Travel health: vaccines, medicines and what to pack

What this article covers

When should you start health preparation for a trip?
Vaccines: which are mandatory and which are recommended?
Traveller's diarrhoea: the most common and most preventable problem
Carrying medicines across borders: how to avoid problems
Malaria: when you need prevention and what it involves
Your travel first-aid kit: the essentials
Travelling with a chronic condition
Sun, heat and insects: practical protection
After you return: when to see a doctor

When should you start health preparation for a trip?

Many travellers think about health preparation two or three days before departure, which is enough for short trips to low-risk destinations. But if your destination requires specific vaccinations, the ideal time to start is four to six weeks before travel. Some vaccines require multiple doses spaced weeks apart, and others take two to three weeks to reach full protection after the final dose.

A review published in the Sultan Qaboos University Medical Journal in 2020 examined travel health services in the Middle East region and identified a clear gap between the importance of pre-travel medical preparation and actual practice among regional travellers. Many do not know that specialist travel medicine services exist, or underestimate their relevance to their specific trip.

The first step is defining the trip: tourism in Europe or the Gulf does not require the same preparation as travel to sub-Saharan Africa or parts of Southeast Asia. The higher the epidemiological risk of the destination, the more important early preparation becomes, and the larger the difference early action makes.

Pre-travel health preparation schedule

6 to 8 weeks before Visit a travel medicine clinic or consult a specialist. Identify required vaccines. Begin multi-dose vaccine schedules
4 to 6 weeks before Complete core vaccinations. Obtain prescriptions for travel medications. Arrange medical letters for any controlled medicines
1 to 2 weeks before Review medications and documents. Update your medication list in English for emergency use abroad
Day before departure Check no medication has expired. Save emergency phone numbers for your destination country
During the trip Follow food and water precautions. Stay hydrated. Apply sun protection and insect repellent as needed

Vaccines: which are mandatory and which are recommended?

Travel vaccines fall into three groups: routine vaccines that everyone should have regardless of travel, such as tetanus and measles; required vaccines that specific countries demand for entry, most notably yellow fever for travel to endemic zones; and recommended vaccines that protect the traveller based on destination risk.

A 2023 study in the Journal of Travel Medicine assessing travel vaccine priorities by incidence and impact concluded that typhoid, hepatitis A and hepatitis B vaccines remain among the highest priorities for travellers from the Arab world heading to Africa and Asia, given the disease burden in settings where food and water quality cannot be guaranteed. All three are preventable conditions with effective vaccines.

Travellers to sub-Saharan Africa generally need a yellow fever vaccine and an international certificate as proof. Those visiting rural areas of malaria-endemic regions need malaria prophylaxis in addition to personal protection measures. Hajj and Umrah pilgrims are required by Saudi Arabia to present proof of meningococcal vaccination, which must meet the specific serotypes specified in the current requirements.

Key travel vaccines and their priority

Vaccine	Main risk regions	Notes
Typhoid	Africa, South Asia, parts of Middle East	Partial protection only, still observe food precautions
Hepatitis A	All low and middle income countries	Excellent protection, two doses
Hepatitis B	Areas with healthcare infection risk	Three doses over 6 months
Yellow fever	Endemic Africa and Latin America	International certificate mandatory for some countries
Meningococcal	African meningitis belt, Hajj and Umrah	Mandatory for pilgrims, specific serogroups required

Traveller's diarrhoea: the most common and most preventable problem

Traveller's diarrhoea is the most common travel-related health problem worldwide. It affects between 20 and 50 percent of travellers to high-risk regions. The cause is almost always contaminated food or water, not climate change, mineral water differences or tiredness as popular belief holds. Bacteria are responsible for the majority of cases, with viruses and parasites accounting for most of the remainder.

A review published in Current Opinion in Infectious Diseases in 2010 documented that the large majority of traveller's diarrhoea cases are preventable with straightforward precautions: eating only thoroughly cooked hot food, avoiding street food of uncertain preparation time, choosing sealed bottled water or water that has been boiled, and avoiding ice cubes made from tap water. The phrase used in travel medicine is: cook it, boil it, peel it or leave it.

If diarrhoea strikes during the trip, the primary treatment is oral rehydration to replace lost fluids and salts. Oral rehydration solution sachets are ideal when available. A 2017 analysis in Travel Medicine and Infectious Disease cautioned against routine antibiotic self-treatment for typical traveller's diarrhoea because it accelerates antibiotic resistance and may not shorten illness in mild cases. Antibiotics are warranted when diarrhoea is severe, bloody or accompanied by high fever, or when symptoms persist more than 48 hours.

Food and water safety rules when travelling

1Cook it, boil it, peel it or leave it: this single rule covers the essentials
2Avoid cold street food or anything that has sat out at room temperature for an uncertain time
3Drink sealed bottled water or water that has been boiled and cooled
4Decline ice cubes in drinks unless you are confident they are made from clean water
5Wash hands with soap before eating and after using any bathroom facility outside your hotel
6Pack ORS sachets in your hand luggage to use immediately if diarrhoea begins

Carrying medicines across borders: how to avoid problems

This is an area where Arab travellers are frequently caught off guard, because regulations differ sharply between countries. A medicine available over the counter in your home country may be controlled or prohibited at your destination. Prescription pain relievers, psychotropic medications and sedatives that a person carries legally under a valid prescription may be classified as controlled substances subject to strict limits or outright prohibition in another country.

Tramadol, for example, is classified differently across jurisdictions. Patients carrying it for a legitimate chronic pain condition have encountered serious problems at airports and borders. Several Gulf countries and a number of Asian countries apply very strict rules around opioids and strong pain medicines that can result in confiscation, detention or worse for an unsuspecting traveller.

For protection, always carry the original prescription with a doctor's official stamp, a covering letter in English explaining your medical condition and treatment, and if possible a translation into the language of your destination country. Check the import requirements for your medication at the destination country's embassy or official health ministry website in advance. Keep all medicines in their original packaging with the pharmacy label intact, and if the trip is long enough, consider registering with your destination country's health ministry if they offer a pre-clearance system for controlled substances.

Malaria: when you need prevention and what it involves

Malaria is not a risk at every destination, but it remains a genuine and serious threat in specific areas of sub-Saharan Africa, parts of Southeast Asia, Latin America and South Sudan. A traveller from the Gulf or the Arab world visiting these regions typically has no prior immunity to the disease, which can make the clinical course more severe than in populations with lifetime exposure.

Prevention rests on three pillars: antimalarial medication prescribed and supervised by a doctor before, during and after travel; personal protection with insect repellent applied to exposed skin particularly in the evenings and at night when the Anopheles mosquito is most active; and sleeping under an insecticide-treated bed net when staying in rural or high-risk settings.

Common antimalarial drugs include chloroquine in regions where resistance is low, and atovaquone-proguanil or doxycycline in other regions. The choice depends on the destination, your medical history and any other medications you take. Do not select or start antimalarial medication without guidance from a travel medicine specialist, because each drug has its own side-effect profile, contraindications and timing requirements that differ substantially from one to another.

Your travel first-aid kit: the essentials

A small travel first-aid kit in your bag resolves most minor medical situations without the stress of finding a pharmacy in an unfamiliar country, possibly without a shared language. The kit does not need to be large: a compact selection of targeted essentials handles the vast majority of common problems.

The core items are: a simple pain reliever such as paracetamol; an antidiarrhoeal such as loperamide; oral rehydration sachets; an antibiotic for gastrointestinal infection if your doctor has prescribed one in advance; small sterile wound dressings and an antiseptic; DEET-based insect repellent if your destination warrants it; sunscreen of at least SPF 30; and a thermometer.

If you take regular medicines for a chronic condition such as hypertension, diabetes or thyroid disease, carry enough supply for the full duration of the trip plus several days of reserve. A delayed flight or lost luggage should not coincide with running out of a medication that cannot be stopped abruptly. Separately, carry a written list of all your medications with doses, diagnoses and your doctor's contact details in English for any emergency encounter with a foreign health system.

Travel first-aid kit: the essentials

Item	Purpose	Note
Paracetamol	Fever and pain relief	Safe for most people and few drug interactions
Loperamide (Imodium)	Reduce acute diarrhoea	Do not use with bloody diarrhoea or high fever
ORS sachets	Oral rehydration	Add to water and drink after each loose stool
Sterile dressings and antiseptic	Wounds and cuts	Add a mild skin antiseptic such as povidone-iodine
DEET insect repellent	Mosquito and insect protection	20 to 30 percent concentration is effective and safe for adults
Medication list in English	Emergency medical care abroad	Include dose, diagnosis and prescribing doctor

Travelling with a chronic condition

Travelling with a chronic condition such as diabetes, heart disease, kidney disease or epilepsy requires planning beyond simply packing the medication. Before departure, consult your doctor to confirm your condition is stable and that you are a suitable candidate for travel, and to obtain a medical summary letter in English describing your diagnoses and treatments.

Travellers with diabetes face a particular challenge with insulin storage. Insulin degrades at high temperatures, and the interior of a parked car in summer sun in a warm country is sufficient to ruin a supply in hours. Carry insulin in a cool case throughout the journey and store it in air conditioning at the destination, not in a checked bag where aircraft hold temperatures can swing unpredictably in both directions.

Those taking anticoagulants such as warfarin should carry a medical alert card and their most recent INR result. Long-haul flights over six hours carry an elevated venous clot risk, particularly for people with additional risk factors. Discuss with your doctor whether prophylactic measures such as low-molecular-weight heparin are appropriate for the specific journey. Moving regularly during the flight and staying well hydrated are the minimum baseline for everyone.

Sun, heat and insects: practical protection

Sunscreen and insect repellent are not optional extras in tropical and subtropical destinations. Apply a sunscreen of at least SPF 30 to exposed skin twenty minutes before going outside and reapply every two hours or after swimming and sweating. Darker skin tones are not immune to sunburn at tropical latitudes, and any skin cancer risk accumulates with unprotected UV exposure regardless of baseline skin colour.

DEET-based repellents at 20 to 30 percent concentration are effective and safe for adults, providing protection for several hours. Picaridin is an alternative with similar efficacy and a lighter scent. Neither DEET nor Picaridin should be applied to infants under two months of age. Consult a paediatrician before using repellents on young children.

Heat exhaustion is common when visiting humid tropical climates, particularly when arriving after a journey from a cooler environment. The early signs are heavy sweating, dizziness and nausea. Move immediately to a cool indoor space and drink cold fluids slowly. True heat stroke, characterised by very high body temperature, cessation of sweating, confusion or loss of consciousness, is a medical emergency requiring immediate cooling and calling emergency services.

After you return: when to see a doctor

Some travel-related illnesses do not appear immediately but have incubation periods that extend well beyond the return date. Malaria can present two weeks to a month after exposure. Typhoid typically appears one to three weeks after ingestion. For this reason, if you develop fever or unexplained symptoms within a month of returning from a region with elevated disease risk, tell your doctor the full travel history. This single detail redirects the diagnostic workup completely.

Intestinal parasites such as Giardia and Entamoeba can cause chronic low-grade symptoms beginning weeks after return and are diagnosed by stool examination. If digestive disturbance persists for more than two weeks after returning from a developing country destination, medical evaluation is warranted and a stool analysis should be part of it.

Always proactively mention your travel history at any medical consultation in the weeks after a trip. Many tropical illnesses are treated effectively and completely when caught early, and lead to serious complications when diagnosis is delayed because no one asked about recent travel. The information costs nothing to give and can make an enormous difference to the clinical outcome.

Use Sihtak to log any symptoms that appear during or after travel, with dates and your destination, making it straightforward for any doctor you consult to piece together the timeline and exposure history.

Frequently asked questions

Do Gulf residents travelling to Europe need any extra vaccines?

Generally no, provided routine vaccinations such as tetanus and measles are up to date. Europe is a very low epidemiological risk destination and imposes no entry vaccination requirements. If the itinerary passes through higher-risk regions before Europe, the picture changes and specific vaccines may be needed for those transit stages.

Is it safe to travel by air during pregnancy?

Air travel is generally safe until about week 36 of an uncomplicated pregnancy. The safest period is the second trimester between weeks 18 and 24. Avoid travel to destinations with malaria, Zika or other vector-borne diseases during any stage of pregnancy. Consult your obstetrician before any long-haul travel or travel to higher-risk destinations.

Does handwashing prevent traveller's diarrhoea on its own?

Handwashing with soap is essential and reduces risk substantially, but it is not sufficient on its own. The larger risk comes from contaminated food and water consumed before you wash your hands. Combining careful hand hygiene with attention to food and drink sources gives the best combined protection.

Is bottled mineral water always safe when travelling?

Commercially sealed bottled water is safe when the seal is intact and unbroken before you open it. Open it yourself in front of the vendor whenever possible. In some regions, bottles are refilled with local water and resealed, a documented practice in a limited number of markets. When in genuine doubt, boiled and cooled water remains the most reliable option.

Are antimalarial medications safe for long trips?

Approved antimalarials such as atovaquone-proguanil and doxycycline are safe for months when used correctly under medical supervision. Doxycycline increases skin sensitivity to sunlight and requires consistent sun protection. Consult a travel medicine specialist to choose the right drug for your specific destination, trip duration and personal medical history.

Is travel health insurance worth buying?

Yes, and it is one of the most valuable preparations you can make before travelling abroad. The cost of emergency medical treatment in countries such as the United States or across much of Europe without insurance coverage can be very high. Ensure the policy includes medical evacuation cover, which pays for repatriation to your home country for treatment if needed.

Can I bring insulin pens in my hand luggage on a flight?

Yes. International aviation rules permit insulin, injection pens, needles and related diabetes supplies in cabin baggage. Keeping insulin in hand luggage is preferable to checking it in the hold, where temperatures in the cargo compartment can be unpredictably very cold or very warm depending on the route and aircraft type, both of which can damage insulin.

Sources

This content is for health education only and is not a substitute for medical advice. If you have symptoms that worry you, see your doctor.