Planning any Foreign or Adventure Travel this Year?

by Laura Nowosielski, MD

The South Shore Medical Center offers assistance in planning for work-related, tourist, or adventure travel. Medical planning is essential for a safe and healthy trip. Many vaccinations must be given over time, and cannot be administered together.

Please call our office and request an International Travel Planner, or download a copy from our website. This document helps your physician prepare any prescriptions, vaccinations, and specific counseling that will be done at your travel-healthy office visit.

We refer you to the following website for specific recommendations: http://www.cdc.gov/travel

Our world has become much smaller in the past decades. The ease of arranging and arriving in these unusual situations makes it easy to forget the possible exposure to health risks. We want you to have fun on your trip. Allow us to work with you and your travel companions to ensure a safe and healthy trip. Remember that children will require additional safeguards. They are not eligible for all vaccines and medications.

Educate yourself about the countries you are visiting.

What are the common diseases? Are there any disease outbreaks (epidemics)?

Will you require insect repellant or snake bite kits? You may be exposed to rabies, either from cave exploration, or domestic and wild animals.

Consider the weather

Sunscreens may not be readily available. Pack a #30 SPF along with protective clothing, a wide-brimmed hat, and sunglasses. You may need to increase your fluid intake. More on safe drinking water below.

Your host country may not be equipped to handle serious trauma or complex medical problems. You should know the location of the closest embassy that will assist American travelers. As you book your trip you may wish to purchase insurance to cover emergency care and evacuation. We can provide the names of hospitals that are able to provide services in English.

Bring an extra pair of contact lenses and your eyeglasses as well as a copy of your lens prescription along with you. Airplanes and high altitudes are dehydrating and contact lenses may be uncomfortable to wear.

Always pack your prescription and over the counter (OTC) medications in your carry on luggage. The temperature and humidity in the luggage hold may degrade your medicines. And airlines have been known to lose luggage!

Remember, many countries drive on the left (Japan, UK and Ireland, and all countries of the former British Empire except Canada and the USA) so remember to look right before stepping off the curb or it may be a short vacation. And remember to buckle up.

Traveler's Diarrhea

Exploring the tastes and flavors of your host country are one of the joys of travel. Unfortunately traveler's diarrhea is the most common illness affecting travelers. On a month long holiday in a lesser developed country you run a fifty-fifty chance of a bout of diarrhea. If you can't boil it, cook it, or peel it, then forget it. Wash your hands frequently. If you can't do that substitute baby wipes, or an antibacterial gel or spray. Use bottled water at all times, including tooth brushing. If you're not sure about the ice, just say no. Your doctor can advise you in the use of OTC anti-diarrheal agents, and may prescribe antibiotics as well. Gatorade contains replacement salts and sugar. A packet may be added to bottled water to aid in rehydration.

Altitude Sickness

Altitude sickness can develop if you ascend rapidly to elevations over 8,000 feet. You minimize the risk with a slow ascent, rest, adequate hydration, and avoiding alcohol. There are medications that can be taken in advance to reduce your risk of mountain sickness.

Motion Sickness

Motion sickness occurs on land and sea. Sea-Bands, light meals, ginger, and anti-emetic medicines are all helpful. Plan ahead with your doctor.

30% of the population is HIV positive in many countries, particularly in sub-Saharan Africa. We advise universal precautions for all travelers.

Special Risks

Some patients are at special risk. Talk to you doctor about specific advice if you are pregnant, traveling with small children, are immune suppressed, or are followed for any chronic illnesses. Diabetics may need to adjust the timing and quantity of their medications, and may find it easier to carry their own food rather than deal with "special" meals. Patients with chronic lung disease may need supplemental oxygen on airplanes. Dialysis can be arranged away from home.

Vaccinations

Vaccinations provide immunity from common and exotic diseases. You may need boosters on routine immunizations such as tetanus and diphtheria (Td ); polio; chicken pox (varicella); measles, mumps, and rubella (MMR); influenza; and pneumococcal pneumonia (pneumovax). More exotic or adventuresome travelers may benefit from protection from hepatitis A and B, typhoid, meningitis, Japanese encephalitis, rabies, cholera, and yellow fever. Pre and post travel tuberculosis screening may be suggested.

Malaria occurs worldwide. It is caused by the bite of a parasite infected mosquito. The risk of infection can be reduced significantly by preventive medication taken prior to and following visits to affected areas, and avoiding mosquito bites with shelter, clothing, and repellants. If you develop an unexplained fever, even up to a year after your visit to a malaria area, let your doctor know.

Your trip may involve other risks or concerns not mentioned here. Early planning allows us to help you anticipate problems and prepare for them. Your travel should be fun. Let us help you make it as healthy as possible.

Bon Voyage!

Laura M. Nowosielski, M.D.