Travel doctor

I am planning to take a six-year-old and a one-year-old to Costa Rica at the end of December for a month or so. What precautions should we take?
  
  


I am planning to take a six-year-old and a one-year-old to Costa Rica at the end of December for a month or so. What precautions should we take?

Dr Jules Eden replies: Of all the Central American countries, Costa Rica is probably one of the safest to take kids to. It has a good health system and an enviable standard of living compared with others around it. The base shots to have are Hepatitis A and typhoid. Antimalarials are needed, too, and over-the-counter chloroquine and paludrine are recommended. For the latest advice, go to e-med.co.uk and access the information via the Travel Clinic pages.

Depending on where you are going, there may be no need for malaria precautions. Costa Rica has some of the best high montane rainforest. At these altitudes, mosquitoes find it a tad cold, so there's no need for daily tablets.

The only other tip from my experience is that beaches on the west coast seem to support the thorniest of bushes, branches of which lie like some medieval trap under the sand. So buy the children some rubber-soled surf bootees for running around in.

When flying, I occasionally suffer from throbbing localised pain in my forehead as the plane starts its descent. It is usually only on one side of my forehead, although sometimes I have had it on both sides. Is this a sinus problem, or something more serious?

No need to worry, this is nothing more serious than a 'sinal squeeze'. You have three sets of sinuses, and the biggest are in the forehead. These are called the frontal sinuses. When a plane descends, despite the fact that the cabin is 'pressurised' there is an increase in relative pressure. So the air in the sinuses needs to be equalised by blowing more in up the nose. If you can't do this for whatever reason, then a small vacuum forms and begins to cause the sinal lining to swell; hence the pain. If you are suffering this on a regular basis, then it would be worth using a nasal decongestant, such as a Sudafed tablet, or a spray such as Otrivine, about two hours before you land. If this fails, then a trip to an ear, nose and throat surgeon may be needed.

If you have any questions you want to ask Dr Jules Eden, email travel.doctor@theguardian.com, or write to The Flying Doctor, The Guardian, 119 Farringdon Road, London EC1R 3ER

 

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