Most people with sickle cell or thalassaemia are able to travel abroad providing they take appropriate precautions. This leaflet provides advice on the important steps to take to ensure you travel plans go smoothly.
Discuss your travel plans with your GP or hospital specialist as early as possible (at least six weeks before you travel) so they can confirm you are well enough to undertake the trip and advise on any necessary precautions.
When making your booking, make sure the travel agent, airline and insurance company are all aware of your diagnosis, medical condition and that you will need to travel with prescribed medication which may include antibiotics and strong painkillers such as opiates.
Please take time to find out about the medical facilities available in the country you are visiting and know where the nearest treatment centre or hospital is. Your hospital specialist will be able to assist with this and the Sickle Cell Society keeps an up-to-date list of overseas sickle cell organisations. Arrangements can often be made for patients who need planned treatment while abroad. This should be discussed and planned with your hospital specialist at least two to four weeks in advance.
If you have sickle cell disease and develop a severe crisis within two weeks of a planned visit abroad, you should not travel.
If you are unwell the day before or on the day you are due to travel, consult your GP or hospital specialist who will advise you whether it is safe for you to travel.
What to carry with you
1. A copy of a recent outpatient clinic letter or medical report from your consultant or other member of the hospital team stating your diagnosis and treatment. This should include your usual haemoglobin level and medications, any drugs you are allergic to and who to contact for advice in an emergency. If you are taking controlled drugs, for example morphine, make sure this is noted in the letter.
2. For insurance purposes you may need a letter to confirm that you are medically fit to travel and, possibly, a recent blood test result
3. Medication - your antibiotics and other medicines including any painkillers you might need to last the whole trip. It is best to arrange this at least two weeks before travel. Take a copy of any prescription with you. For air travel all medicines should be packed in your hand luggage
4. Mosquito net and insect repellent if travelling to an area where there is malaria
5. Oral rehydration salts if you have sickle cell disease (see below)
Protect yourself against infection
Vaccination
Make sure you are up-to-date with routine immunisations and the hepatitis B vaccine.
Check any necessary travel vaccines and arrange these through your GP practice or a travel clinic at least six weeks in advance. If you are visiting an area that requires yellow fever vaccination and are currently taking the drug hydroxycarbamide please discuss this with your hospital specialist as it may not be recommended.
If you have thalassaemia and have had your spleen removed or if you have any type of sickle cell disease, check you have received the following vaccines:
• pneumovax (given every 5 years)
• haemophilus Influenzae type B
• meningococcal C
• meningococcal ACWY conjugate
• hepatitis B
• influenza (given by your GP in the autumn or winter months every year)
Carry a card with your vaccine record. This can be provided by your GP practice.
It is vitally important to take effective precautions if you travel to or stop over in a country where malaria occurs. Your GP or hospital specialist can advise on the choice of antimalarial medication.
Sickle cell does not protect you from malaria. You should take the relevant anti-malarial tablets prescribed to the country/area in which you are visiting.
Diarrhoea
Diarrhoea is common among travellers abroad. If you have sickle cell disease this can cause dehydration which can trigger a crisis. To avoid we recommend carrying a supply of oral rehydration salt sachets which you can buy from your local pharmacy. If you develop fever or notice blood in the stools (poo) you should seek immediate medical advice.
Other infections
If you are trekking or camping you may be at risk of a rare infection called babesiosis carried by ticks. To reduce the risk of this and other infections transmitted by ticks cover exposed skin e.g. wear long trousers.
Get treatment urgently for any bites (especially dog) as these can lead to serious infections. Any bites should be kept clean and seek medical advice if there are any signs of fever or infection. Ensure you use insect repellent containing DEET, wear protective clothing and use mosquito nets.
Air travel if you have sickle cell disease
When flying (especially for six hours or more) make sure that you:
• keep mobile, warm and well hydrated throughout the flight
• drink plenty of fluid, preferably water, avoid alcohol as consuming it could result in dehydration and cause a sickle cell crisis
• carry warm clothing or use a blanket to prevent chilling - the cabin temperature is often cold
• Wear flight socks to reduce the risk of thrombosis - these can be bought in most large pharmacy stores
Oxygen is recommended for some people during a long haul flight. This can depend on whether you have previously experienced complications during or after air travel. If you need oxygen you will have to give advance notice to the airline which will usually provide a form for completion by your hospital specialist to authorise this. Some airlines charge for providing oxygen. Contact your airline as soon as possible to make these arrangements.
Access to healthcare abroad and travel insurance
Guidance on access to healthcare abroad can be found at:
UK-issued European Health Insurance Cards (EHICs) are still valid and offer the same cover as GHICs in the EU. Once your EHIC has expired, you’ll be able to replace it with a GHIC. Most people can apply for a GHIC online, but some people need to apply by post. There are certain circumstances where you may be entitled to a GHIC or UK-issued EHIC despite living in an EU country, Norway, Iceland, Liechtenstein or Switzerland. You are not entitled to a GHIC if you're insured by an EU country, Norway, Iceland, Liechtenstein or Switzerland but live in the UK. You should contact the relevant authority in the country you're insured by and request an EHIC. Some people may be able to apply for a new UK-issued EHIC if they are covered by the Withdrawal Agreement. This gives you the same cover as a GHIC in EU countries.
It is strongly advised that you take out travel insurance that covers medical costs. The EHIC and GHIC do not cover all costs such as the cost of repatriation to the UK for treatment, any private treatment (not all hospitals or doctors provide state-funded care) or any non-emergency treatment. They do not cover you for travel to any country outside the EEA so make sure you have taken out adequate insurance if you travel outside the EAA. Read the policy details carefully to be sure you are covered for any eventuality e.g. last minute cancellation due to illness and repatriation to the UK by air ambulance. An up-to-date medical report may be needed so plan some weeks in advance if possible.
The Sickle Cell Society or UK Thalassaemia Society are able to offer advice on suitable travel insurance companies.
For further information please see the following links:
