|
|
|
What you
should know
about travelers' perils
If you are planning to be away from home, taking preventive measures before your trip can ease your mind and decrease your chances of getting ill or contracting an unusual disease. Before you travel, be certain that you have had all of your routine medical, dental and eye exams. Take along an extra
 set
of contact lenses or glasses. Wear your emergency medical information bracelet, or have a card in your wallet stating your known allergies and any condition that may require emergency care. Have a copy of your latest cardiogram in your wallet and any emergency phone numbers of people back home who can give health information about you. If you take prescription drugs, carry a refill, the name and dosage of each medication, and a statement of your health problems. Travelers with a history of motion sickness need to bring anti-motion sickness medications and begin taking them before departure.
You may also want to contact the Centers for Disease Control and Prevention (CDC) or your local health department for the necessary immunizations and preventive measures suggested for the area you will be visiting (www.cdc.gov/travel). Many diseases and organisms are particular to various regions, and the CDC can make you aware of these diseases and tell you how to avoid contact with them.
TREATING DIARRHEA AND DEHYDRATION
Traveler's diarrhea is very common among people visiting developing countries. Common symptoms include diarrhea, abdominal cramps, nausea, bloating, urgency, fever, and weakness. While it usually clears up in a few days, severe cases can result in dehydration and the loss of important electrolytes (chemicals) from your body. To prevent diarrhea, don't eat raw vegetables, fruit that you haven't peeled yourself and any foods that aren't steaming hot. Drink only bottled beverages and avoid tap water, including ice cubes. Avoid food sold by street vendors. Taking 2 oz of Pepto-Bismol four times a day may decrease the possibility that you will get the disease but it should not be taken longer than three weeks.
In most cases, simply replacing lost fluids and salts can treat traveler's diarrhea. You may want to take along a few packets of oral rehydration salts (available at most pharmacies and sports shops). You can make your own rehydration drink by combining 1 tablespoon of sugar, 1/4 teaspoon of salt, 1/8 teaspoon of salt substitute (not light salt), and 1/4 teaspoon of baking soda mixed in 12 ounces of bottled water, or just kept dry in a plastic bag until ready to mix. Many sport drinks have similar ingredients and can be purchased in liquid or mixable powder form. Sometimes antibiotics are needed to treat the diarrhea. Usually it is better to delay the treatment until you actually get the symptoms and then respond promptly with increased fluids, antibiotics and antidiarrhea medications. Antibiotics must be purchased by prescription, so you may want to get a supply of them before you leave. If you take the antibiotic along with an antidiarrhea drug, your symptoms will probably go away in about 24 hours. If the diarrhea is severe or associated with a high fever or bloody stools, don't take the drugs. Instead, see a health care provider. An attack of diarrhea that has been treated does not prevent another from occurring.
Children younger than 2 years are at high risk of getting traveler's diarrhea and suffering from dehydration. Breast-fed infants should continue breastfeeding, and bottle-fed infants should get ready-mixed, canned formula. Teenagers and children eating table foods should follow the same precautions as adults.
MINIMIZING RISK OF INFECTION
Some immunizations are not required under the International Health Regulations but are recommended to protect the health of the traveler. For some diseases, such as malaria, no vaccines are available, so specific behaviors or medications are needed. Standard immunizations that you should have include tetanus, hepatitis and all of the adult/baby boosters. Vaccines that are often required in some areas are cholera, hepatitis A, meningitis, tuberculosis, typhoid fever. yellow fever and rabies.
The risk of HIV infection for international travelers is generally low; however, some factors to consider include avoiding direct contact with blood and secretions, and avoiding unprotected sexual contact with potentially infected persons. Be aware that the blood supply in developing countries may be inadequately screened. Currently, there is no vaccine to protect against HIV infection. Special recommendations are available for infants and children at your local health department.
Besides immunization against vector-borne (ticks, insects) disease, there are general protective measures travelers should use. The best protection is avoidance. Avoid rural areas and some seasonal travel. Mosquitoes are most active at dawn and dusk or in the evening. Wear long-sleeved shirts, tucked in: long pants with socks over pant legs; a hat and boots (avoid sandals). Apply repellent to clothing, shoes, tents, mosquito netting, and other gear to enhance protection. Ticks and mites are easily detected on light-colored or white clothing. If window screens are unavailable, use a bed net sprayed with repellent and tuck it under the mattress. The best protection offered is to apply a repellent containing at least 30% N,N-diethyl-m-toluamide (DEET) to all exposed skin and to use a permethrin-containing repellent for clothing shoes, and camping gear.
Contaminated food and drink are common sources of infection (e.g., E coli, shigellosis, giardiasis, typhoid fever, hepatitis A) and are transmitted though the fecal-oral route. Water and ice cubes that have not been adequately chlorinated can cause infection. Avoid tap water where hygiene and sanitation are poor. Instead, try to drink hot beverages made with boiled water (tea, coffee) or canned or bottled beverages (e.g., beer and wine). Wipe off tops of cans or bottles before drinking and avoid brushing teeth with tap water. To purify the water, boil it for one full minute, cool it, and add iodine tablets (available at a pharmacy or sporting goods store). Avoid unpasteurized milk or milk products (cheese) and certain fish (such as barracuda, amber fish and tropical reef fish) and shellfish as they have been known to contain biotoxin and cholera.
Cruise ships seldom pose a problem, as they must follow the CDC Vessel Sanitation Program and comply with CDC inspections. Each ship has a "green sheet" that rates the ship's compliance with CDC recommendations. It is available at
www.cdc.gov/nceh/vsp/vsp.htm or by fax by calling (888) 232-6789. Request document 510051 or, for a specific ship, write the Vessel Sanitation Program at the National Center for Environmental Health.
Pregnant women need to carry documentation of their due date when they travel and to consider the potential problems of international travel. The safest time for a pregnant woman to travel is during the second trimester (18 to 24 weeks). Air travel is inadvisable after 36 weeks and international travel after 33 weeks. Breast-feeding women can be immunized, if necessary.
Resources
 Centers for Disease Control and Prevention, Office of Public Affairs, 1600 Clifton Road, NE Atlanta, GA 30333
(404) 639-3311; (404) 639-3534 for publications.
Consumer Health Information Research Institute
300 Pink Hill Road, Independence, MO 64057
(816) 228-4595
Office of Disease Prevention and Health Promotion,
National Health Information Center, PO Box 1133, Washington, DC 20013-1133
(800) 336-4797
Department of Health and Human Services,
Public Health Service, 200 Independence Ave. SW, Room 717-H, Washington, DC 20201
(202) 619-0257
National Center for Environmental Health,
4770 Buford Hwy NE, Mail stop F-29, Atlanta, GA 30341-3724
(888) 232-0789
Back
to Frequently Asked Questions
|
