You may have more work to do abroad. That's nice! However, the working and environmental conditions are not always comparable to those in our country. The conditions there can become a burden for us, because
- we are not used to it (climate, temperature, humidity) or perhaps because we are not used to it.
- other (lower or no) hygiene standards apply or perhaps because
- other pathogens make life difficult for us because our immune system is not prepared for it.
This affects the countries between 30° north and 30° south latitude and especially the subtropics and tropics. It is not uncommon to "catch" malaria, bilharzia, hepatitis, etc.. The list is long. Therefore you should be well prepared and the occupational health precautions are obligatory for these countries! However, not only there, but everywhere, where special, partly extreme, climatic conditions prevail or special infection danger exists. Countries or continents such as Europe, USA and Canada as well as Australia, on the other hand, are considered harmless.
After returning from "problematic" regions, you have the right to a supply precaution.
You can find further details on occupational health precautions in the DGUV Principle G35 - Stay Abroad - and of course on our website.
To be well prepared automatically means to reckon with the worst. This is not a pessimism, but experience, especially that of the accident insurance companies. Think about what can happen and make preparations to prevent this if possible. Malaria or heapatitis are no fun. Also include accidents and medical precautions on site.
- Take advantage of a company medical consultation and / or contact the Tropical Institute.
- Check your vaccinations. Which vaccinations are necessary? Plan enough time for a complete vaccination protection before you start your journey. Often you will need up to 3 rounds in a period of up to 6 weeks for complete protection.
- Clarify the entry conditions such as HIV test, yellow fever vaccination, medical certificates for medication.
- Visit your dentist or gynaecologist again at home
- Take copies of medical findings (e.g. ECG) with you.
- Fill your first-aid kit (disinfectant, plaster, bandage, if necessary malaria prophylaxis, prescribed medication, etc.)
- Pack sunscreen, mosquito repellent, sunglasses and spare glasses. Creams with a sun protection factor of 30 or more are recommended as sun protection. And: A suitable hat is also sun protection, just like long sleeves and trouser legs!
- Take out a foreign health insurance policy with return transport.
- Obtain information about local medical care, e.g. via the health insurance hotline.
Important vaccinations
For almost all trips, the so-called standard travel vaccinations are given with protection from
- Tetanus,
- Diphtheria,
- Whooping cough,
- Hepatitis A and B recommended.
- Polio usually does not need to be refreshed after a basic immunization for travel in Europe or America, but to (South-East) Asia and Africa.
- A rabies vaccination is recommended for use in remote areas and expected contact with animals.
- The yellow fever vaccination is recommended for journeys to tropical Africa and South America, sometimes even prescribed. Here also the flight routes are important, and/or the intermediate stops.
- A cholera vaccination is, according to current research, also advantageous for people who very easily suffer from travel diarrhoea.
- The meningococcal vaccination is suitable in the African meningitis belt ("Sahel zone") and for travel on the Arabian peninsula at the time of Haij.
- Flu vaccination should be considered at all times.
Malaria
Malaria is the Top Level Candidate among the serious infections on tropical trips!
The activity of malaria-transmitting mosquitoes is mainly limited to twilight and night hours. Since there is no vaccination, drug prophylaxis may be recommended depending on the risk. It always makes sense to take a
- Mosquito protection at night with mosquito net, best impregnated (Permethrin), mesh diameter max. 1.2 mm, better 0.6 mm as protection against e.g. sand mosquitoes, on sufficient size (concealment around mattress must be possible) and
- Mosquito repellent for application (DEET, e.g. in Antibrumm forte®).
If sun protection and mosquito repellent are needed at the same time, it makes sense to apply sun protection first and mosquito repellent after 20 minutes. A very effective protection is clothing with long sleeves and legs!
In most large cities, the risk of malaria is very low. Usually at least 7 days elapse before the outbreak of the disease, i.e. those who are shorter in the country and have a fever are more likely not to have malaria. After the return a malaria is to be excluded immediately with each fever or unclear well-being disturbances on the part of the doctor.
General protective measures against insects
The climate favours the occurrence and reproduction of insects as disease carriers. Day and night active mosquitoes transmit dengue (here no ASA intake!), yellow fever and Japanese encephalitis. Malaria is also spread by mosquitoes, which are, however, more active at dusk or at night (see above). Essential preventive measures are body-covering clothing and "insect-repellent agents" and the stay in air-conditioned rooms, as well as mosquito nets (see below).
Poor hygiene
The water from the public water supply is generally unsuitable as drinking water. In many regions it is even better to use mineral water for brushing your teeth.
Food can be contaminated with germs, so the following (eating) rules are recommended - even if they are sometimes difficult to maintain:
- Eat only thoroughly cooked food, (even) peeled raw fruit or vegetables (caution is also advised with melons, for example, which are "pierced" and placed in water to increase the weight and thus the selling price).
- Do not drink drinks with ice cubes
- No open ice, no open drinks
Disinfect and dress even small wounds. If you have a fever, have it checked as soon as possible. Even after returning home, you must inform your attending physician about your stay abroad, especially if you have health problems.
Loss of fluidity
In order to replace increased fluid loss (sweating), you must make sure that you drink sufficient fluids (at least 2-3 litres), preferably mineral water (from closed bottles) and warm tea!
Bathing in standing tropical waters
For example, when bathing in inland waters, suction worms can be absorbed through the skin, which can cause schistosomiasis. The waters can contain faeces and can lead to diarrhoea when ingested orally. Fleas can also cause diseases in the sand (e.g. melioidosis, more rarely leptospirosis, etc.).
Travel complaints
This does not refer to complaints about the trip, but to complaints that may arise during the trip (flight).
Long-haul flights, which increase the risk of thrombosis by sitting for long periods, are particularly worth mentioning here. Flight tips:
- Move feet and legs regularly (choose aisle seat)
- Drink plenty of water, tea, or juice (avoid alcohol)
- Wear travel stockings
- Drug-based thrombosis prevention can be useful for some chronic diseases or risk factors - company medical advice is indicated.
In the case of medication (e.g. insulin, hormones), the time difference may have to be taken into account. Since the internal pressure of the cabin at an altitude of approx. 10,000 metres corresponds to an altitude of approx. 2,500 metres above sea level, the oxygen supply can be critical for people with considerable cardiopulmonary diseases.
Medicines against travel sickness and regularly taken medicines belong in hand luggage!
Information on medicines in hand luggage
Medicines in hand luggage can be a problem during air travel. If holidaymakers do not have a certificate in English confirming the necessity of the medication, they run the risk of having to hand it in at an inspection.
According to the Federal Institute for Drugs and Medical Devices, a document filled out by the doctor and certified by the highest state health authority is sufficient for trips of up to 30 days in member states of the Schengen Agreement. For travel to other countries, the Bundesopiumstelle advises that a multilingual medical certificate be issued in accordance with the guidelines of the International Narcotics Control Board (INCB).
As a rule, the international health insurance can name a selection of clinics (contact via hotline). International 5-star hotels can sometimes help. In case of serious illnesses, accidents or assaults, the German Embassy can be contacted.
It also makes sense to play through the emergency situation in advance. So, it makes sense to compile emergency telephone numbers, directions to hospitals, medication etc...
Always take important medication and medical findings into your hand luggage! For check-in at the airport, pack the medication in transparent plastic bags.
- If possible, store larger amounts of money in the hotel safe.
- Always carry smaller amounts of money with you. Wear little or no jewellery or expensive watches.
- Only board marked taxis.
- Do not go out alone and pay attention to the time of day. Avoid provocation.
- Store a copy of the most important travel documents in a separate location.
- Pay attention to country-specific information on the website of the Federal Foreign Office!