Medical kit for the trip
Advice to child's parents
Advice to expecting mothers
Advice to the elderly
TO LIMIT BAROMETRIC PRESSURE PROBLEMS
The pressure of air in a plane corresponds to a pressure of 1500 -2000 m altitude when the plane has reached its cruising altitude. This will cause intestinal bloating which could be limited by avoiding :
- Fizzy drinks, including champagne,
- Gas producing food: dry vegetables, milk, cabbage.
If this does not help, then try obstructing both nostrils and ears.
Pressure variations during landing provoke hearing disorders which can be responsible for barometric otitis. During descent it is necessary to frequently swallow to balance middle-ear’s pressure and avoid eardrum's shrinkage.
People sensitive to motion sickness, airsickness results in headaches, nausea, sweats and dizziness. To reduce these symptoms effects: choose a seat at the center of the plane. Avoid copious meals and alcohol ingestion. Possibly, take a preventive medication under a doctor’s supervision.
JET LAG -World Health Organization Recommendations-
Jet lag can provoke indigestion, general discomfort, insomnia and reduces physical and mental performances. Travelers who regularly take medicines -insulin, oral contraceptives- should consulta medical doctor. Under medical supervision, sleeping medicines could be helpful.
The following measures could reduce jet lag effects :
- Be well rested before departure and try sleeping during the flight your routine amount of hours.
- Drink soft drinks abundantly, before and during the trip.
- Eat slightly and drink little alcohol during the flight
For short-term stays, it is not always necessary to compensate for jet lag. Do not hesitate to consult a medical doctor.
ECONOMY CLASS SYNDROME
Economy class syndrome is associated with venous thrombosis which can lead to pulmonary embolism. Because of the immobility, this type of incident is frequent in long-term flights.
Known risk factors are: venous thrombosis or pulmonary embolism history, age above 40, estrogens intake -oral contraceptives, hormones therapy-, pregnancy, surgery or recent trauma in particular the abdomen or lower limbs, cancer, coagulation abnormalities, tobacco consumption, obesity and varicose veins.
Air passengers presenting one or more of these risk factors must consult a medical doctor before departure. During flight, it is recommended to do the followings as a precautionary measure: Light exercise like walking around the aircraft, ankles flexions-extensions, avoiding legs crossing, wearing baggy clothes, avoiding girdles and belts, drinking water frequently –about one liter every four hours-, refraining from using tobacco and sleeping pills.
Moreover, People with venous history can wear support stocking. LMWH -low molecular weight heparin- prescription or vein-tonic treatment can be justified, but under medical supervision.
CASES IN WHICH FLIGHTS SHOULD NOT BE TAKEN - World Health Organization recommendations -
Flights are not to be taken in the following cases :
- Newborn aged seven days or less.
- Women in their last four weeks of pregnancy - eight weeks in case of multiple pregnancies - and within seven days of child delivery. However, in case of urgency and with a medical doctor’s consent, a flight can be authorized within 24 hours of delivery, under conditions that bleedings are stopped and hemoglobin count is normal.
- People suffering from an angina pectoris crisis or scuba diving decompression syndrome.
People, who practiced diving for several continuous days, should not fly within 24 hours after stopping diving; rule of thumb is 12 hours from a dive not exceeding two hours.
- Intracranial pressure increase, due to bleeding, traumatism or infection.
- Sinus, ears or nose infection, especially if the Eustachian tube is blocked.
- Chronic respiratory affection.
- Breathlessness at rest.
- Sickle-cell anemia.
- Arterial high blood pressure with a systolic pressure superior to 200 mm Hg,
- A recent psychiatric affection.
- Myocardial infarction warnings during the days following surgery or traumatism which support air trapping like abdominal traumatism, gastrointestinal surgery, craniofacial and ocular lesions, neurosurgical intervention, and ophthalmic surgery.
Medical kit for the trip
Read carefully the following comments :
1. Chemicals and medicine names are given for information only; there exist others which are effective as well. Ask a doctor or a pharmacist for advice.
2. Some indicated products and drugs are subject to warnings, consequently, ask a doctor or a pharmacist for advice before using them or read the instructions for use if you cannot contact a doctor or a pharmacist.
3. Names marked with an asterisk (*), correspond to names of proprietary medical products which can have different naming in other countries than Morocco.
4. Make sure that you have enough medicines - birth control pills, insulin…- for the whole duration of your stay, even a little more in the event of a delayed return.
5. Consult your dentist to leave with healthy teeth.
6. Do not forget your international vaccinations notebook.
7. Carry your blood-group card.
8. Subscribe to a repatriation medical insurance.
CARE PRODUCTS AND BANDAGES
- Sterile compresses, band-aid, hypoallergenic sterile bandages
- Support bandages, adhesive bands, safety pins
- Scissors, small tweezers
- Single-use Syringes
- Antibiotic cream, antibiotic bandage
- Anti-itching ointment
- Anti-hemorrhaging bandages
COSMETICS AND HYGIENE PRODUCTS
- Unbreakable thermometer
- Chapped lips stick
- Sun screen, sun hat
- Two pairs of sun glasses, especially if you carry corrective lenses
- Heatstroke treatment
- Mosquito repellent -see our technical note on protection against insect bites
- Water filter or disinfectant
- Ear plugs
- Analgesic and antipyretic
- Anti-nausea, antiemetic
- Motion sickness drug
- Broad-spectrum antibiotic
- Eye lotion
- Eyes rinsing products
- Ear drops
- Light sleeping pills
- Urinary antiseptic
Depending on type of trip - destination, duration, conditions - and after doctor’s advice, add to your medicine kit the following :
- Medicine for preventing and possibly treating malaria if you are staying in a risk area,
- Salts for oral rehydration solution - in purchased bags or can be self prepared: 6 tsp. of sugar + 1/2 tsp. of salt in one liter of drinking water,
- Mountain sickness medicines.
Carry at all times a doctor’s prescription if you are using medicine containing opium or its derivatives, of if you are carrying syringes and needles.
Advice to child's parents
If an infant or a child is traveling, it is necessary to check his or her vaccinations validity -D, T, and P -.
Other vaccinations like anti-meningococcal and anti-hepatitis A are advisable depending on destination and type of stay
Typhoid vaccination is not recommended before age two.
Yellow-fever vaccination is not required for a child less than one year old, but could be done at age of six months if the infant is exposed and as of resumption of birth weight.
A child is sensitive to heat and sun, so dehydration is very frequent. Therefore it is necessary to make him or her drink good quality water, protect him or her from sun and heat. He or she is also much more sensitive to diarrhea.
To rehydrate a child, use rehydration packs of prepare a solution yourself with 6 tsp. of sugar + 1/2 tsp. of salt in 1 liter of drinking water.
Children are easily enticed by animals - domestic, wandering or exotic like monkeys -. These animals can be carrying bacteria, virus like rabies or man pathogenic parasites.
For a journey in areas where malaria prevails, you should plan on taking :
- An adapted chimioprophylaxie, while keeping in mind that « Méfloquine » is not to be used on a child weighing less than 15 kg and that « Doxycycline » is to be avoided by a child of less than 8 years old,
- A mosquito net and repellents.
NB: the use of a mosquito net and repellents will also limit stings of other diseases carrying mosquitoes.
Advice to expecting mothers
Flights are not to be taken after the 8th month of pregnancy, besides airline companies refuse flight to women at the end of pregnancy. The ideal period for a journey is in between the 16th and 28th week of pregnancy.
"Alleviating" vaccines by a pregnant woman are not recommended, except the anti-amarilic vaccine – against yellow fever -, if planning to journey into endemic disease areas better wait until the end of pregnancy’s 1st quarter.
Malaria is much serious in pregnant women. Protection against this disease is thus absolutely essential, still the use of Méfloquine or Doxycycline is not advisable during pregnancy.
Moreover, Halofantrine, used for malaria treatment, is also not advisable for a pregnant woman. To avoid mosquitoes stings, repellents are useful. Ask for medical advice.
Advice to the elderly
- A trip is an excellent opportunity to verify conventional vaccines validity, in particular anti-tetanus, anti poliomyelitic and anti-diphtheric.
- In the event of chronic disease, it is desirable that the patient has a medical file written in English, mentioning the disease, its complications and the treatment.
- Patient must carry necessary treatment during entire journey, whatever its duration.
- Heart patients must watch their salt intake and not to eat shellfish.
- Patients with heart failure must have their Trinitrine medication within reach.
- If a diuretic is to be taken then diarrhea can cause a serious potassium loss, even more dangerous if it associated with an anti-arrhythmic.
- People with poor venous situation must preserve heat and immobility, to avoid phlebitis risk, and wear, under medical advice, support stocking.
- Try doing some walking inside long-haul flight planes.
- Take time to become acclimatized, in particular, to the temperature difference and to the jet lag.
- People suffering from chronic respiratory and\or cardiovascular affections need to be careful with altitude.
- Plan a chimioprophylaxie antipalustre for journeys in endemic disease area.
- It is recommended to check if your vaccines are up to date because vaccines can be required from passengers of certain destinations.
- It should be noted that certain vaccines must be administered in advance and can in fact require a period of time.
Starting Saturday April 25, 2009, ONDA set up a preventive device ensuring the protection of various borders affected by the virus A (H1N1).
ONDA has also set up, in various airports of the Kingdom, security gates equipped with infra-red cameras determining body temperature of passing through people, in order to detect the presence of a fever which is a type of influenza’s symptom. However, when a passenger passes through the gate and the indicators are set off, it does not necessarily mean that this passenger is carrying the virus.
The sanitary border service is carrying out, at this time, the necessary tests, to confirm or invalidate the virus contamination. First tests are made on the spot by border's health control service doctors. This service is operational 24/7, all year round.
What is called this new influenza virus ?
The influenza known as “swine” flu is a human infection by a flu virus which usually infects pigs. In the current epidemic, the virus, as isolated in patients, is a virus which belong to family A/H1N1.
In this case, it is not swine influenza, it is an infection with a virus developed in pigs but now is transmitted between men.
This virus is different from seasonal flu virus H1N1, virus of human origin and usually circulates.
How is “swine” influenza spread ?
Within the framework of the current epidemic, the transmission is made in the same manner as that of seasonal flu :
- Airborne, i.e. spreading of virus in the air via coughing, sneezing or saliva droplets;
- By close contact with an infected person by a respiratory virus when we give a kiss, hug or handshake;
- By contact with contaminated objects like a door handle.
Thermal security gates
What are human cases symptoms of “swine” influenza A/H1N1 ?
“Swine” Flu A/H1N1 human symptoms are, generally, the same as those of seasonal flu: fever, aches, cough and tiredness.
How long is the incubation period of the “swine” influenza?
The incubation period is 7 days maximum.
How to protect oneself from “swine” influenza?
Influenza germs are mainly airborne -by means of cough, sneeze or saliva droplets- but can also be transmission by the contaminated hands and objects. It is thus necessary to avoid any contact with a sick person, to regularly wash hands with soap and/or an antiseptic solution.
Can one catch “swine” influenza by eating pork?
Animal viruses do not survive cooking.
Are antivirals effective? When can they be prescribed?
American experts have carried out tests on isolated strains in the United States. Oseltamivir (Tamiflu) and Zanamivir (Relenza) are effective on these viruses. Tests on Mexican strains are ongoing but antiviral should be effective.
Antivirals are prescribed by health professionals after consultation and diagnosis of first flu symptoms appearance.
Are antivirals effective on children?
There exists, of course, an antiviral treatment for children (antiviral in pediatric form) which is prescribed by a health professional where necessary.
The treatment can, however, be only symptomatic on children less than one year old.
If you think that your child is showing “swine” flu A/H1N1 symptoms (aches, cough, tiredness,) you must contact your attending physician or call 15.
Is there a vaccine against “swine" flu A / H1N1?
At the moment, there is no vaccine against this new virus. According to experts, who have studied it, there is no confirmation that the seasonal flu vaccine could be effective against this new virus.
The strain provision for vaccine manufacturing will be carried out under the OMS responsibility. The strain, once ready, will be given to pharmaceutical companies for vaccine manufacturing. A period of several weeks to several months will be necessary for the vaccine to be available.
Could we / do we have to have Tamiflu prescribed before leaving to Mexico?
Before leaving, you can contact your regular attending physician or an international vaccination center to optimize your journey’s medical preparation. These health professionals could, if need be and according to official sanitary recommendations, decide whether necessary to prescribe an antiviral or not.
What are the various types of available protection masks?
There are two 2 types of masks :
- Surgical mask is intended to avoid, during exhalation, secretions projection - saliva droplets - which can contaminate people standing close by.
- Respiratory protection mask (mask FFP2) is, in fact, a disposable respiratory protection device protecting against inhaling contagious infectious agents. It is mainly intended for the health professionals and people in regular contact and at close distance from patients.
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