daughter had been bitten by a monkey. It wasn't a serious bite, but I still had a friend contact the Centers for Disease Control and Prevention in the US, only to be reassured that rabies was not a risk there at the time. We were lucky: bites can be dangerous, and monkeys do carry diseases.

In a 2013 review of travel-related infections in children, Christenson and his colleagues noted the increasing numbers of children now travelling to developing countries.

Children, just like their parents, may need anti-malaria medication and immunisations against diseases such as typhoid, yellow fever and Japanese encephalitis (found all over Asia).

They also need to be up-to-date on regular immunisations, since those diseases, including flu, measles, meningitis, polio and hepatitis A, will be more prevalent in the developing world. In fact, travelling babies as young as six months can get an early measles vaccine to keep them safe.

Hagmann was the lead author of a 2010 study in the journal Pediatrics that found that children who were sick after international travel were more likely than adults to be hospitalised, and more likely to have gone without a pre-travel health visit.

Still, "kids who get sick overseas tend to get sick with illnesses they would have got at home, ear infections rather than malaria or tsutsugamushi fever", says Dr Karl Neumann, a New York City paediatrician who maintains a website and electronic newsletter about travelling with children.

He suggests a "modern medical kit" that might include a filled prescription for antibiotics for a child prone to ear infections, and contact information for home doctors.

Parents travelling with small children in countries where the water supply is not safe need to be rigorous about the old Peace Corps mantra: boil it, cook it, peel it, or forget it.

If children do get diarrhoea, they need to keep drinking fluids; if they start to get dehydrated, or develop fevers, severe stomach pains or bloody diarrhoea, it's time to seek medical help.

Skin problems are common during and after travel. In a large review of skin conditions in young travellers, published online this month, Hagmann and his colleagues noted that children suffered insect bites and infections, including a parasitic infection, cutaneous larva migrans, that was common in travellers to the Caribbean, and sometimes picked up by running barefoot on the beach.

The first rule of travel medicine is to see a doctor and get advice at least a month before you leave, so the immunisations can take effect.

Finally, remind doctors, even months after your return, that you were travelling should any medical issues arise.

Those who practise in this field believe that travel with children can be managed to make it safe and healthy.

"I encourage people to go to exotic different places," Christenson says. "I always tell them you can go most everywhere around the world with a child. The most important thing is you need to be prepared."

The New York Times

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