'Malaria nearly killed me'

Mo Kanneh nearly died after catching one of the most severe forms of malaria during a trip to Sierra Leone.

He didn't take antimalarial medication, believing the course he had taken for a previous trip to the West African country still protected him.

But he fell ill soon after returning to the UK and spent two weeks fighting for his life in hospital.

A chaplain was even called to give Mo his last rites after doctors feared he would not survive.

“I was told I could have died,” says Mo. “Compared to what I went through, the potential mild discomfort of taking antimalarial pills is nothing.”

Mo hopes his story will raise awareness about the risks of malaria in UK residents visiting friends and family in their country of origin.

Immunity to malaria

In 2010, 61% of the 1,700 cases of malaria reported in the UK were in people who had travelled to a malaria region in their country of origin.

Many people mistakenly think they are immune to diseases such as malaria because they have previously lived in a malaria region.

However, immunity is quickly lost when someone moves to a malaria-free country like the UK.

Mo thought the antimalarial pills he had taken on his previous trip to Sierra Leone 10 months earlier would give him immunity.

He also thought that his genes provided some protection against the mosquito-borne parasite.

Both his brother and grandmother, who live in Sierra Leone, had had malaria and made a full recovery after developing only mild symptoms.

Mosquito bites

Mo flew out on April 11 2013 to join the rest of his family for the funeral of his mother, who had died unexpectedly from a heart attack.

“Her death was such a shock,” he says. “In the rush of making last minute travel arrangements, antimalarials were low down on my to-do list.”

He spent a week in the country travelling between Freetown and his ancestral home attending ceremonial events in honour of his mother.

“I didn’t take any precautions at all,” says Mo, an online marketing manager from east London. “No mosquito net, no mosquito repellent.

“I remember being bitten a few times but we had so many things to deal with that malaria was the last thing on my mind.”

Back in the UK

On his return to the UK, Mo says he felt “absolutely fine”, apart from a complete loss of appetite, which he put down to grieving.

“In a week, I probably managed to eat one banana and a couple of bowls of soup,” he says.

By the end of his first week back, Mo quickly began experiencing symptoms including sweats, muscle ache, severe headaches and breathing difficulties.

“It dawned on me that it might be malaria but I wasn’t too worried,” he says. “I thought it would be cured easily with a few tablets.”

As his breathing worsened, he called for an ambulance and was taken to Homerton University Hospital, in east London, on April 24.

A blood test confirmed malaria. However, it was not just any malaria. Mo had been infected with plasmodium falciparum, the most deadly form of malaria.

Found mainly in Africa, almost all deaths from malaria are due to the plasmodium falciparum parasite.

Intensive care

Mo was placed in intensive care. “A doctor said he was going to put me to sleep for a few hours to insert a tube to help me breathe,” he says.

The next thing Mo remembers is waking up nine days later in St Thomas’ Hospital, in central London, hooked up to life-support equipment.

“It was a complete shock,” he says. “I had tubes and needles going in and out of me. I couldn’t speak because there was a large tube in my mouth.”

The drama of the previous nine days – his family’s distress, the chaplain’s prayers, moving hospital – were revealed to him over the following days.

“When I woke up, the medical staff, family and friends helped me piece together the past nine days.

"It was very upsetting to be told that I had come close to dying.

"The malaria parasite had been attacking my lungs and they were filling up with fluid.

"Pint after pint of brown fluid was being pumped out. The doctors feared I was going to drown in this fluid.”

In falciparum malaria, fluid can accumulate in the lungs and cause severe breathing problems.

“My family was told that the outlook wasn’t good and that they should be prepared for the possibility that I wasn’t going to make it.

“We had only just buried our mother and now they were being told I was probably going to die.”

In case Mo didn’t make it through the night, a hospital chaplain was called to administer his last rites.

Transfer to St Thomas'

With his condition deteriorating by the day, a medical team from St Thomas’ came to Homerton to assess his condition.

It was decided that Mo should be transferred to St Thomas’ where they would try to beat the malaria parasite using different drugs.

By the time Mo woke up after his nine-day blackout, the parasite level had dropped significantly, his lungs had cleared and he was able to breathe unaided.

He remained at St Thomas’ under close supervision for another five days until the parasite had virtually disappeared from his blood.

“The staff at St Thomas’ saved my life, for which I will forever be grateful,” says Mo. “They were fantastic.”

After two weeks in hospital, Mo was discharged on May 8 and spent the following two weeks recovering at home.

“I had lost about two stone and I still felt weak,” he says. “I still had difficulty breathing. Even going to the bathroom was a struggle."

He has since made a full recovery and a subsequent blood test showed that the malaria parasite was no longer present in his system.

"A near-death experience makes you realise life can be taken away from you at a moment's notice," says Mo.

"If I've taken anything away from this experience, it's to never take your health for granted."

The risks of treatment abroad

Before going abroad for medical treatment, it's important to get enough information to make the right choice. There are several issues that need to be considered.

The main mistakes people make:

• Lack of research into the clinic or surgeon.
• Lack of a proper consultation with the surgeon or dentist.
• Not considering their aftercare (for example, corrective treatment).
• Taking travel risks (for example, air travel after surgery).
• Lack of insurance. Most insurers won't cover planned treatment abroad.
• Poor communication and language difficulties.

All types of medical treatment involve some element of risk, whether you receive the treatment in the UK or abroad.

One way to reduce this risk is to get as much information as possible about your treatment options so you can make informed choices.

Some of the research you need to do – such as finding out about a doctor's expertise and qualifications – will be the same wherever you plan to be treated. But getting the information you need is likely to be much harder if you're looking at overseas options.

You may not speak the language of the country you're going to. And your own GP or dentist, and patient support groups in the UK, are less likely to be able to give you advice about practitioners and clinics abroad.

There are also specific issues to consider if you're thinking of going abroad for treatment, such as how to co-ordinate your care after the operation or treatment (aftercare) and how to ensure your medical notes are exchanged between your medical teams in this country and abroad.

The most common problems and how to avoid them

Lack of research

You may be tempted to make a quick decision based on the promise of fantastic treatment at a great price. Don't make a decision that will affect your health without fully considering the implications.

It's only worth saving money if you know you're not compromising your safety, health and peace of mind. Get advice from your GP or dentist. Discuss with them how much they will be involved in your aftercare.

Whether you use a travel agency or broker, or deal directly with a clinic abroad, ask lots of questions and give yourself plenty of time to make a decision. Find out about the doctors or dentists who might be involved in your treatment and the clinic where the procedure will take place.

Check the medical team's qualifications, including any areas they specialise in, and check they're registered with their country's equivalent of the General Medical Council (GMC) or General Dental Council (GDC).

Find out who the professional regulatory body is in the country you're planning to have treatment, the standards it enforces, and who to contact if you have a complaint. You can find out about health regulators and professional bodies in other countries on the Health Regulation Worldwide website.

Also check online message boards and forums about the type of condition you want to treat or the specific procedure you want to have. If you have a clinic or hospital in mind, you may also want to run a search on them to see if there is any useful information that can help.

Don't underestimate how difficult this research can be. Standards vary from country to country, and finding out about qualifications and regulations and how to raise concerns in another country can be a daunting task.

Booking treatment without a proper consultation

Don't agree to any treatment without a proper consultation first. You must understand what the procedure involves to have realistic expectations about the outcome and be aware of any potential complications.

It's vital to have a consultation with a qualified dentist or surgeon, preferably with the practitioner who will treat you, before you commit to any treatment.

The GDC advises you should always be assessed by a qualified dentist before being given a treatment plan and cost estimate. If the consultation takes place in the UK, check the dentist is registered with the GDC. If they're not, they shouldn't be practising in the UK.

Anthony Armstrong, a consultant plastic surgeon and member of the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Association of Aesthetic Plastic Surgeons (BAAPS), says it's best practice to have two consultations with a surgeon before any surgery, and to make sure there's a cooling-off period to allow you to change your mind.

Aftercare

Don't ignore your aftercare. Consider what care you will need both immediately after the procedure and in the longer term. For example, think about whether you will need somebody to travel abroad with you to help you while you recover.

Find out how many nights you will stay in the clinic or hospital. Consider whether, if you then move to a hotel, there are arrangements in place for you to get medical help or advice should you need it.

Think about whether, when you return home, you will need further care or check-ups. Work out who will provide this aftercare and whether it is included in the total price of the procedure.

Ask what would happen if a problem were to arise once you'd returned to the UK. Would you be able to receive treatment in the UK, or would you have to travel back to the clinic where the first procedure was done? It's important to find out who would pay for this.

Find out whether your medical notes will be translated so you have a record of the treatment to show your GP or dentist back in the UK. Aftercare problems can arise several years after the treatment, so make sure you have full documentation about the procedure.

Travel risks

Find out how soon after the procedure you will be able to travel home. Allow some extra time in your travel plans and time off work in case your recovery takes longer than expected.

Both surgery and air travel increase the risk of developing deep vein thrombosis or a pulmonary embolism. Ask the clinic doing the treatment how soon after the procedure you'll be fit to travel.

Medical treatment abroad is sometimes sold as a holiday package. Don't let this influence your choice of destination or clinic. Consider what type of holiday you'll realistically be able to enjoy while you're recovering from your treatment.

Lack of insurance

Most travel insurance policies will not cover you for elective treatment. This means they will not pay claims for anything that goes wrong as a result of planned treatment abroad.

Malcolm Tarling, a spokesperson for the Association of British Insurers, advises anyone travelling abroad for treatment to inform their insurer and find out how this will affect their cover.

Communication problems

Find out whether all the people treating you speak English or another language you understand.

If not, find out whether an interpreter will be provided at all times, and think about whether you would feel comfortable talking to the medical or dental team through an interpreter.

The language barrier may not be the only communication problem. Standards of care and the relationship between patient and doctor or dentist may be different from what you would expect at home. Ask if you can talk to former patients so you have a better idea of what to expect.

Further advice

To help you make an informed choice, read Questions to ask the surgeon or dentist abroad.

'I got DVT from flying'

Journalist Mark Pownall developed deep vein thrombosis (DVT) on a long-haul flight from New Orleans to London.

• Watch a video about DVT
• Get tips on preventing travel-related DVT

He had been in the US for a medical conference in March 2004, reporting on topics including deep vein thrombosis. The night before his journey home, Mark had a few drinks.

The flight was long, with a six-hour transit in Washington DC because of delays. "Door to door, it was a 20-hour trip," says Mark from north London.

"I arrived at Heathrow feeling as though I had slept quite badly. I felt a cramp in my left leg, and it got worse over the next few days."

It was when Mark began limping because of the pain that he got medical attention. And that was only at the insistence of his wife, Jill.

"My leg was hot and swollen," says Mark. His GP diagnosed DVT and Mark was sent to the Whittington Hospital in north London, where he received an ultrasound that found a blood clot stretching from his calf to his mid-thigh. "The clot had spread quite a bit," says Mark.

He was kept in hospital for a few days. He received daily injections of the anti-clotting treatment heparin, and was put on a course of warfarin tablets to prevent further blood clots.

"It's ironic that I got DVT after attending a conference on it," says Mark. "I should have known better and gone straight to my GP."

Dehydration

Doctors were puzzled by Mark's DVT. He didn't have any of the risk factors: he was male, a non-smoker, was a healthy weight and had no family history of DVT. They said the long flight, dehydration and a lack of movement contributed to the DVT.

After six months, Mark stopped taking warfarin because doctors thought he was unlikely to have another clot.

But he did. In June 2007, Mark developed pain in the same leg. And the consequences could have been far worse.

"It was a dull muscular pain, which came and went," says Mark. But even then, despite having experienced DVT, Mark didn't realise what it was. "I think I was in denial," he says.

Pulmonary embolism

After a few days, he developed severe chest pains. He went to hospital, where a spiral CT scan found five blood clots in his lungs, known as a pulmonary embolism.

"Part of the clot in my leg had broken off and got into my pulmonary artery," says Mark. It's a potentially fatal condition.

He was in hospital for four days, where he was treated with heparin and warfarin. "I was very lucky," says Mark. "I was healthy, and that's why I'm still alive.

"With the first DVT, I just thought I was unlucky. But with the second one, it was the first time I had come face to face with my own mortality.

"Doctors blamed the pulmonary embolism on the fact that I was sitting down for hours on end at my desk without moving, and not drinking enough water," he says.

Mark is now in a high-risk category and he'll probably need to continue taking warfarin for the rest of his life. When flying, he wears compression stockings (also called flight socks) to boost the blood circulation in his legs.

"During the flight, I make sure I drink water regularly, don't drink alcohol or coffee, and exercise," he says. "I try not to fall asleep either, because that means I'm not moving."

Sunscreen and sun safety

Advice for adults and children on sunscreen and sun safety in the UK and abroad.

• Sun safety tips
• What factor sunscreen (SPF) should I use?
• What are the SPF and star rating?
• How to apply sunscreen (video)
• Swimming and sunscreen
• Children and sun protection
• Protect your eyes
• Clothing and sunglasses
• Sunburn
• Who should take extra care?
• Mole protection
• Sunbed advice

Sunburn increases your risk of skin cancer. Sunburn doesn't just happen on holiday – you can burn in the UK, even when it's cloudy.

There's no safe or healthy way to get a tan. A tan doesn't protect your skin from the sun's harmful effects.

Aim to strike a balance between protecting yourself from the sun and getting enough vitamin D from sunlight.

Sun safety tips

Spend time in the shade when the sun is strongest. In the UK, this is between 11am and 3pm from March to October.

Make sure you:

• spend time in the shade between 11am and 3pm
• make sure you never burn
• cover up with suitable clothing and sunglasses
• take extra care with children
• use at least factor 15 sunscreen

What factor sunscreen (SPF) should I use?

Don't rely on sunscreen alone to protect yourself from the sun. Wear suitable clothing and spend time in the shade when the sun's at its hottest.

When buying sunscreen, the label should have:

• a sun protection factor (SPF) of at least 15 to protect against UVB
• at least four-star UVA protection

UVA protection can also be indicated by the letters "UVA" in a circle, which indicates that it meets the EU standard.

Make sure the sunscreen is not past its expiry date. Most sunscreens have a shelf life of two to three years.

Don't spend any longer in the sun than you would without sunscreen.

What are the SPF and star rating?

The sun protection factor, or SPF, is a measure of the amount of ultraviolet B radiation (UVB) protection.

SPFs are rated on a scale of 2-50+ based on the level of protection they offer, with 50+ offering the strongest form of UVB protection.

The star rating measures the amount of ultraviolet A radiation (UVA) protection. You should see a star rating of up to five stars on UK sunscreens. The higher the star rating, the better.

The letters "UVA" inside a circle is a European marking. This means the UVA protection is at least one third of the SPF value and meets EU recommendations.

Sunscreens that offer both UVA and UVB protection are sometimes called broad spectrum.

How to apply sunscreen

Most people don't apply enough sunscreen. As a guide, adults should aim to apply around:

• two teaspoons of sunscreen if you're just covering your head, arms and neck
• two tablespoons if you're covering your entire body while wearing a swimming costume

If sunscreen is applied too thinly, the amount of protection it gives is reduced. If you're worried you might not be applying enough SPF15, you could use a stronger SPF30 sunscreen.

If you plan to be out in the sun long enough to risk burning, sunscreen needs to be applied twice:

• 30 minutes before going out
• just before going out

Sunscreen should be applied to all exposed skin, including the face, neck and ears – and head if you have thinning or no hair – but a wide-brimmed hat is better.

Sunscreen needs to be reapplied liberally and frequently, and according to the manufacturer's instructions.

This includes applying it straight after you've been in water – even if it's "water resistant" – and after towel drying, sweating, or when it may have rubbed off.

Watch a video about staying safe in the sun

Check moles for change

Keep an eye on any moles or freckles you have. If they change at all (for example, if they get bigger or bleed), see your GP as this can be an early sign of cancer.

The earlier skin cancer is caught, the easier it is to treat, so see your GP as soon as possible.

Swimming and sunscreen

Water washes sunscreen off, and the cooling effect of the water can make you think you're not getting burned. Water also reflects ultraviolet (UV) rays, increasing your exposure.

Water-resistant sunscreen is needed if sweating or contact with water is likely.

Sunscreen should be reapplied straight after you've been in water – even if it's "water resistant" – and after towel drying, sweating, or when it may have rubbed off.

Children and sun protection

Take extra care to protect babies and children. Their skin is much more sensitive than adult skin, and damage caused by repeated exposure to sunlight could lead to skin cancer developing in later life.

Children aged under six months should be kept out of direct strong sunlight.

From March to October in the UK, children should:

• cover up with suitable clothing
• spend time in the shade – particularly from 11am to 3pm
• wear at least SPF15 sunscreen

Apply sunscreen to areas not protected by clothing, such as the face, ears, feet, and backs of hands. Get more sun safety advice for children.

To ensure they get enough vitamin D, all children under five are advised to take vitamin D supplements.

Protect your eyes in the sun

A day at the beach without proper eye protection can cause a temporary but painful burn to the surface of the eye, similar to sunburn.

Reflected sunlight from snow, sand, concrete and water, and artificial light from sunbeds, is particularly dangerous.

Avoid looking directly at the sun, as this can cause permanent eye damage.

Clothing and sunglasses

Wear clothes and sunglasses that provide sun protection, such as:

• a wide-brimmed hat that shades the face, neck and ears
• a long-sleeved top
• trousers or long skirts in close-weave fabrics that don't allow sunlight through
• sunglasses with wraparound lenses or wide arms with the CE Mark and European Standard EN 1836:2005

How to deal with sunburn

Sponge sore skin with cool water, then apply soothing aftersun or calamine lotion.

Painkillers, such as paracetamol or ibuprofen, will ease the pain by helping to reduce inflammation caused by sunburn.

Seek medical help if you feel unwell or the skin swells badly or blisters. Stay out of the sun until all signs of redness have gone.

Read more about treating sunburn.

Get tips on preventing and treating heat exhaustion in hot weather.

Who should take extra care in the sun?

You should take extra care in the sun if you:

• have pale, white or light brown skin
• have freckles or red or fair hair
• tend to burn rather than tan
• have many moles
• have skin problems relating to a medical condition
• are only exposed to intense sun occasionally – for example, while on holiday
• are in a hot country where the sun is particularly intense
• have a family history of skin cancer

People who spend a lot of time in the sun, whether it's for work or play, are at increased risk of skin cancer if they don't take the right precautions.

People with naturally brown or black skin are less likely to get skin cancer, as darker skin has some protection against UV rays. But skin cancer can still occur.

The Cancer Research UK website has a tool where you can find out your skin type to see when you might be at risk of burning.

Protect your moles

If you have lots of moles or freckles, your risk of getting skin cancer is higher than average, so take extra care.

Avoid getting caught out by sunburn. Use shade, clothing and a sunscreen with an SPF of at least 15 to protect yourself.

Keep an eye out for changes to your skin. Changes to check for include:

• a new mole, growth or lump
• any moles, freckles or patches of skin that change in size, shape or colour

Report these to your doctor as soon as possible. Skin cancer is much easier to treat if it's found early.

Use the mole self-assessment tool to see whether you could have a cancerous mole.

Using sunbeds

The British Association of Dermatologists advises that people shouldn't use sunbeds or sunlamps.

Sunbeds and lamps can be more dangerous than natural sunlight because they use a concentrated source of UV radiation.

Health risks linked to sunbeds and other UV tanning equipment include:

• skin cancer
• premature skin ageing
• sunburnt skin
• eye irritation

It's illegal for people under the age of 18 to use sunbeds, including in tanning salons, beauty salons, leisure centres, gyms, and hotels.

Find out more by reading Are sunbeds safe?

Before you travel

From travel insurance to vaccinations, here's what to think about before you travel.

Start preparing for your trip, especially long trips, four to six weeks before you go.

Read the latest health and safety advice for the country you're travelling using:

• GOV.UK
• TravelHealthPro country information

Find out if you need travel vaccines and make sure your vaccinations are up-to-date.

If diseases such as malaria are a risk, you may need to start treatment before travelling.

Prepare a kit of travel health essentials, including sunscreen, painkillers and antiseptic.

Consider taking condoms with you to avoid the risk of buying fake, and potentially unsafe, brands when you get there.

Sun protection

When choosing sunscreen, the bottle's label should have:

• the letters "UVA" in a circle logo and at least four-star UVA protection
• at least SPF15 sunscreen to protect against UVB

For more information, read the Sun safety Q&A.

Travel insurance

Whether you're off on a six-month trek to the Himalayas or a family holiday in Spain, it's vital to have the right travel insurance.

Make sure your policy covers your destination and the duration of your stay, as well as any specific activities you might do.

When travelling in Europe, make sure you have a valid European Health Insurance Card (EHIC).

The EHIC will entitle you to free or reduced-cost medical care. However, it won't cover you for everything that travel insurance can, such as emergency travel back to the UK.

Deep vein thrombosis

If you think you may be at risk of developing deep vein thrombosis (DVT), seek advice from your GP.

On long-haul flights, get up from your seat to walk around and stretch your legs whenever you can. Drink regularly, but avoid alcohol, and wear loose, comfortable clothes.

Jet lag

Jet lag is worse when you move from west to east because the body finds it harder to adapt to a shorter day than a longer one.

Travellers who take medication according to a strict timetable, such as insulin or oral contraceptives, should seek medical advice from a health professional before their journey.

Get tips on dealing with jet lag.

Travel kit checklist

• antiseptic
• sunscreen
• after sun lotion
• insect repellent
• condoms
• antihistamines
• anti-diarrhoea pills
• rehydration sachets
• first aid kit

For more on what to pack to stay safe and healthy abroad, go to Travel health essentials.

Travelling with a heart condition

Most people with a heart condition are able to travel, as long as they feel well and their condition is stable and well controlled.

If you're recovering from a heart condition, such as a heart attack or heart surgery, get medical advice before you make your travel plans.

Health experts advise preparing for a trip four to six weeks before you travel.

Things to consider as part of your preparation include:

• your destination
• travel insurance
• air travel
• pacemakers and implantable cardioverter-defibrillators (ICDs)

Your destination

When you book your holiday, think about how to make your trip as convenient as possible. Stay in accommodation that's easily accessible and close to any amenities.

Avoid destinations that are hilly, unless you've recovered enough and you're fit enough for potentially strenuous activity.

Avoid travelling to high altitudes (over 2,000m) as lower levels of oxygen can cause breathlessness or angina.

Avoid countries where there are extreme temperatures, either very hot or very cold, as this can put an added strain on your heart.

Find out how to get medical help, such as a local ambulance or doctor, at your destination.

Keep an up-to-date list of all your medication, including the generic names, and doses in your purse or wallet, just in case you lose any of them.

Take enough medicines to last you throughout your trip, plus a few extra days.

Travel insurance

Take out travel insurance and check that it will cover your specific heart condition.

Declare all your past and present health conditions. Making a mistake or omission could result in a claim being refused.

Get advice from your doctor before you purchase an insurance policy. They can help you answer the medical questions about your health.

For travel in Europe, make sure you have a European Health Insurance Card (EHIC). This entitles you to reduced-cost and sometimes free medical treatment.

But it's not a substitute for travel insurance, as an EHIC may not cover all the costs of your treatment. For example, an EHIC doesn't cover the cost of being flown back to the UK.

See the British Heart Foundation website for more information on insurance if you have a heart condition. They also have a list of insurers recommended by people with a heart condition.

Air travel

If you have a heart condition or a history of heart disease, you may have an increased risk of deep vein thrombosis (DVT).

Get tips on preventing flight-related DVT, including exercises and compression stockings.

Consider arranging support at the airport terminal, such as help with your luggage and early boarding on to the plane.

It's safe to use your glyceryl trinitrate (GTN) spray while you're on the plane.

Under current security restrictions, you cannot carry containers with liquids, gels or creams (including medication) that exceed 100ml in your hand luggage.

You can carry essential medicines of more than 100ml on board, but you'll need prior approval from the airline and airport, and a letter from your doctor or a prescription.

Pacemakers and ICDs

If you have a pacemaker or an ICD, bring your device identification card with you.

Tell security staff that you have a pacemaker or ICD as it can set off the security metal detector alarm.

Ask to be hand-searched by security staff or checked with a hand-held metal detector. The metal detector should not be placed directly over your device.

Travelling with asthma

A guide for people with asthma to help them plan their trip.

Health experts advise preparing for a trip four to six weeks before travel.

What will I need if I travel with asthma?

Take your usual medication, along with a copy of your prescriptions and your:

• asthma action plan
• travel insurance documents
• European Health Insurance Card (EHIC) for European travel

Things to consider as part of your preparation include:

• asthma health check
• asthma triggers
• air travel
• travel immunisation
• travel insurance

Asthma health check

See your GP or asthma nurse before you travel to review your personal asthma action plan and make sure it's up-to-date.

If you don't have a personal asthma action plan, now is the time to get one. It will allow you to recognise deteriorating asthma and alter your treatment to stay well.

Find out how you can get medical help – such as a local ambulance or doctor – if necessary at your destination. See the Healthcare abroad for more information.

Take spare inhalers in case of loss or theft. These can usually be carried in your hand luggage.

Bring enough medicine to last throughout your trip, plus a few extra days.

Take a print-out of your regular prescriptions, including the generic names of medicines, in case you need medical assistance during your trip or your medication is lost.

See Asthma UK's advice on travelling with asthma.

Asthma triggers

If being exposed to feather pillows makes your asthma worse, you could bring your own non-feather alternative or ask your hotel for a pillow with synthetic filling.

If you're sensitive to tobacco smoke, ask your accommodation provider whether you should book a non-smoking room as smoking rules vary from country to country.

Some holiday activities, such as scuba diving, may be hazardous to people with asthma, and special considerations may apply.

Ensure your asthma is fully controlled, as exposure to allergens and viral infections in confined spaces, such as planes and ships, may make your condition worse.

Air travel with asthma

If you're always short of breath, even when resting, you may need a special evaluation before you fly because of the reduced oxygen levels at high altitude.

Carry all your asthma medicines as hand luggage in case your checked-in luggage goes missing or your medicines are damaged in the baggage hold.

Under current security restrictions, you cannot carry containers with liquids, gels or creams that exceed 100ml in your hand luggage.

You can carry essential medicines of more than 100ml on board, but you'll need prior approval from the airline and airport, as well as a letter from your doctor or a prescription.

All asthma medicines taken on board should be in their original packaging, with the prescription label and contact details of the pharmacy clearly visible.

For more information, read the British Lung Foundation's advice on air travel with a lung condition.

Travel immunisation and asthma

Your GP or practice nurse can tell you what vaccinations and precautions you need to take for the country you're travelling to.

You can have the usual travel jabs that are recommended for your destination, unless there are other health reasons for not having them.

Tell your GP or practice nurse if you have recently used high-dose oral steroids before you have any vaccinations.

Asthma and its treatment don't usually interfere with malaria tablets.

Travel insurance and asthma

Take out travel insurance and check that it will cover your asthma. Many insurers ask you to get permission from your GP before you travel.

Shop around for the best deal. Travel insurance quotes vary depending on your age, medication and destination.

When travelling in Europe, make sure you have a valid European Health Insurance Card (EHIC). The EHIC will entitle you to free or reduced-cost medical care.

However, the EHIC won't cover you for everything that travel insurance can, such as emergency travel back to the UK.

See the Asthma UK website for more information on finding travel insurance if you have asthma.

Travelling with diabetes

Having diabetes should not prevent you from travelling and enjoying your holidays.

Planning ahead is key to having a great time away and dealing with any potential problems with your diabetes.

Health experts advise preparing for a trip four to six weeks before you travel.

What will I need if I travel with diabetes?

Carry your diabetes ID and a letter from your GP, which says you have diabetes and the medication you need to treat it if you are carrying insulin or another injectable medication.

Things to consider as part of your preparation include:

• diet
• medicines and travel vaccines
• travel insurance
• air travel

Food and diabetes

Whether you're at home or abroad, make sure you still eat healthily.

You should be able to choose foods from local menus and still eat a balanced diet.

If you're flying to your destination, airlines can provide information on the times of most meals so you can plan your insulin.

It's best to order the standard meal, though this may not supply you with enough carbohydrate if you are on insulin or certain diabetes tablets, so pack some healthy snacks.

Blood glucose is measured differently from the UK in some countries. See Diabetes UK's blood glucose conversion chart.

Medicines and travel vaccines

Bring twice the quantity of medical supplies you would normally use for your diabetes.

Find out where you can get supplies of insulin at your destination in case of emergency.

See your GP or diabetes specialist for information on travel jabs and how the local weather and changing time zones can affect your condition.

Diabetes shouldn't affect what vaccinations you have, but it's worth asking your doctor if certain jabs could disrupt your diabetes control and how you should manage this.

Travelling to a hot or cold climate may affect how your insulin and blood glucose monitor work.

Travel insurance for diabetes

For travel in Europe, make sure you have a European Health Insurance Card (EHIC). This entitles you to reduced-cost and, sometimes, free medical treatment.

Also take out travel insurance – an EHIC may not cover all the costs of your treatment. An EHIC doesn't cover the cost of being flown back to the UK.

Make sure you declare all your medical conditions, including your diabetes. Making a mistake or omission could result in a claim being refused.

Find out more about getting travel insurance from Diabetes UK.

Air travel with diabetes

Contact your airline several weeks before travelling to discuss medical devices you intend to take on board the aircraft, such as a pump or glucose monitor.

If you use an insulin pump, contact the device manufacturer, the airline and the airport for advice about going through airport screening equipment, such as X-ray machines.

Bring a letter from your GP explaining your need to carry syringes or injection devices, insulin and any other medication.

Some GPs charge for writing a letter. If you travel frequently, ask them to write it in such a way that it can be used more than once.

Carry all your diabetes medicines as hand luggage in case your checked-in bags go missing or your medicines are damaged in the baggage hold.

Travel health checklist

What to pack to stay safe and healthy abroad, including first aid essentials.

Basic travel health kit

The exact contents of your travel kit will depend on your travel plans.

A basic kit can include:

First aid kit

A basic first aid kit includes:

• antiseptic
• painkillers
• wound-cleaning gauze
• sterile dressings
• bandage tape
• plasters
• tweezers
• scissors
• thermometer
• antihistamines
• sunburn treatment
• insect repellent
• insect bite treatment
• medication for pre-existing medical conditions
• condoms

For more detailed information, read Your medicine cabinet.

Sunscreen

The sunscreen label should have:

• the letters "UVA" in a circle logo and at least four-star UVA protection
• at least SPF15 sunscreen to protect against UVB

Country-specific advice

For more adventurous travel and depending on where you're going, you could consider:

• anti-diarrhoea medication
• rehydration sachets
• anti-malaria medication
• mosquito net
• water disinfectant

For country-specific health and safety advice, go to:

• GOV.UK: foreign travel advice
• TravelHealthPro (formerly NaTHNaC)

Sign up for email alerts from TravelHealthPro and the FCO to get the latest updates for that country.

Follow @NaTHNaC and @FCOtravel on Twitter to get the latest travel updates and advice.

Don't travel without health insurance. If you're travelling in the EU, also apply for a European Health Insurance Card (EHIC) to cover costs of any essential treatment while you're abroad.

Watch a guide to staying healthy abroad

Prevent DVT when you travel

If you're travelling long distance, there are several ways you can reduce your risk of deep vein thrombosis (DVT).

Who's at risk of DVT?

Conditions that may increase your risk of DVT on flights of eight hours or more:

• history of DVT or pulmonary embolism
• cancer
• stroke
• heart disease
• inherited tendency to clot (thrombophilia)
• recent surgery – pelvic region or legs
• obesity
• pregnancy
• hormone replacement therapy

Before you travel

If you think you have a risk of DVT, see your GP before you travel.

Don't leave it until the last minute in case you need to buy medication, compression stockings or anything else for your flight.

Wearing compression stockings during flights of four hours or more can significantly reduce your risk of DVT, as well as leg swelling (oedema).

The below-knee stockings apply gentle pressure to the ankle to help blood flow. They come in a variety of sizes and there are also different levels of compression. Class 1 stockings (exerting a pressure of 14-17 mmHg at the ankle) are generally sufficient.

It's vital that compression stockings are measured and worn correctly. Ill-fitting stockings could further increase the risk of DVT.

Flight socks are available from pharmacies, airports and many retail outlets. Take advice on size and proper fitting from a pharmacist or another health professional.

During your journey

Tips to reduce your risk of DVT during a long-distance flight, train or car journey:

• wear loose, comfortable clothes
• consider flight socks
• do anti-DVT exercises
• walk around whenever you can
• drink plenty of water
• don't drink alcohol or take sleeping pills

Recovering from DVT

If you had DVT recently, you're probably on medication, such as warfarin, to prevent the formation of blood clots.

If that's the case, then your risk of developing DVT is low and there is no reason why you can't travel, including long haul.

However, if you're still in the recovery phase, you should get the all-clear from your consultant before travelling.

You should also follow the general DVT prevention advice above.

• Read a traveller's experience of getting DVT from flying.

DVT high-risk factors:

• history of DVT or pulmonary embolism
• cancer
• stroke
• heart disease
• inherited tendency to clot (thrombophilia)
• recent surgery (pelvic region or legs)
• obesity
• pregnancy
• hormone replacement therapy

If you think you have a risk of developing DVT, see your GP before you travel.

Flight socks

• Flight socks are recommended for people at high or moderate risk of DVT.
• They should be worn throughout the flight.
• Use below-knee graduated stockings with an appropriate compression.
• Class 1 stockings (exerting a pressure of 14-17 mmHg at the ankle) are generally sufficient.
• Get advice from a health professional (doctor, nurse or pharmacist) on correct size and fitting.