Hygiene on the move - avoiding illness when travelling

24th of November 2015
Hygiene on the move - avoiding illness when travelling

An increasing number of people travel abroad these days whether on holiday, on business or to visit friends and family.  Ann Laffeaty looks at the hygiene issues involved when venturing to other countries and finds out where in the world you are most likely to fall ill - and whether you can do anything to prevent it.

A mere 50 years ago it was not unusual for people the world over to live their entire lives in their home country – or even in their home town. Travelling was not on most people’s agendas either because it was too expensive or too difficult or both. Many had little leisure time to spare for a holiday in any case, and those who did would simply head for the nearest beach or country resort.

But when Mediterranean package tours began to take off in the 1960s large numbers of Europeans developed the ‘travel bug’. Before long holidaymakers had begun seeking ever newer destinations to satisfy their wanderlust.

There followed a quiet revolution in travel and tourism. A staggering 1.1 billion tourists travelled abroad during 2014 according to the UNWTO World Tourism Barometer. This was 51 million more than the number travelling worldwide the previous year, representing a 4.7 per cent increase.

Meanwhile, business travel has also been on the rise with growing numbers of companies becoming multinationals. The expansion of emerging markets such as China, India and Brazil has fuelled this growth and as a result an expected 8.6 per cent increase in global business travel spend is forecast in 2015.

This explosion in travel has led to a number of benefits. People are becoming more enlightened and are developing a greater understanding of other cultures. We are more open to exotic cuisines than ever before and we also tend to be braver when crossing new frontiers and trying out new experiences.

However it is an unfortunate fact that some of these experiences are making us ill. Our immune systems have not yet evolved to enable us to fight off the diseases and stomach bugs that we routinely meet when we travel.

In some countries the danger is greater than others either because of graver health risks, poorer healthcare provision or both. According to health security risk services company International SOS, the worst destinations to become ill while on holiday in 2015 include North Korea, Sudan, Zimbabwe and Afghanistan. These all fall into the ‘extreme risk’ category since they combine inadequate healthcare provision with common incidences of serious diseases such as dengue fever, malaria, typhoid and cholera.

These four diseases may also be encountered in Egypt, Sri Lanka, Cambodia and Cuba which are listed as high risk destinations. These countries are said to offer limited emergency care and low access to quality prescription drugs.

South Africa, Thailand, Mexico, Cyprus and Turkey are considered to be medium risk countries since malaria, dengue fever and waterborne diseases may be present. In fact only Western Europe, North America, Canada, Australia and New Zealand fall into the low-risk category.

Luckily the risk of contracting a serious illness on holiday is generally considered to be relatively low. But even a mild illness on holiday such as a stomach bug caused by contaminated water or food poisoning can ruin a much-needed break.

According to a recent UK study around a quarter of Brits have been struck down with food poisoning while on holiday. Many of the respondents claimed that the illness had wrecked their break, with half adding that their travelling companions’ trip had also been ruined. One in six respondents had had to be admitted to hospital during a holiday.

The study of 2,000 holidaymakers carried out by travel specialists at law firm Slater and Gordon revealed that nearly 40 per cent of British respondents consider the hygiene implications before deciding where to book. For example, more than 20 per cent said they would not risk travelling to India due to health concerns.

The survey showed that British holidaymakers were most likely to fall ill in Spain, Turkey or Egypt.
However with people travelling further afield all the time – and the popularity of different countries constantly rising and waning – it is impossible to draw up a definitive list of ‘riskiest’ countries. Spain may be top of Slater and Gordon’s UK list, but this result might be skewed by the fact that Spain is also one of the most popular tourist destinations of the British.

In fact a previous survey carried out by Holiday Which? in the UK put Peru at the top of the list of risky holiday destinations, with two-thirds of British visitors claiming to have become ill there. Nearly half of all travellers to Kenya and around 40 per cent who went to India also reported being unwell, with stomach upsets accounting for nearly 50 per cent of maladies.

Meanwhile, a poll of 3,000 Australians by the Travel Doctor revealed that India, Vietnam and Thailand topped the list of riskiest travel destinations while Spain, Egypt and Turkey did not feature.

Presumably this is partly because Australians are more likely to visit the three relatively close Asian countries than to travel to Western Europe. The Philippines, Indonesia and Myanmar also featured on the Travel Doctor list, backing up this theory.

Of course it could be that each nationality is particularly susceptible to specific bugs and illnesses. As an example, all our studies point to a potential health risk when travelling to India whereas Sweden emerged as one of the safest destinations. But from anecdotal accounts when a team of Indian IT workers recently visited the headquarters of a hygiene company in Gothenburg, the Indian visitors were observed to quickly catch colds while their Swedish colleagues remained healthy.

So any of us can fall ill anywhere – particularly when we are visiting somewhere new.

Since only one in 1,400 of us contract a serious illness overseas according to the Holiday Which? study – and most people can handle a holiday cold - the chief dangers to travellers are stomach upsets caused by food poisoning or contaminated water.

According to the Slater and Gordon study, most illnesses caused by food poisoning are fortunately short-lived and can easily be treated. Others – such as Salmonella - can be more serious and even have life-changing effects.

But whether a stomach upset overseas is mild or monumental, It makes sense for travellers to be on their guard and make informed eating and drinking choices when travelling to a high-risk country. Tap water in any unfamiliar country – even where it is claimed to be safe to drink – can still cause upset stomachs to an unseasoned traveller. Bottled water is therefore a sensible option in higher-risk countries and care should be taken to ensure that the bottle is sealed before use, since some unscrupulous restaurateurs have been known to simply refill a used bottle from the tap.

Salads and other foods that may have been washed in tap water plus unpeeled fruit should be avoided. And ice cubes – usually made from tap water – could represent a risk in countries where the water is not safe to drink.

Good cleaning and hygiene regimes can play an important part in holiday health. Where high standards of cleanliness are observed and a hand hygiene policy is in place in hotels and restaurants, illnesses are less likely to occur. A supply of antibacterial wipes may seem like overkill, but a quick wipe of hotel surfaces such as the door handles, light switches and the TV remote could prevent any illnesses contracted from the previous occupant’s unwashed hands.

Most people will quickly shrug off a mild bout of food poisoning and will not let it ruin their holiday. In fact, only three per cent of the Britons questioned in the Slater and Gordon survey said a bout of food poisoning would deter them from returning to the same country again.

But poor health as a result of poor hygiene standards will still have an adverse effect on tourism. If we take into account the fact that more than 800,000 Britons visit India each year and around 40 per cent of them fall ill – and three per cent of that figure would avoid returning – that is still 960 visitors a year from Britain alone who will have opted to shun India. Just consider how that figure will grow when visitors from other countries are factored in.

So where high standards of professional cleaning are maintained and an emphasis is placed on the importance of professional cleaning, travellers will be healthier and tourism to those countries will benefit.


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