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HealthHints

Health Tips for Travelers
Pack Your Bags:
What to take with you for health & medical purposes

May 2008 – Vol. 12, No. 5

Editors: Janet M. Pollard, MPH; and Carol A. Rice, Ph.D., R.N.

“Expect the best, but prepare for the worst should be the official traveler’s motto.”¹ When you pack your bags, you will want to take a travelers’ health kit containing:

general items for first aid and minor health care, and
prescription medications or medical supplies for preexisting medical conditions.

Minor First Aid: Prevention & protection

General first aid items should be available in your travelers’ health kit to take care of minor problems as they occur. These items should include:

adhesive bandages
sterile dressing/gauze
ace bandage/wrap
antiseptic wound cleaner
cotton-tipped applicators
antibiotic ointment
hydrocortisone cream (1%)
antifungal ointment
Lubricating (emollient) eye drops
Sunscreen (SPF 15 or greater)
insect repellent (with 30%-50% DEET)
insect bite treatment and Epi-Pen if needed for allergic reaction
hand sanitizer (containing at least 60% alcohol)
aloe gel for sunburn
digital thermometer
oral rehydration solution packets (in case of vomiting and/or dehydration)
small tools like a mirror, scissors, tweezers, safety pins, and nail clippers (be sure to learn about permitted and prohibited items)
pain reliever/fever reducer (e.g., acetaminophen or ibuprophen)
antihistamine
decongestant
cough suppressant/expectorant
antidiarrheal medication
mild laxative
antacid
throat lozenges
anti-motion sickness medications
anti-malarial medications, if applicable
water disinfectant
extra pair of contact lenses or eyeglasses, if applicable
contact lens solution, if applicable
personal prescriptions, sterile syringes and needles, and appropriate documentation, if needed (see the following for more information).^2,3,4,5,6,7

Pre-Existing Conditions: Prescriptions & Medical Supplies

When packing personal prescriptions and medical supplies for pre-existing conditions, there is much you should know.

Necessary prescription drugs should remain in their original bottles so that precise names of the drugs and the instructions for taking them can be reviewed in case of an emergency.
Have the generic name of the drug, in addition to its brand name. The generic name of a drug is more useful than the brand name – brand names may differ among countries.
Pack an extra supply of medications in carry-on bags in case checked bags are lost, stolen, or delayed in transit.
Some drugs and devices, such as opioids, syringes, and large amounts of any drug are likely to raise suspicions among security personnel or customs officers. For this reason, travelers should carry a doctor’s note explaining the medical needs for the supplies. Note: All doctor’s notes should be signed and on letterhead paper.
A traveler going abroad with a pre-existing medical condition should also carry a letter from his/her attending physician, describing the medical condition, in addition to the necessary medications.
Syringes should always be packed together with the drugs that are dispensed in them.
Travelers should check with airports, airlines, and embassies to determine what additional documentation is helpful in making travel with these supplies least complicated.
Travelers should also check with the foreign embassy of the country they are visiting to make sure any required medicine is not considered an illegal narcotic in that location.^8,9

Be aware of permitted and prohibited items, and pack accordingly. If traveling by air, follow the 3-1-1 rule, which allows for 3-ounce containers of liquid or gel, placed in 1 quart-sized plastic bag, and 1 bag per passenger. Know the exceptions (e.g., breast milk, formula, medication, etc.) and how to claim these at security check points. If you have a medical alert bracelet or necklace, please wear it.

Those who have underlying health problems – such as diabetes (PDF), heart disease (PDF), lung disease (PDF), or cancer (PDF), who are on any form of regular medication or treatment, who have recently had surgery or been hospitalized, or who are concerned about their fitness for travel for any other reason (e.g., traveling while pregnant [PDF] or with pacemakers, implantable defibrillators, implanted metal devices, or coronary stents [PDF]) – should always consult their doctor for examination and information on travel necessities and precautions.¹⁰ Following are a few more recommendations that may help. In addition to preparing with appropriate medical supplies and medical history documents:

Make sure you have had any recommended medical testing or screening before traveling.
Wear a medical ID bracelet or necklace, if you have one (get one if your doctor recommends it for your condition).
Request special meals (e.g., low fat, low salt, low cholesterol, etc.) if recommended by your doctor. Be sure to make this request at least 48 hours before your trip so you can be easily accommodated.
Request other supplies well ahead of time, such as supplemental oxygen. This request must be arranged by you, but it is provided by an outside vendor or by the airline or cruise line, etc. Be sure to confirm arrangements 48 hours ahead of time to have supplies at all layovers and stoppages.
Learn the language. If traveling abroad, learn enough of the language to ask for appropriate help should an emergency arise.
Wear appropriate clothing that allows for comfort and treatment that you may require. This may include loose-fitting clothing for administration of insulin, compression stockings for healthy circulation, and comfortable shoes for support and protection of your feet.
Know the signs of a problem. If you experience symptoms, report them and seek immediate medical care – don’t wait.
Always carry the phone numbers of your doctor(s) and family members.

Infants & Children: Caring for your family while traveling

Traveling with infants and young children will require some advance planning on your part. Talk with your doctor about any necessary vaccines needed for your children, as well as the potential need for prophylactic (preventative) drugs and medicine for motion sickness. Pack additional items in your health kit for your children, such as diaper rash ointment, waterless hand sanitizer, hand wipes, water- and insect-proof ground sheet for play outside, oral rehydration solution packets, baby formula, and medications specific to your child’s needs.¹¹

Note: Medications, baby formula and food, breast milk, and juice are allowed through airline security in reasonable quantities exceeding three ounces and are not required to be in a zip-top bag. All items including formula, breast milk, and juice will be inspected. You or your infant or toddler will not be asked to test or taste breast milk, formula, or juice. Security officers, however, may test liquid exemptions (exempt items more than 3 ounces) for explosives.¹²

It is a good idea to inform children ahead of time about your travel plans. Make them aware of new concepts like air pressure, security check points, x-raying baggage, motion changes, laws in different countries, etc. Discuss your plans with your children, and talk about any concerns they may have. Adjust their sleep schedules as you would yours to account for changing time zones and “jet lag.”

Whether traveling by land or air, you should have your child in an age-appropriate car seat. Children less than 1 year old and 20 pounds must be rear-facing; children at least 20 pounds and 1 year old may be forward-facing. Children greater than 40 pounds can safely ride using the aircraft restraints,¹³ but you should use a booster seat (if the vehicle is equipped with lap/shoulder belts) in a car, bus, or train until they are 4'9" tall (usually between ages 8–12). All children under 13 years of age should ride in the rear seats of vehicles.¹³ Finally, just like you (and likely more so) children need to move about. Allow children to get up or out and move at least every 2 hours. Don’t forget to pack bags of toys, activity books, healthy snacks, and safe drinking water to keep your child occupied and comfortable during your travels.¹³

Child Safety Seat Guidelines

Use the following guidelines to determine the safest way for children to travel.

Infants should be in a rear-facing child safety seat until at least 1 year and at least 20 pounds. It is recommended that children remain rear-facing until they reach the maximum weight or height allowed by the maker of the safety seat.
Toddlers over 1 year old and between 20–40 pounds can be in a forward-facing child safety seat. Higher harness weight seats are now available.
Children over 40 pounds and under 4'9" tall can be in a booster seat using the vehicle’s lap/shoulder belt.
Children over 4'9" tall usually fit safely in lap/ shoulder belts. See our ABCs on Child Safety Seats information sheet for more information.

These are just some of the tips to help you pack and plan ahead for healthy travels for you and your family. For more information, see the resources section below.

Medical Conditions, Disabilities, & Other Concerns: Resources to address your needs

People with specific medical conditions encounter special problems in transit. If you have heart disease, lung disease, diabetes, cancer, some other disability or hidden medical concern (e.g., pacemaker, defibrillator, other implanted medical device, or metal implant, supplemental oxygen needs, suppressed immune system, etc.), or are pregnant, you may want to refer to the following resources.

Medical Conditions & Specific Needs

Diabetes

Heart Disease

Cancer

Pregnancy and Travel with Young Children

Take Necessary Precautions for Your Journey: Keep supplies close at hand

A final reminder about health supplies… Medications, medical supplies, and health kits are useful only if they are available. They should be carried with the traveler at all times (e.g., in carry-on baggage, when allowable, and on excursions). All medications, especially prescription medications, should be stored in carry-on baggage, in their original containers with clear labels. With heightened airline security, sharp objects and some liquids and gels will have to remain in checked luggage.²

Remember, “it is the traveler’s responsibility to ask for information, to understand the risks involved, and to take the necessary precautions for the journey.”⁵

This document is meant for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

References:

Mayo Clinic (2006). International travel: Staying healthy far from home [on-line]. Retrieved February 21, 2008. From http://mayoclinic.com/health/vaccines/HQ00760.
Centers for Disease Control and Prevention (2007). Pre-and post-travel general health recommendations [on-line]. In Health Information for International Travel 2008. Atlanta: US Department of Health and Human Services, 2007. Retrieved February 20, 2008. From http://wwwn.cdc.gov/travel/yellowBookCh2-HealthKit.aspx.
Centers for Disease Control and Prevention (2007). Non-infectious risks during travel [on-line]. In Health Information for International Travel 2008. Atlanta: US Department of Health and Human Services, 2007. Retrieved February 20, 2008. From http://wwwn.cdc.gov/travel/yellowBookCh6-MotionSickness.aspx.
Centers for Disease Control and Prevention (2007). International travel with infants and young children [on-line]. In Health Information for International Travel 2008. Atlanta: US Department of Health and Human Services, 2007. Retrieved February 20, 2008. From http://wwwn.cdc.gov/travel/yellowBookCh8-SafeInfantsChildren.aspx.
World Health Organization (2007). Health Risks and precautions: General considerations [on-line]. In International travel and health 2007. Retrieved February 20, 2008. From http://www.emro.who.int/sudan/media/pdf/Health%20Risks%20
and%20Precautions_general%20considerations%20chapter%201.pdf.
American Family Physician (2006). Traveling abroad: Tips for staying healthy [on-line]. Retrieved February 20, 2008. From http://www.aafp.org/afp/20060515/1809ph.html.
University of Maryland Medical Center (2007). Travel medicine: Guide for the adventurous traveler [on-line]. Retrieved February 20, 2008. From http://www.umm.edu/travel/guide.htm.
U.S. Department of State (2008). Tips for traveling abroad [on-line]. Retrieved February 21, 2008. From http://travel.state.gov/travel/tips/tips_1232.html.
Merck & Company (2003). Travel and health: Merck manual home edition [on-line]. Retrieved February 22, 2208. From http://www.merck.com/mmhe/print/sec25/ch303/ch303a.html.
World Health Organization (2007). Mode of travel: Health considerations [on-line]. In International travel and health 2007. Retrieved February 20, 2008. From http://whqlibdoc.who.int/publications/2007/9789241580397_2_eng.pdf.
Centers for Disease Control and Prevention (2007). Traveling safely with infants and children [on-line]. In Health Information for International Travel 2008. Atlanta: US Department of Health and Human Services, 2007. Retrieved February 20, 2008. From http://wwwn.cdc.gov/travel/yellowBookCh8-SafeInfantsChildren.aspx.
Transportation Security Administration (2008). Traveling with children: Air travel [on-line]. Retrieved February 21, 2008. From http://www.tsa.gov/travelers/airtravel/children/index.shtm.
American Academy of Pediatrics (2008). Travel safety tips [on-line]. Retrieved April 15, 2008. From http://medem.com/search/article_display.cfm?path=\\TANQUERAY\
M_ContentItem&mstr=/M_ContentItem/ZZZSV4Z3EBE.html
&soc=AAP&srch_typ=NAV_SERCH

Health Tips for Travelers Pack Your Bags: What to take with you for health & medical purposes