Many families have jumped at the chance to go on more far-flung adventures since the easing of pandemic restrictions worldwide. They’ve also learned that family members getting sick on vacation with a cold, flu, coronavirus or other illness is still one of the harsh realities of travel. While it’s never fun to get sick while traveling, it’s particularly distressing when a child becomes ill in a foreign country where you don’t speak the language. Trust me, I’ve been there. When touring Mexico, our daughter fell victim to severe traveler’s diarrhea. She had a blistering fever and became dangerously dehydrated. I was terrified she might have a seizure and felt completely unprepared. Not knowing Spanish compounded our inability to get care. The night she became ill, soft drinks from a hotel vending machine were the only available bottled fluids. Regretfully, we didn’t even have the correct foreign coins to operate the vending machine. Memories of that dreadful week have informed how we travel since. I’m also a pediatric nurse, and the following bits of advice have been drawn from my professional and personal experiences. I’ve learned that preparation and prevention are your best defense against a vacation plagued by sickness.
What to Do Before You Travel
When planning to travel internationally, several months before departure check with your child’s healthcare provider and the Center for Disease Control (CDC) website to make sure your child is fully vaccinated, including recommended shots specific to the countries where you’re going. Don’t put off getting needed vaccines until just before you leave, as some may cause your child to feel mildly ill. Cranky is no way to start a much-anticipated vacation.
Always carry medications in their original containers in your carry-on bag. Never pack medications in your checked luggage. Medication names are not always the same worldwide, and language translation apps aren’t great when it comes to meds.
If your child takes any prescription medication, whether daily or only as needed (such as an inhaler for asthma), be sure to take enough to cover all days you will be away, plus extra in case of travel delays. Also, keep prescription medications in your carry-on bags. The stress of getting and filling a prescription in a foreign country when your luggage doesn’t arrive can be overwhelming and is something you can easily avoid.
Over the Counter (OTC) Medications
Nothing will interfere with your travel plans more than unexpected illness. I learned the hard way that it’s worth the extra space and weight to pack small bottles of several OTC drugs. In the USA, we are lucky to have OTC medications available in grocery stores open 24 hours a day. This isn’t true in many other countries. OTC medications may only be available from a pharmacy open from 9 a.m. to 5 p.m., but kids always seem to get sick in the middle of the night, right? Additionally, in many places, pharmacies (also called chemists) are closed on national and religious holidays. If you’re not deeply familiar with the country, they may catch you by surprise.
Suggestions for OTC Medications to Pack
- A powdered electrolyte replacement such as Pedialyte 8 count variety pack for diarrhea. Mix with bottled water or water that has been boiled.
- A fever and pain reducer such as acetaminophen (Tylenol), which is also called paracetamol or Panadol in some countries.
- An antihistamine (liquid or pill) such as diphenhydramine (Benadryl) for allergic reactions. This can also be helpful if a child is having trouble sleeping but always follow the recommended dosage.
- A topical anti-itch cream or gel. This could be an antihistamine like Benadryl cream or gel, or a steroid cream that contains 0.5% hydrocortisone. Be careful not to “double dose” by putting Benadryl cream or gel on a rash and giving your child oral Benadryl at the same time. Even normal doses of antihistamines can make some children sleepy.
- A cough and cold medication for children 2 years and older. These days a cough, especially if experienced with fever and a headache, can be particularly worrisome as it may be a symptom of COVID-19. Ask your child’s health care provider which cough and cold medication they recommend and pack a small bottle. Read the label carefully. If the medication contains acetaminophen, do not “double dose” your child by also giving acetaminophen to reduce a fever or body aches at the same time.
Other Items to Pack
The following items can go in your checked luggage if necessary, but I find it’s easier to keep all health supplies together in a clear plastic ziplock bag. TSA security screening requires liquids to be 3.4 oz or less, so look for small product sizes to take in your carry-on bag.
- Bug (mosquito) repellent
- Hand sanitizer
- Electronic thermometer
- COVID test(s)
Access to Health Care Advice When Abroad
Ask your child’s healthcare provider to recommend a reputable internet-based telehealth service in case you need advice while traveling. There are many such companies, but like wines, some are much better than others. Not all countries have “urgent care” centers and a trip to the emergency room at a local hospital (especially when you don’t speak the language) can be a nightmare.
Tips for Keeping Kids Safe and Healthy While Traveling
Diarrhea and vomiting are two of the most common illnesses children experience when traveling, especially in foreign countries. The following are precautions to decrease the likelihood of tummy troubles derailing your vacation.
- Wash hands before eating. Use hand sanitizer if soap and water aren’t available.
- Drink only bottled water and beverages from their original containers. If bottled water isn’t available, boil water before use.
- Don’t use ice in your drinks (usually made from local tap water that may be unsafe to drink).
- Use bottled (or boiled) water to brush teeth.
- Eat only fruits that can be peeled like bananas, oranges, mangoes and melons, and vegetables that have been thoroughly cooked like green beans, peas and squash.
- Don’t eat raw, rare or undercooked meats and seafood.
- Avoid buffets, particularly if food may have been sitting out for hours without heat or refrigeration.
Most travel-associated diarrhea and vomiting will resolve without medication, but children can easily become dehydrated. Give them powdered electrolyte packets dissolved in bottled water, but do not mix them with formula if your baby still takes a bottle. The amount of fluid your child needs is based on how much they weigh. An easy way to tell is to look at their urine. A dark yellow color means the child is dehydrated. Light yellow means they are getting enough fluids.
The mosquito is the world’s deadliest insect. It carries viruses like malaria, dengue fever, West Nile, Zika and Japanese encephalitis. Prevent mosquito bites by wearing long-sleeved shirts and pants, shoes and socks. Apply a chemical repellent to areas not covered by clothing. If your child has mosquito bites, use a topical cream or gel to stop the itching. In a pinch, use a non-gel toothpaste applied to the area around the bite to decrease itching.
Fever is associated with many different illnesses. Common causes of fever include colds and respiratory viruses like the flu or COVID-19 and ear infections. The most accurate way to tell if your child has a fever is to use a thermometer. Digital multiuse thermometers are lightweight, easy to pack and easy to read. Use a rectal thermometer on infants and young children and one that you can slip under the tongue for kids over 4. Normal body temperature is approximately 98.60F (370C). Seek medical care for fever if your child:
- Is under 3 months and has a temperature of 1010 F (380C) or higher.
- Is over 3 months and has a fever greater than 1040F (400C).
- Has a fever for longer than 3 days.
- Has a fever that does not respond to medication (such as acetaminophen).
- Is acting unusually sick, drowsy, has a stiff neck, an abnormal cry, rash, is dehydrated or experiences a seizure.
To treat a fever, keep your child well hydrated (bottled water and juices are best when traveling and popsicles are a great way to increase fluid intake). Also, give your child fever-reducing medication such as acetaminophen or ibuprofen. Use the suggested dosage and frequency on the package. Do not give your child aspirin as it has been linked to a serious illness called Reye’s syndrome. Keep your child in a cool setting—not in the sun, hot car, or bundled up in blankets—even if they have chills. A cool wet towel placed on the forehead or under the arms may help.
If after traveling overseas to a tropical location your child has a persistent fever or complains of feeling sick, be sure to see the doctor as they may have contracted an infectious disease while abroad.