What Happens When Kids Fall Sick On A Holiday?

Fashion-lifestyle entrepreneur Andrea Chong, 32, had mapped out an eight-day itinerary for her family’s Perth holiday in August. There was much to explore in the Western Australia capital with her lawyer-husband Imran Rahim, 36, and their two sons. What she did not expect was that both Elia Adam Imran, two, and Ezra Isa Imran, three, would fall sick during the trip.

It started with Elia developing a fever on the second day of their trip. For the next five days, his temperature went up and down, spiking to 39 deg C. He had no other symptoms.

“He was uncomfortable, obviously. He couldn’t really communicate with us as he was only two years old, so he cried a fair bit,” says Ms Chong, who runs online boutique Good Addition.

Thankfully, she had packed travel medication and had ibuprofen to relieve his high fever, but she also went to a pharmacy to get more.

The family managed to do some sightseeing, working around Elia’s nap times.

“He perked up whenever he saw something interesting,” she says. “But we were mindful about when we should return to our accommodation so he could rest properly.”

Ms Chong also made good use of their Airbnb apartments’ kitchens to cook familiar, comfort soup to whet his appetite.

Unfortunately, on the sixth day, their firstborn Ezra ran a fever too, so the couple decided to catch a flight home one day earlier.

The fever episodes did not end there. Ms Chong became the third person to be down with it when they landed in Singapore.

Their family doctor ruled out influenza and Covid-19, and told her it was a viral fever.

No doubt the illness dampened the holiday mood, but Ms Chong took it all in her stride.

She says: “You can plan the best vacation for your kids, but they are the ones who dictate the itinerary, especially if they are unwell. You just have to be very flexible.”

Ms Chong’s recent travel experience is not uncommon as kids – and adults alike – can fall sick while on a holiday.

Depending on the holiday destinations, the travel-related illnesses can vary.

For example, gastrointestinal infections due to poor food hygiene, which cause vomiting and diarrhoea, are more common when holidaying in South-east Asian or South Asian countries, says Dr Natalie Epton. The specialist paediatrician and neonatologist is from SBCC Baby and Child Clinic at Mount Elizabeth Novena Specialist Centre.

Viral respiratory infections, leading to cough and nasal congestion, are usual during winter holidays.

The chances of getting such infections are also increased when one goes on a long-haul flight. This is due to breathing in the cabin’s “recycled air” for a prolonged period, allowing respiratory viruses to spread easily, she says.

Dr Darryl Lim, a consultant paediatrician from Kinder Clinic at Mount Alvernia Medical Centre, points out that hand, foot and mouth disease can be transmitted from contaminated contact surfaces that children play on.

Teach your kids to maintain good hygiene practices, such as handwashing, wherever they go. As soap and water may not be located conveniently, it is useful to carry along a small bottle of hand sanitiser, he suggests.

“But do not just think about your children,” says Dr Epton. If you fall ill, it can just as easily ruin the vacation for everyone.

She encourages parents not to fill the travel itinerary with too many activities and factor in plenty of downtime.

Make sure your kids’ bedtime stays reasonably similar to what they are used to at home, and stick to their nap hours and mealtime routines as closely as possible.

“Too many activities and too many late nights will make your children overtired and cranky, leading to unmanageable behaviour and a miserable holiday for everyone.”

The Straits Times asks paediatricians for more ways to keep your family healthy on a trip, and how to cope when kids fall sick on a holiday.

What travel vaccines do my family need?

First, ensure that your kids’ immunisation schedules are up to date and catch up on the missing childhood vaccinations before travel, Dr Lim says.

If you are going to a cold country, consider getting an influenza vaccination. Kids under nine years old require two doses of the influenza vaccine a month apart if they have not received it before, Dr Lim adds. Ensure that they complete the second dose at least two weeks before travelling.

Separately, you may want to take vaccinations for hepatitis A and typhoid if travelling to a South-east Asian or South Asian country, Dr Epton says. A course of two doses of hepatitis A vaccination will give lifelong protection and a typhoid vaccine needs to be renewed every three years.

Dr Lim adds that some jabs are more country-specific, such as yellow fever vaccination for sub-Saharan Africa or South America.

Discuss your travel plans with your doctor a few months ahead to allow time for vaccinations and reduce the risk of a family member falling ill. Your doctor can also advise you on medications to take along.

What should be in our travel health kit?

Besides prescribed medications that a family member takes regularly, pack remedies for fever, such as paracetamol and ibuprofen, and antihistamine, such as Zyrtec and Clarityne for runny nose or an itchy rash.

To relieve an upset stomach, get medications such as Smecta and Lacteol Fort, Dr Lim says.

If you are going on a beach holiday, take along aloe vera gel for sunburns and a small bottle of vinegar for jellyfish stings. Also, buy some eye lubricants, preferably those that come in small vials and are preservative-free, in case sand gets into your peepers.

For winter travel when air is dry, a saline nasal spray, such as Sterimar, would help moisten the nasal passages. Decongestants, such as Iliadin and Otrivin, will help reduce nasal congestion and relieve nose bleeds.

Children with previous wheezing episodes should have their inhalers with a space chamber. Take along a new one, so it does not run out while you are away, as most do not have a dose counter.

If you are packing a nebuliser, check that the machine can handle the voltage of the country you are visiting.

Other useful items include a thermometer, a tweezer for splinters and simple dressings such as gauze and plasters to manage wounds.

Pack face masks for each family member too. Wear them if you are in an enclosed crowded space or if a family member falls ill.

What else should I prepare before the trip?

For syrup medications, take along unopened bottles that will not spill in the baggage and need not be refrigerated in transit, Dr Lim says.

Especially when two or more children are sharing the same medication, make sure you know the correct dosage for each kid. Prepare a list and print or save it in your mobile phone. That way, you will be less stressed as you need not scramble for the information when your child falls ill.

If your kids have food allergies, show the restaurant staff a printed allergy card with photos, in case there is a language barrier, as a picture is worth a thousand words.

How do I manage my sick children while on holiday in a foreign land?

If your kids are sick while on a holiday, manage the symptoms as you would at home with the medications you have packed, says Dr Epton.

Keep your children well rested and hydrated. Apple juice is as effective as hydration salts for replenishing fluid and electrolytes, and your little ones are more likely to accept it.

Although it may be tempting to continue with your travel itinerary, it is not advisable to take a sick child around to sightsee or ski, she adds. They are likely to become more ill and are at greater risk of sustaining injury or contracting a secondary infection due to their weakened state.

Before travelling, Dr Lim suggests locating the nearest hospital or clinic to your hotel or accommodation.

If you require help or clarification for common conditions such as fever, cough, diarrhoea and vomiting, go to KK Women’s and Children’s Hospital’s online resource Urgent Paediatric Advice Line (www.kkh.com.sg/UPAL). The free service is available 24 hours daily, but local data charges may apply.

How can I prevent motion sickness in my kids?

Parents often give their children mobile phones and tablets to occupy them during long journeys. This results in the young ones looking down, which can cause or worsen motion sickness, Dr Epton says.

Encourage your kids to look out of the window instead. Try playing games such as I Spy or counting cars of a certain colour. These help keep them engaged too.

If you are travelling in an older car, there may be a slightly stale smell which can cause your kids to feel nauseous. Combat the smell with lavender essential oil or others with a light floral or citrus scent.

It helps to keep your children cool in light, loose-fitting clothing. Tilt the air-conditioning vent towards them or wind down the windows slightly.

Dr Lim also recommends avoiding a large meal right before or during the car trip.

For kids who are prone to motion sickness, consider giving them over-the-counter medication, such as dimenhydrinate, at least one hour before the journey. The medication may cause drowsiness in some children. But that is not a bad thing as it can help them sleep through the ride.

Remember to keep some plastic bags close to you and not deep in your backpack.

If your children are feeling ill, Dr Epton says you can let them suck on sweets or offer sips of apple juice.

Motion sickness on boat outings is also common. Choose a seat near an open window or on an open-air deck, she adds.

On a beach holiday, what are some health and safety precautions that families often overlook?

Never leave your child unattended near water, whether it is the sea or a swimming pool, says Dr Epton.

She points out that drowning is the third leading cause of accidental death worldwide, with most incidents occurring in kids aged one to four years old. It can take as little as two minutes for a child to drown, even in shallow water.

Many countries in Europe and North America have legislation ensuring that private pools in villas are appropriately fenced. Sadly, this is not the case in South-east Asia and South Asia, she says.

If you are renting a villa in Indonesia or Thailand, be aware that your children will have easy access to the pool and therefore need to be supervised at all times.

Watch your children around hotel pools and near the sea. If you have to step away, entrust someone to watch the kids. If this is not possible, take them away from the water with you. Always think safety first, she reminds.

It is also important to slather on sunscreen with SPF50 and repeat doing this frequently if you are spending time outdoors when the UV index is moderate or high, or after swimming.

Apply insect repellent if there are mosquitoes or sandflies. If you are using a stroller, buy a mosquito net that also incorporates SPF. They are usually free-size, fitting most strollers, and can be easily bought from baby product retailers.

My kids will have close contact with the animals during a farm stay. What should I take note of?

Countries such as Australia and New Zealand, as well as many in Europe, have strict laws governing animal safety and welfare, so a farm stay there should be relatively safe. The animals are usually screened for communicable diseases, and appropriate safety features are put in place to prevent accidental injury.

Countries in Asia have less regulation of animal welfare and farming, so supervise your child at all times. If the animals appear to be unhealthy or not well cared for, make the decision to leave.

Rabies is extremely rare in Europe, Australia and New Zealand, but still relatively common in Asia.

If your child is scratched or bitten by an animal, allow the wound to bleed freely to remove any infection before cleaning with iodine, which is known to be effective against rabies.

Seek immediate medical attention if the animal is suspected to have rabies, as your child may require the rabies vaccine and immunoglobulin.

If this is not available where you are travelling, quickly return to Singapore to get treatment within 72 hours of blood exposure to a rabid animal.

This article was originally published on The Straits Times.