Everyone needs and enjoys a break away from everyday routine and there is nothing nicer than planning a family holiday together. There are some factors to consider before and during your holiday to ensure your child stays well and has the best time possible.

Is it ok to go abroad?

Yes, your child can go on holiday abroad. We would not recommend this during the first year after transplant until your child has fully recovered from their transplant and is very stable.

It is always wise to discuss your plans with your transplant team before making any bookings. This will ensure that an appropriate destination is selected and give an opportunity for any additional factors to be discussed.

Many families enjoy holidaying in their home country during the first year after transplant before venturing farther afield later on.

Will my child need a check-up first?

It is always wise to have a recent check-up and monitoring blood tests carried out before going on holiday, particularly if going abroad. This will help identify any problems which are developing and ensure that blood test results are all satisfactory.

Please discuss arrangements at least eight weeks in advance of travel with your transplant team on the numbers at the end of the leaflet.

What about holiday insurance?

Holiday insurance is very important and may prevent a costly bill if your child is unwell on holiday. Insurance should cover emergency treatment and transfer back to the UK if necessary. Ensuring the information, you share about your child is accurate is also important to avoid invalidating the policy.

Not all policies will cover activities such as winter sports so be sure to check that your policy will cover any activities your child will be participating in.

The cost of insurance can vary greatly between different companies year on year. Contacting various companies for the best deal can also be very time consuming and frustrating. A good source of information is from fellow transplant families who have also been seeking holiday insurance and have already done their research.

Contacting patient organisations such as the Freeman Heart and Lung Transplant association (FHLTA) can be a rich source of information and support. They also have static caravan accommodation available which transplant patients, and their family and friends are given priority to when booking. For further information see the website address below or they are available to contact via Facebook and X (formerly known as twitter).

As well as insurance it is also advisable to apply online for a UK Global Health Insurance Card (GHIC) which gives access to medically necessary state healthcare on the same basis as residents in some areas such as the European Economic Area. This has replaced the previous European Health Insurance Card (EHIC).

The EHIC can still be used until it reaches its expiry date but then you must apply for a GHIC. Children need their own GHIC card which will take around 14 days to arrive after the application has been received.

Please note

This does not replace travel insurance or cover situations such as mountain rescue, private treatment or being flown back home. There may also be a small charge for necessary care in some areas.

Will my child need holiday vaccines?

Depending upon where you plan to travel to, additional vaccines may be needed. Ensure your child’s routine UK vaccinations are up to date.

Don’t forget live vaccines are not allowed after transplant. If unsure which vaccines your child has had, contact your GP’s practice, they will be able to check for you and arrange for any missing vaccines to be given.

Always allow at least eight weeks to find out which vaccines are needed, to plan appointments and allow time between doses if necessary. Not all vaccines are free on the NHS even if they’re recommended when visiting some areas. Other than your GP’s surgery, travel vaccines are available in private travel vaccination clinics and pharmacies that offer travel services.

Some countries also need written proof of certain vaccinations on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country. It may be possible to obtain a vaccine waiver, but it is at the discretion of the destination country whether they will accept it. ICVP’s are usually available via travel vaccination clinics or pharmacies offering travel services.

Malaria can also be a problem in some countries in which case preventative anti malaria medication may be needed as well as advice about how to avoid mosquito bites and products which deter them.

Useful advice covering a range of travel related topics including vaccinations can be found in the resources section at the end of this leaflet.

What about taking medicines and medical equipment on holiday?

It is always wise to order prescriptions well ahead of your travel date and to take extra medication with you in case of delays or unexpected circumstances.

Always carry your child’s medications and essential medical equipment in your hand luggage to avoid potential problems if your luggage goes astray. Split the medication between bags so if one bag goes missing, you still have medicine in the other.

If you have items that need to be kept cool during transit, these can be transported in a cooler bag with an ice block or discuss potential arrangements with your pharmacist or transplant specialist nurse. Aircraft don’t normally have suitable refrigerated areas to store medications which need to be kept cool.

Liquid medicines can be an issue especially when flying and there are volume restrictions. This can normally be successfully addressed by obtaining an explanatory letter from your transplant team and making your travel company aware.

Keeping the medications in the original packaging with the information leaflet will also avoid any issues arising from unidentified medicines in a medication dispensing box. Additional equipment such as needles and syringes can normally be carried if you have an explanatory letter from a healthcare professional.

If your child has additional equipment such as oxygen, feeding pumps, nebulisers etc, please discuss arrangements with your transplant team and your travel company as in some circumstances additional tests or arrangements may need to be made well in advance of travel.

What about different time zones and medication times?

If you are planning on traveling across different time zones this can create a significant time difference which will have an impact upon medication timing. The easiest way of dealing with this situation is by devising a plan for staggering dosing times, particularly of immunosuppressant medicines on the outward and return journeys accounting for the time difference. This will allow medicines to be given at your child’s usual time during the holiday and keep disruption to a minimum. Please discuss this with your transplant specialist nurses and provide details of your itinerary. They will be able to help.

Is there any extra paperwork to take with us?

It is usually a good idea to take a copy of your child’s latest clinic letter and prescription with you. If going abroad, obtain a letter from your transplant specialist nurses confirming that your child is fit to go on holiday and detailing which medications and equipment you will be carrying with you.

This normally avoids any major issues when travelling. If you are travelling to an area that needs proof of exemption from certain vaccinations, you will need to provide the relevant certification.

Are there any dietary restrictions whilst on holiday?

Illnesses caused by food or water are commoner in countries that have lower levels of hygiene. It is important to take general hygiene precautions to help prevent your child becoming unwell after eating or drinking contaminated food or drink.

You can help by

Encouraging regular handwashing with soap and water especially before eating, after using the toilet, after touching animals and after activities. Alcohol based hand sanitiser can be used if not able to wash with soap and water although this is less effective against certain germs.
Use canned or bottled water for drinking or teeth cleaning but ensure the seal is intact.
Avoid ice cubes which may have been made from contaminated water.
Choose foods which are cooked fresh and are piping hot. Avoid pre prepared foods from buffets which may not be kept adequately hot / cold and may be contaminated by other diners.
Don’t eat meat that is still red or pink.
Avoid raw shellfish.
Avoid dishes that may contain raw or inadequately cooked eggs such as mayonnaise.
Peel raw fruit and vegetables before eating them.
Avoid salads and products which may have been washed in contaminated water
Choose pasteurised products such as milk or fruit juices from sealed containers
Avoid “Mr Whippy” type ice-cream

What about skin protection?

If you are planning on holidaying somewhere hot and sunny, protecting your child’s skin is important to avoid sunburn and to minimise the increased risk of developing skin cancers in the future.

Seek shade during the hottest part of the day and cover up with a sunhat and clothing to minimise sun exposure. High factor sun cream, factor 50 ideally, should be applied regularly especially after swimming or towelling.

Are there any activities my child shouldn’t do on holiday?

Your child should be able to take part in most activities with careful planning. Taking measures to avoid excessive sun exposure and insect bites is important. Contact with animals is also to be avoided to prevent injury and potential infections such as rabies.

If the water has been inadequately treated when using swimming pools, hot tubs and waterparks, then skin, ear and eye infections are more common.

Avoid Turkish baths and areas with stagnant water to reduce the risk of infection. Sexually active young people should also take safe sex precautions.

If there are any specific activities that your child would like to participate in and you would like further advice, don’t hesitate to contact the transplant specialist nurses.

What if my child is unwell whilst on holiday?

If your child is unwell whilst on holiday, it may be necessary to seek medical advice locally either at a pharmacy, doctors or local hospital depending upon the situation.

Your transplant team are always available on the numbers at the end of this leaflet, to discuss the best course of action and would like to be kept informed. If you have booked a package holiday, contact your travel representative to locate the nearest service.

Remember that some services may need payment up front, keep any receipts and speak with your travel insurance company as soon as possible.

It is always wise to take a first aid kit with you of items which may be required including paracetamol, antihistamines, insect bite cream and rehydration sachets such as Dioralyte or similar. Children can quickly become dehydrated if they develop diarrhoea so prompt action may be required.

Your transplant team will advise if you should take any additional medications such as antibiotics with you in some situations.

If you would like to speak to someone further, please don’t hesitate to talk to a member of staff at your next clinic appointment, or, you can call the children’s transplant nurse specialists on the numbers at the end of this leaflet.

Resources

The following websites are useful sources of travel information including general travel advice, vaccine requirements and country specific advice:

Contact

For further information, contact the transplant nurse specialists.

Office hours: Monday to Friday, 9am to 5pm

[email protected]

Contact out-of-hours

Outside of these times please ring ward 23 if you have an urgent query affecting your child’s transplant health.

0191 213 7023

Further information

PALS (Patient Advice and Liaison Service) for help, advice, and information about NHS services. You can contact them on Freephone 0800 032 02 02, email [email protected]