With an ever-increasing choice of holiday destinations and activities, young people with CF are more keen than ever to make the most of every opportunity for a more adventurous life. However, we encourage anyone planning a holiday to discuss their travel plans with the CF team.
Optimising health before travelling
Some patients may require a course of IV antibiotics before they travel to optimise their health. The CF team need to know travel dates in advance so that a plan for admission can be made. However, admission priority will always be for patients who are unwell and need treatment. Every effort is made to accommodate pre-holiday treatment but admission dates have to be flexible. Additionally, patients may need to consider taking back-up oral antibiotics with them.
There may be circumstances where patients are advised not to travel such as recent haemoptysis, recent pneumothorax, gastrointestinal obstruction or acute chest infections. These will be discussed with the consultants at the time. Unfortunately, travel plans may need to be postponed or cancelled.
Fit-to-fly tests –
If patients have an FEV1 of <50% or oxygen saturations of <95% they are advised to have a fitness-to-fly test, which will identify if oxygen is required on a flight. Patients should have a repeat test before each trip as their oxygen requirements may change. Oxygen, nebulisers and compressors –
Each airline has its own policy on oxygen transport and in-flight usage. Patients should contact their airline before they book in order to find out the policy. The airline will need to know whether oxygen is required during the entire flight or intermittently. Some airlines will provide oxygen free of charge or for a small fee. The airline will request a MEDIF form, which will need to be completed by a doctor from the CF team stating the patient’s oxygen requirements and that they are fit to travel.
Some low-cost airlines do not supply oxygen but they will allow patients to take their own approved oxygen supply on board (commonly, portable oxygen concentrators). Portable oxygen concentrators are fairly new but are increasingly being allowed on flights. Portable oxygen concentrators are lightweight and can run on electricity or battery. They are available to purchase but bear in mind they remain an expensive piece of equipment. If patients require oxygen at their destination, or during stop-overs, the patient should get in contact with their UK oxygen supplier who should be able to arrange this. Medication –
Patients are advised to pack a separate set of medication in their hand luggage as well as in their suitcase in case their luggage goes missing. If medicines need to be refrigerated, patients are advised to carry a cool bag or vacuum flask on board. Any equipment that will be needed during the flight should be battery powered. Most airlines will not allow the use of nebulisers during take-off or landing. If patients need to carry out treatment / medication during the flight they should inform the airline. Power, pumps and plugs –
Power supply varies from country to country. UK electrical appliances such as nebulisers may not work in certain countries. The physiotherapy department may be able to offer a travel compressor and patients should purchase electrical adapters for different plug sockets. Paperwork –
When travelling abroad patients should carry a letter from their CF team listing all the medicines and equipment that they will need to travel with (including needles, syringes, compressors). Travel insurance is essential and, though it may be more expensive, must cover “pre-existing” conditions or the patient will not be covered for CF-related treatment.
When travelling in the EU patients can apply for a European Health Insurance Card (EHIC). This entitles them to either free treatment or treatment at a reduced cost if they fall ill when travelling in Europe. It also covers treatment for chronic or pre-existing conditions. However, this should not be a substitute for travel insurance –
it only covers emergency care and does not include some medication costs or repatriation. Vaccinations and immunisations
– Patients are advised to visit their GP as soon as possible to check if they need any vaccinations or other preventive measures (such as malaria tablets). Remember, these treatments are not usually available as NHS prescriptions.
Documentation required for patients to travel
- Fitness-to-fly letter from doctor
- A letter detailing current medical condition, medication and equipment
- Travel insurance certificate
- EHIC (if travelling in EU)
Places to avoid
Over recent years, there have been several cases of melioidosis
. This is an infection caused by Burkholderia pseudomallei
and can be potentially life threatening. Burkholderia pseudomallei
is found in fresh water and damp soil in some areas of Asia and northern Australia.
Patients should also be aware of the potential risks of going to countries where hygiene standards and medical care are poor. Read the fact sheet
from Australia's Northern Territory government and visit the CF Trust website
for more information.
Risk of salt depletion
Heat can cause excessive sweating, which can lead to dehydration. Slo-Sodium (4-6 daily) is recommended. Patients travelling to hot countries and those who will be engaged in strenuous sports or other activities (e.g. cycling and skiing) must be prescribed enough for the duration of the holiday and are advised to stay well hydrated (particularly when drinking alcohol).
General travel health advice
Sometimes general health issues can be forgotten when planning travel. Therefore, patients are reminded to use a high-factor sunscreen and avoid excessive sunbathing, especially if they are on certain oral medication (e.g. voriconazole, ciprofloxacin). Patients are also reminded to practice safe sex and are advised to take condoms with them, as quality can vary in other countries.