I’m a GP – these are the holiday mistakes most likely to put you in hospital

Many of us count down the days until we can go on a summer holiday. But how can we keep ourselves safe and healthy while travelling to avoid a dream holiday turning into a nightmare? Here, Dr Arpit Srivastava, a GP based in Oxfordshire and co-founder of messageGP, explains the most common errors people make on holiday which could lead to needing medical treatment. Tucking into the hotel buffet I commonly see people getting food poisoning from hotel buffets. If they travel further afield to places such as Asia, it tends to come from consuming street food or unsafe water. At buffets, cooked meat, fish and poultry are left out and if it falls to room temperature it isn’t hot enough to keep bacteria away and they start to thrive again as it cools down. Commonly, the types of bacteria causing food poisoning are Campylobacter and E. coli. Additionally, some cheeses and dairy products also have the potential to go off if they’re not cold enough. Choose foods that are piping hot and to check white meat is cooked through, with no pinkness. I recommend using the live stations at buffets, which many places have, because the food is cooked in front of you. Shorts In some exotic destinations, such as Egypt, India and other parts of Asia, salad can cause food poisoning if it’s been washed in local water which can contain harmful bacteria. Make sure you know how the food is being prepared and washed and how long it has been left out. The main symptoms of food poisoning are diarrhoea and vomiting, and more rarely, blood in poo. It’s best to seek medical help if you get it abroad because they may need to take stool samples as some types of bacteria require treatment with specific antibiotics. Severe cases of food poisoning can cause problems with kidneys, eyes and joints. It can lead to dehydration – this is the main reason why people are admitted to hospital with food poisoning – so it’s vital to have enough water and rehydration salts. Avoid Imodium if you get food poisoning as it traps the bacteria in the stomach, and it’s better to let it get out of your system. Drinking too much at the airport I often have consultations with people before they go on holiday about fear of flying. Some people want to take medication like diazepam, which is often prescribed to treat anxiety, but that’s probably not the best option. That’s because we don’t know how the body will react to it when you’re mid-flight. It can alter behaviour and make people feel spaced out and act in an odd way at inappropriate times, for example after you’ve landed when you’re going through security. Similarly, having an alcoholic drink at the airport or on the plane to calm your nerves is a bad idea – in fact, it’s best to completely avoid alcohol. It can actually make anxiety worse. I strongly recommend fear of flying courses that the major airlines organise. A lot of the anxiety comes from the uncertainty of what’s happening on the aircraft, so you can also watch videos on YouTube where people talk you through what happens during a flight. Sitting still on long flights Flying is a main risk for blood clots, especially on flights lasting longer than four hours. Risk factors for blood clots include having cancer therapy or cancer, having a family history of blood clots, being overweight, smoking or recently having surgery. Avoid alcohol because it dehydrates you and that can make your blood thicker and more prone to clotting. Instead, drink plenty of water, use travel socks (these keep your blood flowing back up your leg rather than pooling at the ankles), and make sure you’re moving your legs while on board. This can be by rotating your ankles while sitting down, walking around the cabin at least once an hour and staying as mobile as possible – these steps all keep your blood flowing. Symptoms of blood clots include calf pain, calf swelling, coughing up blood or sudden onset chest pain and breathlessness. If you have those symptoms, seek help straight away. Jumping into cold water Take extra care when swimming on holiday, especially in open water. Be aware of cold-water shock, which can affect you if you’re somewhere baking hot and then you enter a freezing cold body of water. If you suddenly dive in your body can go into shock due to the temperature which can make it a struggle to swim competently. If you’re going to swim in cold water, put your feet in first and gradually get in. Don’t go anywhere too deep to stand. Check local advice for tides and currents, and where the “safe to swim” flags are by the sea, and ensure a lifeguard is there. Drowning is a big risk as people can get caught up in tides and currents in unfamiliar areas. Always keep a very close eye on children when they go swimming and stay in the water with younger children. Going on strenuous hikes Often people want to explore their surroundings on holiday but don’t take this on lightly. Choose the best time of day to do this if you’re in a hot country, avoiding the peak of the sun. Stick to well-known routes because they’re usually mapped out, signposted and other people are there if you need help. Ensure your phone battery is fully charged before you set off. Do something within your physical capabilities, especially considering the climate will likely be different to what you’re used to. If you’re hiking, stock up with carbohydrate-heavy snacks and plenty of water. Drink water with electrolytes (add lemon, salt and sugar to water) beforehand. When it’s hot and you’re on a hike, you’re often in direct sunlight, so wear a hat, cover up and frequently apply factor 50 sunscreen. Try to avoid overheating. If you start to sweat profusely and lose a lot of salt then imbalances in sodium and potassium can cause issues with kidney function and heart rhythm. If you start feeling light-headed or nauseated, then sit down, rehydrate and eat a snack, and if you’re still not well then call for help or start turning back. The further you are from other people, and from where you started, the more dangerous the situation could become. Putting medication in hold luggage We encounter people forgetting to take their medication on holiday a lot. This can be due to people being out of their normal routine, or sometimes people in the rush of packing don’t properly quantify how much they need. Check what you need and keep it in your hand luggage. I recommend packing spare medication in your suitcase so that if you lose your hand luggage, you’ve got a backup supply. Be mindful that common drugs can vary between countries, so sometimes you can’t get hold of it abroad. If it’s important and you’ve forgotten it, go to a doctor or pharmacist and try to get it there. The medication you’re on can affect energy, hydration and blood sugars levels. For example, some medications which lower blood pressure can make you more prone to dehydration, and coupled with being in a hot country, that could make you even more dehydrated. Many medications interact with alcohol, so if you’re drinking more alcohol than normal it can affect the efficacy of your medication. Not checking if your insurance covers high-risk activities It’s important to follow the safety rules if you’re using equipment or doing activities that aren’t familiar to stay safe and avoid injuries. When doing water sports, such as hiring a jet ski, then make sure you really understand how to use them and always wear a life jacket. People also tend to do things like quad biking on holiday when they might not have used them for a long time, so exercise caution and don’t go beyond what you’re confident doing. If possible, read reviews of the companies running the activities to make sure they follow safety standards. It’s also worth checking if your travel insurance covers the activity, especially if it’s high risk. Otherwise, if something goes wrong there could be serious financial implications.