The summer season is associated with an increased risk of heat-related illnesses, insect-borne infections, injuries, and health risks related to water activities. The Institute of Public Health of the Republic of North Macedonia recommends careful preparation and adherence to the following measures to protect your health while travelling.

Before You Travel

Find out about the current health situation, communicable diseases, and potential health risks in the country or region you plan to visit.

At least one month before departure, check whether vaccination or preventive medication is recommended (for example, yellow fever vaccination or malaria chemoprophylaxis).

Ensure that you and your family members, especially children, are up to date with all routine vaccinations.

If you require additional advice, consult your family physician or your local Centre for Public Health.

Prepare a travel health kit containing:

·         all regular prescription medicines;

·         a basic first-aid kit;

·         medicines for fever and pain relief;

·         medicines for gastrointestinal problems;

·         alcohol-based hand sanitiser;

·         insect repellent;

·         sunscreen with SPF 30 or higher;

·         relevant medical documentation and travel health insurance documents, if available.

Four Rules for Protection Against Insects

1. Use Insect Repellents

Apply insect repellents, particularly if travelling to areas where mosquito-borne diseases are present.

Repellents containing DEET (30–50%) or icaridin (also known as picaridin) are recommended.

Apply repellent to exposed skin, avoiding contact with the eyes, nose, and mouth. Repellents may be used both indoors and outdoors at any time of day, strictly according to the manufacturer's instructions.

Remember:

•   Reapply repellent as directed, especially after bathing, swimming, or heavy sweating.

•   If using both sunscreen and insect repellent, apply sunscreen first, followed by the repellent.

•   Pregnant women, breastfeeding women, and children should use only products specifically approved for these groups and always follow the manufacturer's instructions.

•   When travelling to tropical or subtropical destinations, bring enough repellent for the entire duration of your trip.

2. Wear Appropriate Clothing

Wear light-coloured, lightweight clothing made from natural fabrics such as cotton or linen. Whenever possible, choose long-sleeved shirts, long trousers, closed shoes, and socks.

The risk of mosquito bites may be present throughout the day.

Mosquitoes that transmit dengue, chikungunya, and Zika virus are most active during the daytime, particularly in the early morning and late afternoon, while mosquitoes that transmit malaria are most active between dusk and dawn.

3. Stay in Protected Accommodation

Whenever possible, stay in air-conditioned accommodation or in rooms fitted with insect screens on doors and windows.

If sleeping outdoors or in accommodation without adequate protection, use a mosquito net, preferably one treated with insecticide.

4. Seek Medical Care if Symptoms Develop

If you develop a fever (38°C or higher), rash, severe headache, vomiting, or any other symptoms of illness during your trip, seek medical attention immediately.

Malaria and other tropical diseases can progress rapidly and require prompt diagnosis and treatment.

Water Safety

If you plan to swim, dive, or participate in boating or other water activities, follow these recommendations:

·         Swim only at designated bathing areas where water quality is regularly monitored in accordance with public health standards.

·         Avoid swimming in water that appears polluted or has an unusual colour, unpleasant odour, visible waste, or excessive algal growth.

·         Avoid swallowing water while swimming, and ensure that young children do not ingest water.

·         Shower with clean water after swimming and wash your hands before eating.

·         If you have open wounds or skin injuries, avoid swimming in natural bodies of water.

·         Follow all safety warnings and instructions issued by lifeguards and local authorities.

·         Never allow children to remain near water without constant adult supervision.

·         Always wear a life jacket when boating.

·         Avoid swimming in rivers, lakes, or other freshwater bodies in countries where diseases such as schistosomiasis or leptospirosis occur.

Safe water recreation depends not only on preventing drowning and injuries but also on the quality of the water. Using safe, monitored bathing sites significantly reduces the risk of skin, eye, ear, and gastrointestinal infections.

After Returning from Travel

If you develop a fever or other symptoms of an infectious disease within three weeks of returning home, inform your healthcare provider where and when you travelled.

Please note that voluntary blood donation may be temporarily deferred after returning from certain countries.

General Recommendations for Hot Weather

1.       Avoid direct sun exposure and outdoor activities between 11:00 a.m. and 5:00 p.m.

2.       Wear lightweight, light-coloured clothing. When outdoors in direct sunlight, wear sunglasses and a light-coloured, wide-brimmed hat with a high crown.

3.       Stay indoors in air-conditioned environments whenever possible.

4.       If you must be outdoors during the hottest part of the day, take frequent breaks in the shade and avoid prolonged exposure to direct sunlight.

5.       Keep windows and blinds closed during the day and open them at night when temperatures are lower.

6.       Eat moderate amounts of food. Avoid fatty, high-calorie foods and foods high in sugar.

7.       Drink sufficient fluids throughout the day without waiting until you feel thirsty. Water is the best choice. Mineral water and other non-alcoholic beverages may also be consumed. Avoid alcoholic drinks, beverages containing caffeine, and very cold drinks.

8.       If you are in a parked vehicle, open the windows to improve ventilation. Fully enclosed vehicles can become dangerously hot. Never leave anyone inside a parked vehicle.

9.       Take cool or lukewarm showers as needed. Cold compresses or soaking your feet in cool water may also help reduce body temperature.

10.    People with chronic medical conditions, especially cardiovascular, neurological, and respiratory diseases, should follow these recommendations particularly carefully and continue taking their prescribed medication. Any changes in health status should be discussed promptly with their healthcare provider.