How to prepare a safe trip with children: before, during and after the journey

Children are increasingly travelling abroad. Although data on children falling ill during or after international travel is limited, commonly reported health issues include diarrhoea, skin infections, malaria and injuries from traffic or water-related accidents.

Certain groups, such as children, face greater health risks when travelling. Taking appropriate precautions before, during and after travel can help minimise them. It is also recommended that both children and adults visit the travel clinic.

Before setting off

Health insurance

You should find out how the local healthcare system works and take out a health insurance policy with appropriate coverage.

Pre-travel visit

If possible, visit the travel clinic at least 4 to 8 weeks before departure to learn about the health risks associated with your destination and how to prevent or minimise them. In this section you can find more information about the Travel Clinic, the international health program and how to make an appointment. Vaccinating children for travel requires a careful assessment to establish whether any routine childhood immunisations need to be brought forward and to address any specific age-related indications, precautions or contraindications for travel vaccines. Malaria is a potentially life-threatening disease transmitted by mosquitoes in some parts of tropical countries. Infants and children under five face the highest risk of developing a serious infection. Malaria can be prevented with medication and by avoiding mosquito bites. Depending on the destination, children may also need to take medication to prevent malaria.

While you are away

Water and food

Contaminated food or drink can lead to traveller’s diarrhoea, as well as other illnesses. Safer eating and drinking habits can help reduce the risk of children falling ill while travelling.

• Make sure you wash your hands with soap and water, particularly before eating and after using the bathroom.
• Drink bottled water or water that has been boiled, filtered or treated with water purification tablets.
• Avoid unpasteurised milk and other dairy products.
• Don't use ice in drinks.
• Only consume food that has been properly cooked and served hot, and avoid raw or undercooked items.
• If you want to eat fruit, it is best to choose fruit with the skin on, then wash and peel it before eating.
• In the event of diarrhoea, it is crucial that you remain hydrated by taking oral rehydration salts. If the patient is a young child and cannot tolerate oral rehydration salts, or if they have a fever or there is blood or mucus in their stool, medical attention should be sought.

Mosquito bites

Certain illnesses to which travellers may be exposed (such as malaria, dengue, chikungunya, zika or Japanese encephalitis) can be transmitted by mosquito bites. There are vaccines and medicines that can prevent infection or reduce the severity of these illnesses. A pre-travel visit is recommended in order to learn about the risks you may encounter. You should also follow these recommendations:

• Sleep under a mosquito net or in an air-conditioned room.
• Put a mosquito net over the baby carrier and/or pram or buggy.
• Use insect repellent, ensuring it includes one of the following ingredients: DEET, icaridin or IR3535 (suitable from two months of age). Products with very high amounts of DEET (over 50%) will not provide more effective or longer-lasting protection.
• Wear light-coloured clothing that covers your arms and legs.
• If using sunscreen, apply it 30 minutes before insect repellent.

Animal contact and rabies

To reduce the risk of rabies, do not interact with animals (e.g. petting, feeding or taking photos with them). Children are at greater risk of this disease, as they may not report minor contact with an animal to an adult. It is important to teach them to tell you if they are scratched or bitten by an animal, no matter how minor the injury may seem.

• If a person is bitten, scratched, or has direct contact with saliva from a mammal (such as a dog, cat, monkey or bat) on the eyes or mouth or an open wound, the area should be washed with soap and water for 15 minutes, and urgent medical attention should be sought to assess the need for rabies vaccination and if necessary, anti-rabies immunoglobulin.
• Even if the individual has already been vaccinated against rabies, immediate medical attention should be sought to decide whether they should have a booster dose.
• A vaccine given shortly after the contact may be effective in preventing the disease. Once symptoms have started to appear, however, there is no effective treatment.

Climate

UV exposure is highest near the equator, at high elevations, in the middle of the day and in places where light is reflected off water or snow. Because their skin is finer and more sensitive, children need sun protection, and severe sunburn is considered a medical emergency.

Parasitic infections

To prevent certain parasitic infections when travelling to Central and Sub-Saharan Africa or parts of the Middle East, Caribbean, South America or Asia, you should:

• Avoid swimming in unchlorinated freshwater (such as rivers, waterfalls and lakes). If you are travelling to other areas, check the specific recommendations during your pre-travel visit.
• Don't walk barefoot or lie directly on the sand. Children and babies should wear protective footwear and play on a sheet or towel rather than directly on the ground.

Tick bites

Some illnesses can be transmitted through tick bites. Tick-borne encephalitis, for example, can be spread this way in some Central and Eastern European countries. There is a vaccine that can prevent infection or reduce the severity of this illness. A pre-travel visit is recommended in order to learn about the risks you may encounter. You should also follow these recommendations:

• Use insect repellent and wear closed-toe shoes and light-coloured, full-length trousers.
• Inspect your body carefully after any outdoor activities, paying particular attention to skin folds, armpits, groin and scalp.
• If you find a tick, go to a healthcare facility for safe removal.

Accidents

Drowning and traffic-related injuries are among the most common types of injuries in travellers.

• When travelling by car or other vehicles, children should be properly secured using a car seat, booster seat or seat belt, according to their age, height and weight.
• They must always wear a helmet that meets safety standards when riding a bicycle or motorcycle.
• Care should be taken when crossing the road.
• Children should always be under adult supervision when in the vicinity of water.

After your return

Seek care of a specialised healthcare facility if any travellers experience fever, diarrhoea or skin rashes after returning from an international trip.