Asthma: A Travel Message – Is It A Storm or Fair Weather?

Diagram of a heart with asthma condition

Important Tips: Before booking your holidays, Discus with your Travel Health Advisor or Asthma Nurse. Make sure your asthma is well controlled before Travel. Carry important Contact numbers on your person, including your doctors and the recommended doctor at your destination.

If your asthma is normally well controlled, you should be able to go sightseeing, trekking, swimming and other leisure activities you wish, so enjoy yourself but do not Scuba Dive. 

Must Know: Your symptoms may vary greatly, from mild and infrequent to debilitating and severe.  This may influence the type of trip and destination you choose.  Know your triggers. (many people with Asthma have allergies which can trigger asthma symptoms e.g. House dust mites, animal dander, molds, pollen and cockroach droppings.  Tobacco smoke is an irritant that often aggravates asthma.  Also air pollution, strong odours and fumes).   Please, if you are advised not to travel, do not travel.  Some food items may help you stabilise your asthma and some others could trigger the symptoms.  Consult your nutritionist. 

Before departure:  A detailed history will be required of you including mode of transport and destination. 

Plan your diet: If you have food allergies, be certain that the food you will be eating does not contain substances to which you are allergic. Let whoever is preparing the food — airline, cruise ship, hotel, restaurant, family member, or friend — know what you are allergic to as far in advance as possible. 

Keep your allergy shot schedule: If you are taking a long trip, discuss with your allergist how to continue to take or receive your allergy shots. Health Insurance is essential.  You will have to declare your asthma status and it should include repatriation. Make sure you have a self-management plan with details of medication and use, what to do in an emergency and contact numbers.  Two inhalers must be taken in case of loss or theft (one in your hand luggage, and one with your responsible companion or checked in luggage).  The same goes for stand by emergency suppositories.  Wear an information bracelet or neck chain were possible (Get from Medic-Alert or SOS Talisman).  Take a little more medication(all clearly labelled) than you think you need and carry a print out of all regular prescriptions in case you lose your supplies and to prove the medicine is for your personal use. An adequate supply of all your medication should be in your carry bag (Hand luggage).

The usual immunisations for your destination should be taken along with annual influenza shots and also pneumococcal vaccine.  Any use of high dose oral steroids should be mentioned prior to immunisation. All malaria tablets, if recommended for your destination can be used.  It is advisable to use a standard metered dose inhaler and a large volume spacer device which is cheap, portable, obtained by prescription and just as effective as a nebuliser, which requires prior permission to use on an aircraft and voltage problems on route and at destination requiring all sorts of adaptors and regulators.  Electricity power may not be available at destination.  If you cannot walk 50 meters at a steady pace without feeling breathless and needing to stop, you may need on board oxygen in-flight and disabled assistance at airports possibly at your cost. (early arrangements may be necessary).

Plan for an emergency: Ask your doctor for an asthma action plan that will outline what to do in case of an asthma episode. Keep your doctor’s name and phone number with you. If you have a nebulizer, take it when you travel for use at the destination. 

After Departure:- On Route: Do not over-indulge in food and alcohol especially when on the move. Drink plenty of water and non-alcoholic drinks in flight.  Sit well forward in non-smoking areas in aircraft(most flights are non-smoking these days).  Avoid smoking areas in the Airport.  Do not smoke.  Irritability could be an early sign of reduced oxygen intake. Try to move about every hour, to exercise your legs to prevent blood clots. Give the note from your doctor (detailing Condition and Medication) to the ships doctor if you are going on a cruise. 

At Destination:  Your condition may improve or deteriorate during your holiday due to climate change, absence of allergic triggers (fewer allergens at high altitude), stress or exercise/exertion. Virtually all large cities in the developing world have significantly polluted air and the developed world in some major cities.  Air pollution can be severe in cities where there are no controls over petrol and diesel exhausts.  If possible avoid heavy traffic.  Temperature changes, like sudden exposure to cold and dry air can bring on asthma symptoms, also aerosol metered dose inhalers may not function properly under freezing conditions and may need to be warmed in the hands before use. All beds and pillows harbour dust mites-unless they are treated with a microbial compound (for example, UltraFresh) which inhibits their growth. Be wary of hotels that look unclean.   Take all necessary precautions as a regular traveller. You can do virtually all activities, but do not overexpose yourself to the sun and other extreme conditions. Be cautious if you have exercise-induced asthma, especially exertion of mountain climbing.  Acclimatise properly.  If you must dive, go snorkelling instead and not scuba diving.  Increased asthma therapy prior to exercise will achieve better control but intensive exercise should be avoided as much as possible.

Sports: If you are going to exercise a lot, especially activities that you are not used to, such as mountain climbing, hiking, etc., remember that exercise itself can trigger asthma symptoms. Any activity should start with a warm-up, and your quick-relief medication should be taken 15 to 20 minutes before you begin. 

All is Clear: If you have a clearly labelled Medication & Spacer (in your carry on bag), a responsible companion (if necessary). Your Asthma is stable.  A letter with details of your condition and medication & information bracelet or neck chain. You are all clear to go.  On return, you may need to inform your doctor of your experiences so he can plan better and safer trips for you and other asthmatics. Gather more information from the following websites and literature. www.fitfortravel.nhs.uk/General/Astma.html , www.asthma.org.uk (subscribe to Asthma Magazine), www.asthmacontrol.com (Gives you an idea of how well your asthma is controlled). 

Answer: With due consultation, it is not a storm, but fair weatherHave a Nice Journey!

FAQS
You can ask your travel health Advisor the following questions:  

  • Why does air travel affect people with lung conditions?
  • Why does lower pressure in aircraft cabins affect people with lung conditions?
  • How do I know if I might have difficulty travelling by air?
  • Can I use oxygen to help me when travelling by air?
  • Does the length of the flight make a difference?  It Does 
  • Am I covered by medical insurance for any delays or difficulties due to my chest condition while on my trip?
  • What happens if I get a chest infection while on holiday? He will most likely in this case, tell you to completely treat the infection before you fly home.  The flu season differs between the Northern and Southern hemispheres.
  • What else should I remember before flying?   Apart from the non-exhaustive items listed above amongst others, she will tell you if in doubt, check with your doctor.

 Statistical Information:  In an Australian study on the Great Barrier Reef in Queensland, the leading cause of death for the 100 dive fatalities were drowning, pulmonary barotraumas and cardiac disease.  25% of the 100 deaths had preexisting medical contraindications.  Out of this 25% (25 people), 8 were asthmatic and 7 had respiratory disease (8% & 7% respectively. Total 15%). For each 50 parts per billion increase in peak ozone levels, hospitalisation rates increase by 6% to 10% for asthma, pneumonia and chronic obstructive pulmonary disease.

Asthma: A Travel Message – Is It A Storm or Fair Weather?

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