Advice for Child Travellers

Travelling with children requires practical consideration and careful planning. It is advisable to consult a travel health practitioner at least 6-8 weeks in advance of departure. The risks to health vary and many factors need to be taken into account such as destination, length of stay, planned activities, age and the general health of your child.

Vaccination

Vaccinations may be advisable for some destinations. The age of your child often determines which vaccines they may be able to receive and should have already received as per the UK Vaccination Schedule. Parents should be aware that some children may be too young to receive the vaccinations recommended for their chosen destination. Your health care practitioner can discuss additional preventative measures to reduce the chance of disease transmission in these circumstances, however you may be advised to change your travel plans.

The timing of vaccinations is important, some vaccines may offer disease protection within two weeks, whereas others may require over a month. Some vaccine schedules require two or more doses given over weeks or months before adequate protection is obtained.

Some vaccines are available free on the NHS, however, there may be a charge for some recommended vaccines. This should be taken into consideration when planning and budgeting for travel. 

Malaria

Children are at particular risk of severe and fatal malaria; parents are therefore advised to avoid taking infants and children to malarious areas. If travel is unavoidable it is imperative that infants and children are well protected against mosquito bites and receive appropriate chemoprophylaxis (antimalarials).

A) Awareness of Risk

Malaria is now predominantly a disease affecting Africa, South America, Southeast Asia, the Indian sub-continent and less so in Central America and the Middle East:

• individual country pages should be checked to determine the risk at the destination
• for further information see the  malaria advice pages.

B) Mosquito Bite Prevention

• Parents and children must be aware of the risk and take precautions to avoid mosquito bites, including the use of repellents, nets and suitable clothing.

C) Chemoprophylaxis (antimalarials)

It is important to discuss antimalarial suitability with a qualified doctor, nurse or pharmacist:

• the choice of antimalarial is determined by the destination, age and weight of the child
• parents must supervise their child's antimalarial consumption and be careful not to exceed the recommended dose, overdosing antimalarials can be particularly toxic for children
• it is preferable to avoid crushing or breaking tablets, however, it may be necessary to crush some tablets in order to administer the correct dose. Qualified pharmacists should be able to offer further advice; tablet cutters can be purchased to help facilitate correct dosage
• infants and young children may resist taking medications, mixing tablets with jam, honey, chocolate spread or similar foods may make administration easier
• no antimalarial is 100% effective and should always be used in combination with mosquito bite avoidance

D) Diagnosis and Treatment

• Prompt diagnosis and treatment of malaria is essential and the importance of this should be stressed to all parents visiting malarious regions. Fever, occurring at least 7 days after exposure, is the most common symptom of malaria, but infection can develop even up to one year later.
• Symptoms in young children may be difficult to determine.  Parents must be aware that any child returning from a malarious zone who seems ‘off colour’ or just ‘not their normal self’ should be screened for malaria promptly.

Rabies

Rabies is spread through the saliva of an infected animal (particularly dogs, cats, monkeys and bats) via a bite, scratch or lick of mucous membranes or broken skin. There is no specific treatment available for rabies once symptoms develop and those that develop symptoms will die.Children can be more likely than adults to be exposed to rabies. Natural curiosity and exploration may entice them to approach animals; fear of being chastised may make them conceal an exposure.

• It is important that children are aware of the need to avoid animal contact during travel and equally the importance of reporting any exposure that does occur.

Pre-travel rabies vaccination should be considered for children travelling to countries that are considered high risk for rabies. Please see the Rabies advice page for further information.

Food and Water Hygiene

Children, especially young children may be more likely to be exposed to food and water borne illness during travel due to their natural exploratory nature and hand to mouth habits.Risk can be reduced by frequent hand washing (or use of alcohol based hand cleansing gel when hand washing is not an option).  Children should eat freshly cooked, hot food when possible and avoid raw food that cannot be peeled or cooked and unpasteurised dairy products.Water for drinking, making up formula milk, diluting drinks and cleaning teeth should be bottled or boiled; see the Breastfeeding and Bottle-feeding advice page for further information.Children and infants should be discouraged from drinking shower, bath or swimming pool water. Parents of toddlers may decide to take pre-packaged food with them.Children suffering diarrhoeal illnesses can become dehydrated quickly, rehydration is a priority:

• clear fluids such as diluted fruit juices or oral rehydration solutions  should be drunk liberally
• all rehydrating drinks must be prepared with safe water
• children with severe or blood/mucous stained diarrhoea, high fever or severe abdominal pain should receive medical attention immediately