The perils of paradise

It's holiday time. We want to believe that the paradise pictured in the brochures - lithe bronzed bodies frolicking in foamy …

It's holiday time. We want to believe that the paradise pictured in the brochures - lithe bronzed bodies frolicking in foamy blue seas, palm trees waving on white sandy shores - will be ours for a week or two. So, dire warnings about mosquito molestation, virulent viruses, searing sun hangover headaches and Delhi belly are duly ignored. Irish people travelling abroad are risking their health by failing to get the necessary vaccinations, drinking local tap water and eating contaminated food, according to the Irish Society of Travel Medicine (ISTM).

It seems that the further we travel, the greater our chances of becoming ill. More than 25,000 holiday-makers have been in contact with the British Consumers' Association about the bugs and medical mishaps that took their toll during recent trips abroad. Some 15 per cent of long-haul travellers fell ill compared to 11 per cent of those on short-haul trips, according to the association's survey, which was published last month. Stomach troubles were the most common problem in the countries with the worst illness records. Peru topped the table for making travellers , while 41 per cent of those travelling to India and 39 per cent of those holidaying in the Dominican Republic became ill. Next came Egypt, Tunisia and Mexico, all popular destinations with Ireland's package holiday-makers.

This year, it is expected that one million package holidays will be sold in the Republic; many other people will make independent arrangements. The British Consumers' Association survey found that package holiday-makers were more likely to fall ill (14 per cent) than those who travelled independently (11 per cent). The good news is that reports of serious illness, such as malaria and salmonellosis, were rare. Stomach problems accounted for nearly half of all illnesses, followed by coughs and colds, which afflicted one in five travellers. For those thinking of travelling far afield, holiday health precautions may include vaccinations or anti-malarial medication, which have to be organised well in advance of the trip. Dr David Thomas, president of the ISTM, says travellers heading to destinations other than northern Europe, North America, Australia, Hong Kong and Singapore should contact a GP or travel clinic for advice.

"We are concerned that people are not doing this because of the cost. They may be underestimating the risks involved," he says. The necessary vaccinations could cost around £100.

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He dismisses worries about the possible adverse effects of the vaccines themselves, saying they are much safer than they were 20 years ago and that reactions are not as severe. The four basic vaccinations, says Dr Thomas, are hepatitis A, typhoid, diphtheria and tetanus boosters for those who have not been vaccinated in the previous 10 years. For some destinations, polio immunisation might also be required. Immunity from polio, diphtheria and tetanus vaccines lasts after which it will also confer a 10-year immunity period. "One can't underestimate the need for correct advice about malaria prophylaxis. People can die from malaria - there are regular deaths in the UK and occasional deaths here," says Dr Thomas. It is important for travellers to continue taking malaria tablets after their return, as recommended. People concerned about possible side-effects may be heartened to hear that new safer and more effective drugs are in the offing.

"We would expect these to be available in Ireland in the next two or three years," Dr Thomas says.

In countries where malaria is a problem, the best protection, obviously, is to avoid mosquito bites, by using repellents and wearing long trousers and long-sleeved shirts, especially in the early morning and early evening. Mosquito nets may also be required.

Young travellers, in particular, should be aware of the dangers of contracting hepatitis B from body piercing while on holiday abroad.

Those who are sexually active should remember that AIDS is endemic in many countries, so safe sex is a must. Drinking too much alcohol increases the likelihood of risk-taking, notes Dr Thomas, who as director of TCD's health services is aware of the dangers young people may face.

Whether heading for Ballybunion or Barbados this summer, holiday-makers should keep the Irish Cancer Society's SunSmart Code in mind. The advice is to wear a wide-brimmed hat and a loose-fitting T-shirt with collar and sleeves. Dark clothes with tightly woven fabric provide an added sun barrier.

A spokeswoman for the Irish Cancer Society says holiday-makers shouldn't stint on the sunscreen. Put it on; go for the oil-slick effect, she says. Sunscreen should be applied before going out into the sun and then re-applied every two hours and after swimming or exercise. The SunSmart Code advises people "not to forget ears, neck, hands, feet and balding areas (if any)".

The facts are sobering. Skin cancer is the Republic's commonest cancer. The most recent figures from the National Cancer Registry show 7,915 new cases of skin cancer and 82 deaths from the disease in 1996.

Finally, don't forget to take out travel insurance. Most holiday-makers buy travel insurance from a travel agent when purchasing a holiday, but while this may be the handiest option, it is probably not the cheapest one. But if it's all beginning to seem like too much trouble, it's time to flick open the pages of those travel brochures and leaf through those seductive sunny sandy scenes again. Bon voyage.

Useful websites:

www.fitfortravel.scot.nhs.uk (indexed website compiled by a team of experts from the Travel Medicine Centre at the Scottish Centre for Infection and Environmental health)

www.which.net (British Consumers' Association survey)