An outbreak of cholera or malaria can destroy your holiday. Do you trust to luck and set off anyway, do you cancel everything or do you get every injection you can? Veronica Stivala seeks advice from seasoned travellers.

Thomas Morgan knows a thing or two about travel-related diseases.

He has contracted typhoid fever seven times, malaria seven times, giardiasis twice and amoebic dysentery (both violent attacks on the bowels) in his trips around the world.

In northern Somalia he got salmonella along with a string of Staphylococcal infections that started from an insect bite in Mombasa and ended up with him needing surgery.

It may be hard to believe, but Thomas does not actively seek virulent diseases. He just likes to travel a lot (he has been to 30 countries in Africa alone), has lived in a wide range of countries and is not easily worried.

He explains his attitude to disease outbreaks: “When there’s an outbreak of something I’ll tend to keep to my normal life but just be careful – I’ve been through cholera outbreaks in Guinea some time ago and in Guinea-Bissau when I lived in Senegal in 2012.”

Thomas’s approach is to adopt an ‘it won’t happen to me’ attitude ­– not the most foolproof of plans – but he also tries not to eat high-risk foods like salad, and avoids ice cubes.

He admits that because he lives long-term in countries where there are often disease outbreaks, it would drive him crazy to think about everything dangerous, as opposed to being able to be extra careful when on a two-week holiday.

Still, he keeps a close eye on himself and gets a blood test whenever he thinks anything might be wrong.

Admittedly, Thomas is an experienced traveller (and recipient of diseases), so he knows how to take calculated risks.

Getting ill is like your team losing; it sucks for a few days and then you forget about it and you’re ready to go again

He confides how having had malaria and typhoid so many times, he is less concerned about contracting them and knows they are easily curable if you catch them early.

“I won’t bother with malaria pills unless I’ll be somewhere remote and won’t be able to see a doctor any time easily,” he says.

“A couple of times the malaria has left me unable to stand up straight, so it can be very rough.

“The good thing is, in a place like Sierra Leone they know everything about malaria and – assuming you get drugs that aren’t counterfeit, which is a big problem there – they can get you back to health quickly.

“So I’ll definitely travel with a course of malaria treatment if I’m really out in the bush from now on, and try to self-medicate if I really suspect that it’s that.”

Thomas’s approach will not suit everyone, but his philosophy is to first and foremost enjoy oneself.

The most important thing, he says, is that while you should throw yourself in, you shouldn’t go in so deep that you’re going to be frightened or paranoid the whole time.

However, travelling to countries that are known to have outbreaks of new, less-treatable diseases and pandemics, such as avian and swine flu or, more recently, the sometimes-deadly Middle East Respiratory Syndrome (Mers) is strongly advised against, particularly as visitors may not have built up certain levels of immunity that locals possess.

A more cautious traveller is Alexia Rossi, who has been volunteering in Africa since she was 16.

Her annual summer trip has become an integral part of her schedule, both because of the sense of fulfilment and the thrill of visiting far-flung countries.

Like Thomas, although she was always aware of the health risks, both the illusion of invulnerability and her love for travel and the expected exhilaration would sway the balance heavily in favour of the trip, reducing any fear of illness to negligible.

Although she is very careful, she did contract a bad strain of malaria that could have been fatal.

“I am cautious by nature,” she explains, “and took the necessary precautions clearly outlined by the health department and all travel books.”

She used mosquito nets and insect repellent with over 50 per cent DEET in the areas of Ethiopia affected by malaria (for example, Addis Ababa is malaria-free due to its altitude).

She also took the malaria prophylaxis medication (Mefloquine) before departure, during the trip as well as after, as indicated.

While she took the medication religiously, she was less vigilant with the other precautions and after a few days would often sleep without a mosquito net and forget to re-apply repellent throughout the day.

It is clearly indicated that the prophylaxis, while being a good prevention, is not 100 per cent effective, leaving a small margin of chance of infection.

Alexia initially attributed feeling ill to carsickness, though she got progressively worse to the point of falling unconscious during the night.

The good thing is, in a place like Sierra Leone they know everything about malaria – assuming you get drugs that aren’t counterfeit, which is a big problem

While she did have one of the worst forms of malaria, the care she received locally was top-notch; regular visits from the doctor, appropriate medication and additional treatment to prevent its recurrence.

The treatment took a little while to work, and while the fever and aggressive vomiting remained for the first few days, it then started to subside and she became less anxious and scared of the outcome.

The whole convalescence took about eight to 10 days, which were very miserable as she couldn’t go to work, slept most of the day, ate very little and became tired very quickly.

Thomas sums up falling sick while travelling: “Getting ill is like your favourite team losing; it sucks for a few days and then you forget about it and you are ready to go again.

“Sometimes, if they lose four or five times in a row, it can make you question how much you love the game – but deep down you know you wouldn’t trade it for the world.”