Bug Bite Relief
TMB Water Purification Tablets are the safest way of making sure you don’t drink any nasty germs on your holidays. Chlorine Dioxide (ClO2) is one of the most effective water disinfectants available. Effective against diseases such as Cryptospoidium and Giardia.
Each pack contains 30 individually foil wrapped tablets – each tablet will treat 1 litre of water.
- A powerful water treatment in convenient tablet form
- Kills a wide range of bacteria and pathogens
- Ideal for water sourced from rivers, wells and taps
- Extremely easy to use
- Ensures safe drinking water on the go
- Leaves no after taste or discolouration
- Provides 30 litres of clean drinking water per pack
- Far superior to chlorine
- Does not create harmful by-products or carcinogens
TMB branded products are now available on-line at travelshop.ie and the following retailers:
- Dunnes Stores
- Lloyds Pharmacies nationwide
- Pure Pharmacy (Dublin Airport)
- Ingredients: Sodium Chlorite (<10%)
- Effective on: 30 litres per pack
- Available in: Packs of 30, 100mg tablets
- Suitable for: Everyday use and all types of travel
TMB – we have you covered
Make the Tropical Medical Bureau part of your travel plans by calling into one of our 22 clinics nationwide. Get expert travel advice and any vaccinations that you require all under one roof. Plus, we offer all customers a 24/7 helpline while they are away and consultations upon your return if necessary. TMB – wherever you are, wherever you’re going, we have you covered.
Visiting Friends and Relations (VFR travel)
The world has become a ‘global village’ as has been stated many times over the past decades.
Cheap and regular international flights mean that we can now visit friends and relations in the far distant reaches of our world. Areas where in the past we would not have considered possible are now well within our grasp.
Nevertheless this easy accessibility has increased the risk of diseases being moved from place to place and also of our travellers being unprepared for the potential health risks of visiting regions of the world very different to our own.
Travelling safely with Children
Children can make a holiday but also some of the most harrowing experiences abroad are associated with them getting sick, having an accident, getting lost or being bitten by an animal while away from home. If you are planning a trip with young children then take some sensible care.
Too Old to Travel?
To define what is meant by ‘old’ is quite emotive. Many would think that anyone 20 years older than themselves is clearly within that category and obviously well past their ‘sell-by’ date. The era of receiving your free bus pass is being seen as the ultimate evidence of ‘old age’.
However for many people the older years are the first time that they have the twin joint blessings of some free time and the available resources to allow them travel to regions of the world where they have dreamt of visiting for many decades. So what holds them back and what sensible precautions should be taken?
What needs to be in place to ensure they have a marvellous trip and return home with only good memories to cherish?
Swim Safety Tips for Travelling Abroad
The pleasures of swimming while abroad can be immense. Nevertheless there are risks and naturally care must be taken to ensure that silly and potentially dangerous mistakes are limited, if not fully avoided. The risks are related to where you swim and the safety factors of that area. Here are of top swim safety tips and advice.
Safety Tips for Swimming in Pools
Swimming pools in many regions are clean and safe especially if qualified lifeguard cover is on hand. The risk of drowning or infection is very small but certain basic care is needed.
- Are there lifeguards on duty when the pool is open?
- Check how clean the pool is kept. Are the water filters clogged?
- Is the pool well chlorinated?
- Can you see the bottom of the pool?
- If it’s an open-air pool is there any shade available?
- What are the changing facilities like?
The risk of picking up an infection in a well chlorinated pool is generally quite low. Over chlorination can cause eye and skin irritation. Some sensitive people can contract conjunctivitis this may be caused by infection or chemical agents like chlorine. In either case the use of goggles or eye bathing solutions will ease the effect. Infection is more likely to occur in and around the pool area. Children’s pools can also be a source of contamination due to faecal matter from inadequately secured nappies.
Sea Swimming – Safety Tips
Never underestimate the power of the sea especially when you’re not familiar with local currents and conditions. Coral reefs are a big attraction but often have unexpected strong currents that catch even the best swimmer. Get good local advice and stick to it.
Irish people are used to seeing jellyfish and the odd dolphin around their coast. As a traveller be aware of the other ‘monsters of the deep’ that may lurk around the shores of your chosen destination. In addition to jellyfish, sharks, sea snakes and poisonous fish may share your bit of sea. Again heed local advice.
In some areas untreated sewage is pumped into the sea be sure to scan the resort area for signs of contamination or suspicious looking pipes protruding into the sea. The shoreline line itself can be source of contamination. If dogs and other animals roam the beach it is likely that parasitic diseases may be present. Lie on a beach towel or sun bed and wear sandals or flip-flops when possible.
Scuba diving is becoming an increasingly popular sport but it does have its risks. Always check out the operator and choose the one with the best equipment and most sensible approach. Before you dive make certain you well prepared. If you suffer from heart problems, asthma or other respiratory disease always inform you instructor. Some special scuba diving holidays require you to under go a medical before being allowed to dive.
Finally always wear a life jacket when boating or canoeing being on holidays doesn’t make you float any better unless of course you’re in the Dead Sea.
Fresh Water Swim Safety
We’ve all seen Tarzan dive majestically into some idyllic lake in the middle of Africa take on the a few crocodiles and emerge on the other side unscathed. He never seems to get eaten or pick up some parasitic disease. The lakes and rivers in Africa, South America and some parts of Asia can present a significant risk to travellers.
Most travellers that take a plunge into these waterways are on safari and the temptation is often too great especially if the rest of the group is going in. Often guides will incorrectly inform you that those diseases like schistosomiasis do not occur in their area. Many Irish travellers return from a swim in lake Gambia or Malawai with schistosomiasis after being informed that the part of the lake they were in was safe. Find out more about travel vaccinations for Gambia.
Apart from crocodiles hippopotamus present a real danger and are responsible for almost as many deaths and injuries as crocodiles. Their favourite activity is over turning canoes and other small boats that get too close. While your avoiding crocodiles and hippopotamus keep an eye out for snakes as well!
Swimming in fresh water lakes and rivers in Africa and South America is generally not a good idea. Wait until you get back to the resorts pool or the beach.
How to Stay Safe in the Sun on Holiday
Living in Ireland has many blessings but acceptable exposure to the sun does not happen to rate well on its list of attributes. So, when we escape overseas we frequently soak up the sun’s rays in excess just in case we don’t see them for a long time. You see it all the time; pale and pasty leaving Dublin airport and red and roasting on their return. So, what do you need to know about sun exposure and how to stay safe in the sun when on holiday.
- Sun burn is associated with skin cancer and is becoming a more serious problem as the years go by.
- Travellers must ensure that they take care especially during the first few days of their trip.
- Gentle limited exposure must be the rule while using adequate sun blocking agents.
- Those with very sensitive skin should start with factor 20+ and only work down towards the lower factors if they are not burning.
- Skiing and sea adventure holidays are a particular risk in this regard.
- Remember that dreadful sun burn can occur closer to home on the Mediterranean holidays.
- If you are badly burnt make sure you drink plenty of fluids and use the after sun creams to lessen the effects.
- If you are travelling alone and get badly sun burnt never lock yourself into your room to recover. You must tell others of your predicament in case your absence is not noticed and the situation becomes severe.
- Severe dehydration and sunstroke can kill.
- Remember children get burnt very easily and they should wear sensible clothing to cover up well while playing in the sand.
Sun Safety Check List
- Pack your sun cream
- Start with a high factor and work down
- If burnt take plenty of fluids
- Seek medical attention early
- Take especial care with children
Staying healthy on your Skiing Holiday
Skiing holidays have become a regular pastime for many travellers each year. In some cases it is their first venture into an unknown activity and for others it has become a routine part of their yearly activities. Both these groups can potentially face some serious health risks associated with their activity.
Following some commonsense rules may make the difference between an uneventful trip or a serious accident which could incapacitate the individual for many months – or worse. Each year a number of deaths also occur due to severe exposure and/or avalanches.
Sexually Transmitted Diseases
Whether travelling on business or on holiday’s peoples behaviour often changes, inhibitions come down and alcohol consumption goes up. Holidays in particular are about entertainment and in some countries the sex industry is very much a part of this ‘entertainment’. Irish travellers fall into two categories.
The Business Traveller and Casual Tourist
This type of traveller finds him or herself in ‘trouble’ usually due too much alcohol or too much temptation close to the hotel. They did not intend to have any causal sexual encounters but it happened nonetheless. The next morning begins in panic with the traveller left worrying about the consequences of previous night. If you can’t remember the previous night this will cause you greater concern.
Remember that it’s not just other nationalities that carry these diseases, you may fly a 1000 miles and meet the girl or guy that lives next door, a few drinks and…
The Sex Tourist
This is just as big an issue with Irish travellers as it is with other nationalities. While both males and females fall into this category but the majority travelling from this country are often young males travelling in small groups. Their prime intention is to engage in sexual activity will abroad. For some countries this is a major industry bringing in valuable foreign currency even if its not officially encouraged. Whatever about the moral views, this type of ‘tourist’ are exposing themselves and other partners to the risk of many diseases like AIDS, Hepatitis B, syphilis an so on. It is estimated that over 80% of prostitutes in Thailand have AIDS.
Condoms do not offer fully protection and diseases like Hepatitis B have other ways of spreading. Often locally produced condoms may not be of the same standard and so may place the traveller at greater risk.
When you return seek immediate advice from your doctor, you could be placing yourself, partner or children at risk. The best advice is not to put yourself at risk in the first place. Watch your alcohol consumption and don’t leave your brain at the Airport!
How to Prevent Insect Bites
- Where Possible avoid going out of doors between dusk and dawn
- Wear long sleeves to cover your arms and long trousers
- Avoid dark coloured clothing
- If possible choose an air-conditioned room
- Keep doors and windows closed
- Avoid using perfumes and aftershaves
- Choose a room above the third floor. Insects don’t tend to fly to this height. Of course they do get carried.
- If living in the area ensure there are no open water containers. Still water is often the preferred breading ground of some insects.
Insect Repellents and Other Items
- Use insect repellents with between 30 to 50% Deet (diethyltolumide) are the most effective. Higher dosages and non-Deet products are available for Children.
- Wash excess of your skin before going to bed.
- Use a Mosquito net if necessary and ensure it is correctly fitted
- Use Mosquito nets impregnated with permethrin to discourage insects from landing on the net.
- Use sprays around dawn and dusk.
- Mosquito coils and plug-in repellents are very effective.
- High pitched buzzers are not effective.
Insect Bite Reactions and Allergies
- Creams which contain steroids or antibiotics are most effective against insect bites
- Carry some antihistamine tablets. Remember these react with alcohol so reduce your alcohol intake or abstain.
- If your allergy is very severe you may need to take an antihistamine throughout your time abroad. In this case, start the day before you arrive and continue to take them for a day after you return. More modern antihistamines are now non-sedative.
- If you are prone to collapse or anaphylactic shock when bitten or stung make certain you wear a medi-alert bracelet all the time. Also inform your courier and ensure other members of your party are aware of your condition. In some cases you may consider carrying an epi-pen. This contains a single dose of adrenaline for instances of anaphylactic shock.
Easing and Soothing Insect Bites
- Try and avoid scratching insect bites as this is how they become infected. Rubbing gently will have the same soothing effect and lead to less trouble.
- Try taking a luke-warm bath or shower
- If irritation is severe try sleeping tablets at night.
Seek medical advice before you travel especially if you are prone to allergic reactions to insect bites. If you have been badly bitten attend a doctor on your return.
Download this PDF on How to Relieve Insect Bites
Leaving on a Jet Plane
There comes a stage in most young people’s lives when they need to break free of parental control and show that they are capable of independent living!
Nowadays this often comes about as the almost compulsory overseas trip where they circumnavigate the world with their one year travel pass.
The day finally arrives when their plans come to fruition and they are off at last – disappearing to some far flung destination – promising their parents to stay in contact and not to do anything silly!
How to Avoid Jet Lag
Any travel, especially if it involves travel at night, may be associated with sleep disruption and subsequent fatigue. However, flight across time zones results in different body rhythms that are not initially synchronised with the day-night cycles at the time zone of destination. This causes the combination of day-time sleepiness and night-time alertness, the major features of jetlag. Symptoms of jet lag are common with time zone changes of 5 hours or more. Problems of jet lag may also increase with age.
Other Symptoms of Jet Lag
Additional symptoms can include Fatigue, Mood disturbance, Anorexia, Gastrointestinal symptoms. In general westward flight is better tolerated then eastward travel. As a rule of thumb its takes one day for every hour time difference to recover.
Tips to Avoid Jet Lag – Before Departure
- Have 2 to 3 good nights sleep before travelling
- Choose best flights for sleep – direct flights usually during ‘Home’ daytime If you’re not able to sleep on flights have a nap the afternoon of the flight. Use a short acting hypnotic e.g. Benzodiazepines.
During the Flight
- Set your watch to the destination time. If possible sleep and eat according to this time.
Dealing with Jetlag at Destination
- Try to sleep at local night time.
- Restrict alcohol intake.
- Allow nap opportunities for 40 minutes during the day for the first few days.
- Expose yourself to sunlight and exercise.
- Consume caffeine drinks during the day but avoid them 4 to 6 hours prior to sleep.
- Use sleeping tablets if required.
Jet Lag Travel Advice – Check List
- Westward is better then Eastward
- It takes one day to recover from jet lag for every hour time difference
- Rest before you travel
- Set your watch to the destination time
- Sleep and eat according to the local time.
Download our PDF on Avoiding Jet Lag – Travel Health Advice
Hajj Travel – Recommendations & Requirements 2012
Every devout Muslim seeks to perform the Hajj on at least one occasion during their life. This pilgrimage, which is a central duty of Islam, brings Muslims from all over the world together as they visit the holy cities of Mecca and Medina in Saudi Arabia. Each year over two million gather to celebrate the five ‘pillars’ of Islam.
All travellers are required to provide evidence of vaccination against Meningococcal Meningitis (ACYW-135). This vaccine has to have been given to every traveller within the previous three years and at least 10 days before arrival into Saudi Arabia. (Other vaccinations against Meningitis C or Meningococcal A&C are not acceptable.)
Even though it is not a requirement of entry to perform the Hajj or visit Saudi Arabia, travellers are strongly advised to consider the following vaccinations;
- Influenza / Pneumococci
- Pandemic Influenza
- Hepatitis A / Typhoid
- Hepatitis B
Golf and International Travel
This short leaflet outlines some of the health risks associated with playing golf in a warmer climate.
How to Avoid an Upset Stomach when Travelling
There can be no doubt that this is the one main areas where travellers get into difficulty during their trip overseas. It is all very well to want to taste the local produce but commonsense and care must be maintained if you want to avoid spending days looking at the loo walls. Here are out top tips on how to avoid an upset stomach when travelling.
How to avoid stomach upset caused by food
Eat freshly cooked hot food (physically hot that is – not spicy hot). If the food is hot and fresh then the risk of contamination is very small and your stomach will be protected. Cold foods (either salads or cold meats) can easily be infected with a variety of organisms such as bacteria, viruses and parasites.
Stay away from lettuce and undercooked shellfish. These two are the main culprits and responsible for many a spoiled trip overseas. Oysters, shrimps, prawns and mussels are frequently harvested from infected waters and then mildly steamed in preparation for human consumption. This steaming will not sterilise them and you may end up with a seriously upset stomach as a result!
Check out the restaurant before you order your meal. Look to see if the tables are clean and the cutlery is sparkling. If you are unsure be careful and try to find another eating establishment where possible. Probably a wise precaution is to take a visit to the toilets. If they are well maintained then you can usually be assured that the care taken in the kitchens will be of a higher standard.
Choose food from the menu that you recognise, and make certain all meat is very well cooked. Try to avoid eating rare steaks while overseas. If you are not convinced, we can point you in the direction of several patients who have come home infected with 20 foot long tape worms! If your meat dish is still undercooked on arrival send it back for reheating – just make sure that you get your own meal back! (Cut a wedge out of one corner).
How to avoid stomach upset caused by water
Everybody knows that the tap water supply overseas may be questionable. They would never dream of drinking from the taps in their bedrooms. Nevertheless, we often hear that travellers have used this same water for brushing their teeth. This is not a wise move. Water will be absorbed from your mouth very rapidly no matter whether or not you actually swallow.
In regions where the tap water is untreated (smell for chlorine) don’t use ice in your drinks. This ice will be made from tap water and so may be contaminated. In some of the ‘better’ hotels they will provide a jug of ‘fresh’ water each day. Treat this with extreme caution and only use this water for washing your face if necessary. Frequently this jug will have been filled from a tap down the corridor – rather like the one in your bedroom! Bottled mineral water is a much safer option so long as the bottle is well sealed.
One of the other major pitfalls from drinking overseas comes from buying ‘freshly squeezed’ juices from roadside stalls. Often as the coach pulls to a stop they will have seen that they have too little juice for the travellers so they may top up the drink with ordinary tap water and some sugar.
- Eat freshly cooked fresh food
- Avoid bivalve shellfish such as mussels, oysters and clams.
- Eat fruit you can peel yourself
- Check out the restaurant and choose a busy one with lots of people
- Avoid ‘rare’ or under cooked meat
- Smell water for chlorine
- Drink sealed bottled water
- If the water is untreated don’t use it to brush your teeth
- Avoid ice in your drinks
- Beware of those tempting roadside stalls
If you are on holiday and do end up getting an upset stomach, check out this article on how to deal with traveller’s diarrhoea.
Travellers’ Diarrhoea: Prevention and Treatment
These guidelines for travellers’ diarrhoea prevention and treatment are written for adults with no history of allergies or other serious underlying medical conditions. In all other situations you should arrange for specific guidelines from a doctor before your journey. Used sensibly, these guidelines may help to lessen the severity of diarrhoea while abroad.
If you have had a significant problem while overseas always attend for medical screening on your return.
Two to four loose bowel motions in 24 hours and you feel generally well. There is no fever, no blood or mucous in the motion and you are not unusually thirsty.
- Increase your intake of clear clear fluids.
- Use Oral Rehydration Salts (ORS) if they are available.
- Flat 7-up or Coke/Pepsi are usually helpful.
- Take a light diet – mainly soups etc.
- Try and change your itinerary so that you can stay close to adequate facilities.
- Watch for any change in your health which might suggest that the diarrhoea is becoming more serious.
In these circumstances your mild diarrhoea is inconvenient to your travel plans. You may need to attend an important meeting or have move from place to place. In these circumstances you still are generally well but the frequent trips to the loo are causing concern, more a social problem rather than any actual medical worry.
- Follow the guidelines outlined for treating mild diarrhoea.
- You may also add a drug to slow down bowel transit such as Imodium or Lomotil.
- Continue to watch for signs which would suggest that the situation is becoming more serious. (See danger signs section).
Travellers’ Diarrhoea: Severe Diarrhoea
Under these circumstances your diarrhoea will have become very significant. Dehydration will be more evident, a temperature may have developed and mental awareness may become impaired. You must remember that severe diarrhoea can kill at any age and must always be treated very seriously. Even if vomiting is occurring small regular amounts of fluids may usually be taken by mouth and will help the situation.
- Inform others and try to be obtain competent medical attention.
- Ensure that plenty of clean clear fluids are taken.
- Sips and teaspoons every five minutes are usually better tolerated than a full glass given less frequently.
- Suck clean pure ice if possible.
- Soak a piece of cloth in clean water and suck the corner. Rewet the cloth regularly.
- Use Oral Rehydration sachets to replace the lost fluid. If the diarrhoea is very severe it will be difficult to overdose, otherwise just use two or three sachets per day supplemented with other fluids.
- Antibiotics may sometimes need to be self administered if competent medical attention is not easily available.
Travellers’ Diarrhoea: Danger Signs
With diarrhoea, patients, especially children, may rapidly slip from general good health to a more severe state. Watch out for the following:
- Diarrhoea 2 or 3 times each hour
- Severe fluid loss through diarrhoea
- Dry Tongue
- Sunken eyes
- Sighing breaths
- Rapid pulse
- Decreased mental state (confused / uncertain)
- Fever greater than 100F
- Blood or mucous in the bowel motion
Travellers’ Diarrhoea: Treatment Protocol
- Check your temperature
- Replace fluid loss with clean, clear fluids
- Use sachets of ORS if available
- Watch out for blood or mucous in the motion
- Inform others if the situation is becoming more severe
- Look for competent medical attention, if possible
- In the more severe cases, (in patients with no history of allergy) consider using antibiotics such as Cotrimoxazole 2 tablets twice a day for 5 days or Ciprofloxacin 500mgs twice a day for 3 days.
- If you are in an isolated situation try and move back to a larger town or city where medical attention is available
Many cases of mild/inconvenient diarrhoea abroad are associated with sunstroke. Take care to ensure that your fluid intake is always maintained if the climate is hot or if you are exercising significantly.
When the body perspires it excretes both water and salts. Oral Rehydration Salts (ORS) are the best way to ensure that you do not lose a significant amount of salt and potassium.
Especially remember that children are very prone to dehydration and you need to make certain that they maintain a high fluid intake under these circumstances.
Download a PDF version Dealing with Diarrhoea
Cultural Concerns while Travelling
The world is shrinking to the extent that we can now very easily move from one region to another within a matter of hours. We recognise the change in climate and other issues relating to what is happening around us, but often we don’t recognise that customs and actions which are regarded as perfectly acceptable at home areÂ socially wrong or just plain rude in the country or among the people group we are now visiting.
Doing some research and learning about the country’s culture and beliefs will go a long way towards ensuring that your visit is not only worthwhile but also a pleasant experience.
The attached leaflet is modified from “The Responsible Traveller” which is available fromÂ the International Society for Travel Medicine at http://istm.org/
Cruising safely in the Caribbean
Over the past years cruising has become a much more popular option for the standard tourist with many individuals and couples , and also family groups, benefiting from the falling prices and the superb level of service which the major cruise liners are now offering.
No longer is cruising seen as the haunt for only the mega rich!
Coping with Business Travel
Ask any business colleague and they will confirm that inter-continental travelling brings it’s own special brand of stress and strain.
Missed connections, climatic changes, new unfamiliar contacts, language uncertainty and many more difficulties all add together to ensure that the `glamour’ of business travel is not all that it is made out to be.
The business traveller faces problems each day and it is essential that they remain in good, if not perfect, health in order that they stay well and that the business of the day can be completed to everyone’s satisfaction.
Building Hope & showing love in action
The Irish have clearly shown over the years how very generous they are towards those in desperate need. We have seen this through huge financial giving but also there are many others (like you) who have personally travelled to distant lands to share their skills and to make an improvement into the lives of others.
These volunteers are certainly ‘building hope’ but the structures they leave behind only show one element of what is achieved. The knowledge that people in Ireland care enough to travel to help others less well off is worth its weight in gold and, in many cases this is the greatest benefit to the programme.
A list of the TMB Clinics throughout Ireland
The Tropical Medical Bureau has a series of clinics throughout Ireland. Their locations and services are shown on the web pages http://www.tmb.ie/clinics-map.asp
However, if you would like to have a paper copy please download the current pdf file.
Many of our staff have worked in Aid & Development settings & have a keen understanding of your needs.
We assist with educational seminars, vaccination visits etc, to coordinate your group travel plans.
We work with many of Ireland’s leading companies who engage in business in developing regions.
Wherever you are, our international network of travel clinics has you covered. Find your nearest clinic.
Find a clinic