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Travelling Seniors – what you don’t know CAN hurt you.

February 20th, 2018

Of the gladdest moments in human life, methinks, is the departure on a distant journey to unknown lands. Sir Richard Burton explorer

Look at the bucket list of most seniors, and you will see some form of travel. Money and time means the world is your oyster…Unfortunately, what the glossy brochures don’t tell you, is that sometimes travellers get sick. The fancy internet sites don’t mention illness, or that some hospitals overseas will make a patient worse not better. Many travel health problems are preventable with the right pre-travel preparation: Like the motto of the boy scouts, travellers need to “Be Prepared”.

Senior travellers are at higher risk of illness during travel than their younger counterparts. Unfortunately with increasing age, one’s immune system – like one’s eyesight – is not what it used to be. Seniors may travel with some form of pre-existing illness or require regular medication. Increasing age is not necessarily a barrier to travel – one just needs to plan in advance. Of course, not all seniors are the same: A fit 70-year-old will cope better than a overweight, 55-year-old who has diabetes, heart and kidney disease.

Of all the travel vaccines, the Yellow Fever vaccine merits special mention. This vaccine is mandatory for travel to certain parts of Africa and South America. Senior travellers frequently come to our clinic for a yellow fever vaccine. Seniors think that getting a yellow fever vaccine is akin to getting a tetanus vaccine. They often bemoan the fact that they must visit a special clinic in the city to get the vaccine. When they get here, they may be quite shocked to learn that the Yellow Fever vaccine can cause some very serious side effects when given for the first time to persons over 60 years of age – the vaccine can even be fatal. That would definitely spoil your holiday.

For example individuals over 75 years of age, having a Yellow Fever vaccine means 18 times the risk of serious reactions and 9 times the rates of hospitalization or death compared to those 25 to 44 years of age. Sometimes a medical exemption certificate must be given instead of the vaccine.

That is why Yellow Fever vaccine has to be given at a properly resourced travel medicine clinic, and is best discussed with doctors who have completed formal qualifications in travel medicine. Visit www.travelmedicine.com.au or phone 1300 42 11 42 to find your nearest travel medicine provider.

For those seniors who will be visiting countries where traveller’s diarrhoea is more common, it is worth knowing that they are also more susceptible to complications of bacterial gut infection. Sadly, as we age, we make less stomach acid, and it is our stomach acid that kills invading gut bacteria. Some drugs can decrease the stomach acid production even further, so for some travellers, it may be worth a discussion about stopping such medication temporarily. Diarrhoea may also worsen heart and kidney problems.

Packing an appropriate medical kit is as important as packing shoes. Medicines should ideally be carried in the aircraft cabin to minimise problems if the luggage goes astray.

As you get older, vaccines take longer to take effect, so it is recommended to seek travel medicine advice at least 6 – 8 weeks before departure. Information about simple tips to stay well can make all the difference to a trip: Some problems such as heat exhaustion, dehydration, chest infections and deep vein thrombosis may be worse in seniors. It’s not all bad though, happily, seniors generally suffer less altitude sickness and less motion sickness.

As part of the specialised consultation, travel medicine doctors will recommend appropriate vaccines, medical supplies and information on how to stay healthy while away. The book, Travelling Well is a useful source of travel health tips.

Senior travellers should always see their dentist before travel, as dental issues are much harder to sort out when overseas.

It is wise for senior travellers to ask their GP for a written medical history to carry in their documentation,  in case something happens. This brings the locally treating doctor up-to-speed quickly. Travel insurance is critically important for all travellers, but for senior travellers it is even more so, especially the medical cover. Travellers should read the policy, and often need to provide their complete medical history to the insurance company even if not specifically required, so they can’t be refused later for not giving information. As the Australian smart traveller website says “If you can’t afford the travel insurance you can’t afford to travel”.

Last but definitely not least, most travel means more physical activity, so it pays to get fit before departure. Walk for an hour a day, at least for the 6 weeks before travel. Wear your travel shoes as an insurance policy against future blisters. Packing a trekking pole can be handy to enhance stability over rough terrain – especially around old ruins. These collapsible poles can fit in your suitcase and may also be useful to fend off stray dogs in countries where rabies is a risk.

In summary, overseas travel can be a source of great joy and good stories, but a little forward planning will make sure you have a holiday to remember, rather than one you would like to forget.

Dr Deb Mills is the Doctor with a passion for travel and health. She is the Medical Director of the Travel Medicine Alliance – a network of travel medicine doctors around Australia. She has been looking after Australians travelling overseas since 1988.

4 Responses to “Travelling Seniors – what you don’t know CAN hurt you.”

  1. Marg says:

    I have been diagnosed with hep A. Should i ggo to Bali in 2 weeks

    • Dr Deb says:

      HI if you are recovering and feeling well, then prior Hepatitis A is not a contraindication to travel or reason not to go

  2. PAUL CAOUETTE says:

    I am a fit 75 year old having just hiked Tiger’s Nest in Bhutan within the last year and traveled to Israel, Jordan and Egypt for 23 days last month. Traveling is my hobby and I have a safari to Kenya and Tanzania planned for August of 2019. The Yellow Fever vaccination is causing me some concern. I have no medical issues other than mild psoriasis and minor high blood pressure for which I take medication daily. I exercise (walk)at least 4 times a week for 1 hour and a half each time.

    Should I risk the Yellow Fever shot or cancel my trip? I have an appointment with my general physician in January to discuss this but I would like your opinion. Thank you.

    • Dr Deb says:

      Hi, thanks for your question. There is no easy answer to this question and I cannot answer to your personal situation on a blog, but here are my more detailed thoughts
      It really depends on how much risk you feel personally comfortable accepting. We all take a risk by getting out of bed in the morning and travellers – especially those to remote parts of the world – frequently take risks. There could be a car accident, one could have a heart attack remote from medical care and defibrillators, one could pick up a dreadful disease, be mugged, have a plane crash etc etc – you get the idea.
      The risk of yellow fever vaccine has to be balanced with the risk of the disease. Tanzania for example (below) has not had any cases for a while so it maybe recommended to just carry an exemption certificate to solve the paperwork requirement.
      You really need to see a yellow fever provider who has the most up to date information about the size of the risk on your trip and can help you decide about the balance of risk-benefit. No disrespect to general physicians but many do not know enough about yellow fever to give you the detailed advice you need.

      Health recommendation: CDC does not recommend yellow fever vaccine for most travelers to Tanzania. However, you might consider this vaccine if you are staying a long time or will be heavily exposed to mosquitoes.

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