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.
Before you travel
Discuss your travel plans with your GP or hospital specialist as soon as you can. Do this at least six weeks before you travel. They can:
• confirm you are well enough to take the trip
• advise you about precautions you need to take
When making your booking, make sure the travel agent, airline, and insurance company all know:
• about your diagnosis
• about your medical condition
• that you will need to travel with prescribed medication, which may include antibiotics and strong painkillers such as opiates.
Spend a little time finding out:
• about the medical facilities available in the country you are visiting
• where the nearest treatment centre or hospital is to where you are staying
Your hospital specialist will be able to help with this.
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.
Talk to your hospital specialist so you can make a plan. Ideally, do this four weeks before you travel, or at least two 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. This should give details of:
a. your diagnosis and treatment
b. your usual haemoglobin level
c. your medications. If you are taking controlled drugs, for example, morphine, make sure this is noted in the letter
d. any drugs you are allergic to
e. who to contact for advice in an emergency.
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. This includes 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 prescriptions 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 taking hydroxycarbamide, yellow fever vaccination may not be recommended. Please talk to your hospital specialist if you are going to an area where this is needed.
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. You can get this from 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 antimalarial tablets prescribed to the country or area 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 this, we recommend carrying a supply of oral rehydration salt sachets. You can buy these 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, which is carried by ticks. To reduce the risk of this and other infections transmitted by ticks, cover exposed skin, for example, wear long trousers. Remember:
• get treatment urgently for any bites (especially dog bites) as these can lead to serious infections.
• keep any bites clean
• seek medical advice if there are any signs of fever or infection
• ensure you use insect repellent containing DEET
• wear protective clothing
• 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 is often cold
• wear flight socks to reduce the risk of thrombosis – buy these in large pharmacies
Oxygen
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.
• Your hospital specialist will usually have to complete a form 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:
If you are travelling to a country within the European Economic Area (EEA) you are entitled to emergency healthcare at a reduced cost or free. To access this you need to obtain a European Health Insurance Card (EHIC) or a UK global health insurance card (GHIC) which is free of charge prior to travel. This can be requested in one of the following ways:
We advise you to take out travel insurance that covers medical costs.
The EHIC does 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.
The EHIC does 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, for example, 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 can offer advice on suitable travel insurance companies.
For further information please see the following links:
