Most travellers know that they need to take preventive measures against diseases such as malaria or hepatitis A when they are travelling to exotic countries, but there’s definitely a need for more awareness around some of the other illnesses and infections that can be picked up on a foreign holiday.
A recent study revealed that 78 per cent of people admit that they don't take the time to do any research into potentially dangerous diseases that might be prevalent in their destinations before they leave the UK. Most travellers haven’t heard of infectious and unpleasant diseases such as West Nile virus, giardiasis or chikungunya, for example. There have been over a million suspected cases of chikungunya in the Caribbean islands, Latin American and in the USA, with the worst hit areas being the Dominican Republic and Martinique, where there have been more than 700,000 suspected cases. The mosquito-borne disease has claimed the lives of as many as 175 people.
The stomach infection giardiasis is widespread in Africa, Turkey and some former Eastern bloc countries, and is transmitted via dirty water. It leads to severe diarrhoea and exhaustion, and can be treated. Travellers need to know about preventing diseases such as these, as well as what to do if they are affected by them while abroad. Should more pharmacies become the go-to place for holiday risk assessments, as well as remedies?
Risk assessments for foreign trips could be a service primarily provided by pharmacies in the future, if NHS funding for travel health services is diverted to community pharmacy, as suggested by Larry Goodyer at the Royal Pharmaceutical Society travel medicine conference in March.
Mr Goodyer, professor of pharmacy practice and head of the school of pharmacy at De Montfort University, says that pharmacies need to decide what level of service they want to provide to travellers, ranging from a basic offering involving provision and administration of vaccinations up to a full consultation including a risk assessment. He adds: ‘People who are going to a conference in a five-star air- conditioned hotel or on a resort holiday don’t need a full risk assessment, just some advice, information and vaccines. But a higher level of expertise is needed for many other patient groups, such as those doing voluntary work overseas, people visiting friends and relatives abroad, and backpackers.’
Many holidaymakers do think about planning ahead to purchase a product to tackle holiday stomach troubles. Along with the traditional diarrhoea remedies, Pharma Nord advises customers to begin taking a probiotic before they travel, and continue during and after their trip. Concerned travellers could be recommended a probiotic such as Pharma Nord’s Bio-Culture, which has been proven by several studies to offer protection prevent, treat and limit the duration of travellers’ diarrhoea, says the brand.
‘Advise customers to start two days prior to their journey and continue two days after their return. If consumers are also taking antibiotics while they are away, it is even more important to take a probiotic, so they should continue to do this for several weeks after the course of medication. They should also be advised to allow three hours after each dose of antibiotics before taking a probiotic.’
Adrienne Benjamin, information science executive at ProVen, agrees that beneficial bacteria supplementation should start prior to a trip abroad. ‘The recommendations regarding when to start taking the beneficial bacteria for travel vary, although most experts agree that to provide maximum benefit, it is useful to start taking them prior to a trip abroad and to continue taking them after returning home. We recommend taking them a week before and for one to two weeks upon returning home.’
Each capsule of ProVen Probiotics Acidophilus and Bifidus for Travellers contains 12.5 billion friendly bacteria along with calcium, ginger, glutamine and aloe vera to support the gut whilst travelling. The product doesn’t need to be stored in a refrigerator and its compact packaging should also appeal to travellers, says the brand.
One often-overlooked problem when travellers do end up with a dose of holiday tummy is rehydration. With excess alcohol, heat and then diarrhoea, too, there’s a very real danger of becoming dehydrated, so pharmacists can recommend rehydration remedies, such as O.R.S Hydration Tablets along with the usual diarrhoea remedies and probiotics.
O.R.S is currently running a £1 million TV advertising campaign, which continues to the end of June and features advertising on Sky Sports and ITV, samples being distributed at key summer events and via in-store promotions. Arsalan Karim, director of research and development at Clinova, suggests that pharmacies can maximise sales by using the O.R.S counter display units and positioning alongside other summer holiday products, sun preparations and insect repellents.
‘Ensure that O.R.S is recommended for general hydration, and also position it as a medicine cabinet and first aid kit essential for summer holidays in the UK and abroad,’ says Mr Karim, ‘and promote it as being useful for general hydration on hot days, as well as after sickness and diarrhoea’.
With stress, alcohol and rich foods all contributing to the symptoms of IBS, sufferers will want to consider what’s in their holiday health kit. The newly launched Imodium IBS Relief is something that travellers who suffer from the condition may want to take with them on their travels. Imodium is running a promotional campaign over digital, press and online media from June until August, as well as supporting its other IBS product, Colpermin IBS Relief.
Most long-haul travellers are aware of the need to take precautions against DVT. Research has shown that it’s a real concern for holidaymakers flying long distances; long-haul flights are said to increase the risk of developing DVT by 300 per cent.
Compression hosiery specialist, Activa Healthcare, recommends that pharmacies stock the Unisex Patterned Sock. Unlike many flight socks on the market, the Activa Unisex Patterned Sock is tailored to the individual using calf, ankle and foot measurements, which means that the sock can give travellers the optimum level of compression necessary to prevent formation of a blood clot. Although traditional flight socks based only on foot size do offer some protection, giving the customer a tailored product is advised.
Activa Healthcare provides an online Hosiery Sizer to help customers determine the best size for them and support for pharmacies in the form of the hosiery app which works out sizes, recommends the correct hosiery and also shows the Activa and ActiLymph hosiery ranges.
FranceMed Pharma is accelerating its annual national TV campaign in preparation for the holiday season. The Winking Camel advert will return to the TV screens to promote Magicool. Most UK residents aren’t acclimatised to heat, so a little support from Magicool spray may well be welcomed.
Coll Michaels, Calverton Pharmacy, Luton ‘This category is very important for us. We often get people asking for advice and we are thinking of setting up a travel clinic. It probably won’t be for this season, but certainly I expect that this will be in full swing by the end of the year. Travel sickness remedies are a major area for advice and sales and we offer a number of alternative therapies for travel sickness that seem popular. We also offer advice about malarial prevention and we will be extending that service to the travel clinic. Sun protection is also a very successful area for us.’
Fiona McElrea, Whithorn Pharmacy, Whithorn ‘We’re quite near the ferry terminals [on the west coast of Scotland], so we get the people who are going on the boats, to Ireland, for example. So, we sell quite a lot of travel remedies. Our main sellers are travel sickness tablets, such as Stugeron, Kwells and Joy-Rides. But sometimes the supply chain can be quite difficult and products can be tricky to get hold of, which can be a real problem. We also stock the acupressure Sea-Band product. You wear the band on your wrist, it presses continuously on the acupoint, and that’s supposed to lift nausea. They’re popular with children and pregnant women. In our pharmacy, most of these products are kept behind the counter, so we probably haven’t improved the category that much.’
Shaheen Bhatia, P&S Chemist & Advice Centre, Ilford ‘Have a poster in the pharmacy window encouraging people to get the right advice for travelling and to organise their medicines early. People always leave it till the last minute. I think that when they book their tickets they should book in their medication, too – it should be a priority. Some people need a lot of advice about their medicines if they are travelling. Also, people don’t realise that it takes seven to 10 days before vaccinations are effective. We have decided to launch a travel clinic – we already supply the vaccine for travelling to Mecca, and that service is pretty popular. Some people are also telling us that they are having problems getting an appointment with the GP for other vaccines, too. It makes sense for pharmacists to be able to step in and help ease the workload and start providing these sorts of services. There’s a lot of potential there.’