Health

CONTENTS

BEFORE YOU GO
   INSURANCE
   RECOMMENDED VACCINATIONS
   INTERNET RESOURCES
IN TRANSIT
   JET LAG
IN ITALY
   TRAVELLER’S DIARRHOEA
   ENVIRONMENTAL HAZARDS
   TRAVELLING WITH CHILDREN
   WOMEN’S HEALTH
   SEXUAL HEALTH


BEFORE YOU GO

While Italy has reasonable health care (although public hospitals tend to be less impressive the further south you travel), prevention is the key to staying healthy while abroad. A little planning before departure, particularly for pre-existing illnesses, will save trouble later. Bring medications in their original, clearly labelled containers. A signed and dated letter from your physician describing your medical conditions and medication, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity. If you are embarking on a long trip, make sure your teeth are OK (dental treatment is expensive in Italy) and take your optical prescription with you.

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INSURANCE

If you’re an EU citizen (or from Switzerland, Norway or Iceland), a European Health Insurance Card (EHIC) covers you for most medical care in public hospitals free of charge, but not for emergency repatriation home or non-emergencies. The card is available from health centres and (in the UK) from post offices. Citizens from other countries should find out if there is a reciprocal arrangement for free medical care between their country and Italy (Australia, for instance, has such an agreement; carry your Medicare card). If you do need health insurance, make sure you get a policy that covers you for the worst possible scenario, such as an accident requiring an emergency flight home. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.

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RECOMMENDED VACCINATIONS

No jabs are required to travel to Italy. The World Health Organization (WHO), however, recommends that all travellers should be covered for diphtheria, tetanus, the measles, mumps, rubella and polio, as well as hepatitis B.

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INTERNET RESOURCES

The WHO’s publication International Travel and Health is revised annually and is available online at www.who.int/ith.

Other useful websites:

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IN TRANSIT

DEEP VEIN THROMBOSIS (DVT)

Blood clots may form in the legs during a plane flight, chiefly because of prolonged immobility (the longer the flight, the greater the risk).

The chief symptom of DVT is swelling or pain of the foot, ankle or calf, usually but not always on just one side. When a blood clot travels to the lungs, it may cause chest pain and breathing difficulties. Travellers with any of these symptoms should seek medical attention immediately.

To prevent the development of DVT on long-haul flights, you should walk about the cabin, contract the leg muscles while sitting, drink plenty of fluids and avoid alcohol and tobacco.

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JET LAG

To avoid jet lag try drinking plenty of nonalcoholic fluids and eating light meals. Upon arrival, get exposure to natural sunlight and readjust your schedule (for meals, sleep etc) as soon as possible.

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IN ITALY

AVAILABILITY OF HEALTH CARE

If you need an ambulance anywhere in Italy, call 118. For emergency treatment, head straight to the pronto soccorso (casualty) section of a public hospital, where you can also get emergency dental treatment.

Excellent health care is readily available throughout Italy, but standards can vary significantly. Pharmacists can give you valuable advice and sell over-the-counter medication for minor illnesses. They can also advise you when more specialised help is required and point you in the right direction. In major cities you are likely to find English-speaking doctors or a translator service available.

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TRAVELLER’S DIARRHOEA

If you develop diarrhoea, be sure to drink plenty of fluids, preferably in the form of an oral rehydration solution such as Dioralyte. If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain, you should seek medical attention.

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ENVIRONMENTAL HAZARDS

Bites, Stings & Insect-Borne Diseases

Italian beaches are occasionally inundated with jellyfish. Their stings are painful but not dangerous. Dousing in vinegar will deactivate any stingers that have not fired. Calamine lotion, antihistamines and analgesics may reduce the reaction and relieve pain.

Italy’s only dangerous snake, the viper, is found throughout the country except on Sardinia. To minimise the possibilities of being bitten, always wear boots, socks and long trousers when walking through undergrowth where snakes may be present. Don’t put your hands into holes or crevices, and be careful when collecting firewood. Viper bites do not cause instantaneous death, and an antivenin is widely available in pharmacies. Keep the victim calm and still, wrap the bitten limb tightly, as you would for a sprained ankle, and attach a splint to immobilise it. Seek medical help, if possible with the dead snake for identification. Don’t attempt to catch the snake if there is a possibility of being bitten again. Tourniquets and sucking out the poison are now comprehensively discredited.

Always check all over your body if you have been walking through a potentially tick-infested area, as ticks can cause skin infections and other more serious diseases such as Lyme disease and tick-borne encephalitis. If a tick is found attached, press down around the tick’s head with tweezers, grab the head and gently pull upwards. Avoid pulling the rear of the body as this may squeeze the tick’s gut contents through the attached mouth parts into the skin, increasing the risk of infection and disease. Lyme disease begins with the spreading of a rash at the site of the bite, accompanied by fever, headache, extreme fatigue, aching joints and muscles, and severe neck stiffness. If untreated, symptoms usually disappear, but disorders of the nervous system, heart and joints can develop later. Treatment works best early in the illness – medical help should be sought. Symptoms of tick-borne encephalitis include blotches around the bite, which is sometimes pale in the middle, and headaches, stiffness and other flu-like symptoms (as well as extreme tiredness) appearing a week or two after the bite. Again, medical help must be sought.

Rabies is still found in Italy but only in isolated areas of the Alps. Any bite, scratch or even lick from a mammal in an area where rabies does exist should be scrubbed with soap and running water immediately and then cleaned thoroughly with an alcohol solution. Medical help should be sought.

Leishmaniasis is a group of parasitic diseases transmitted by sandflies and found in coastal parts of Italy. Cutaneous leishmaniasis affects the skin tissue and causes ulceration and disfigurement; visceral leishmaniasis affects the internal organs. Avoiding sandfly bites by covering up and using repellent is the best precaution against this disease.

Heatstroke

Heatstroke occurs following excessive fluid loss with inadequate replacement of fluids and salt. Symptoms include headache, dizziness and tiredness. Dehydration is already happening by the time you feel thirsty –aim to drink sufficient water to produce pale, diluted urine. To treat heatstroke, drink water and/or fruit juice, and cool the body with cold water and fans. It is also recommended to drink rehydration fluids or salts, available from any pharmacy.

Hypothermia

Hypothermia occurs when the body loses heat faster than it can produce it. As ever, proper preparation will reduce the risks of getting it. Even on a hot day in the mountains, the weather can change rapidly, so carry water­proof garments, warm layers and a hat, and inform others of your route. Hypothermia starts with shivering, loss of judgment and clumsiness. Unless rewarming occurs, the sufferer deteriorates into apathy, confusion and coma. Prevent further heat loss by seeking shelter, warm, dry clothing, hot, sweet drinks and shared bodily warmth.

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TRAVELLING WITH CHILDREN

Make sure children are up to date with routine vaccinations and discuss possible travel vaccines well before your departure as some vaccines are not suitable for children under a year. Lonely Planet’s Travel with Children includes travel health advice for younger children.

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WOMEN’S HEALTH

Emotional stress, exhaustion and travelling through different time zones can all contribute to an upset in a woman’s menstrual pattern.

If using oral contraceptives, remember that some antibiotics, diarrhoea and vomiting can stop the pill from working. Time zones, gastro­intestinal upsets and antibiotics do not affect injectable contraception.

Travelling during pregnancy is usually possible, but always consult your doctor before planning your trip. The most risky times for travel are during the first 12 weeks of pregnancy and after 30 weeks.

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SEXUAL HEALTH

Condoms are readily available but emergency contraception is not, so take the necessary precautions.


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