Travel Health

Staying healthy AND safe when travelling abroad

By: Bradley Ihrig

A winter storm warning has been issued and you receive the news with a hint   of guilty delight because you have already booked a vacation to the sunny   beaches of Mexico!  Those of us fortunate enough to escape the winter doldrums, cold and snow should consider some simple pre-trip health preparation. The following are 5 key areas to consider:

SUN: Our skin slowly protects itself from damaging UV radiation through increasing melanin production with sun exposure (a tan). If we have minimum sun exposure in the preceding months and then sit on the beach for a couple of hours in direct sunlight, it’s a sure recipe for a painful and potentially skin cancer invoking sunburn. It is important to wear sunscreen on all exposed areas and a hat, especially for those individuals that are hair-challenged on top. We have all seen people who do not follow this simple advice and end up resembling a well-cooked lobster.

HEAT: Again, our bodies generally acclimatize to increasing temperatures with the change of seasons but are not designed to go from -10 to 90 degrees in one day.  In order to make enough sweat to properly cool the body, one should dramatically increase consumption of liquids, especially water and to wear appropriate loose fitting clothes. Here again the hat proves useful.

TRAVELERS’ DIARRHEA: This is a real phenomenon, but thankfully is mostly mild and self-limiting. I like to travel with the chewable form of Pepto-Bismol and also Immodium, both of which are available without a prescription. If diarrhea persists more than 2-3 days, antibiotics may be useful in shortening the course. Usually either ciprofloxacin or azithromycin is prescribed for 1-3 days.  Your primary care provider can provide an appropriate prescription to take with you just in case. It’s also important to avoid known high risk eating behaviors, such as drinking unbottled or unboiled water, undercooked eggs and non-cooked street vendor foods. Most importantly, practice frequent hand washing! I also bring hand sanitizer along.  Many areas have typhoid, a food and water borne diarrheal illness. This can be partially prevented by a pre-travel immunization.

MOSQUITOES: They carry nasty diseases like malaria, dengue fever and Japanese encephalitis. The best protection is to avoid being bitten altogether.  Diseases can be transmitted by both day and night flying mosquitoes and mosquito repellant is a must. DEET containing mosquito repellant is the longest lasting and newer formulations have less concern for neurotoxicity. Some prefer picaridin-based products like Cutter Advanced, but it is not as long-lasting as DEET.  Clothing can be pre-treated with permethrin liquid sold in most sporting goods stores.  Malaria prevention includes not just preventing bites but also taking pills to drastically reduce the chances of developing symptoms. There is growing resistance to these medications and specific recommendations should be discussed with your primary care provider.

ROAD ACCIDENTS: This is by far the greatest risk when traveling abroad. More accidents occur at night, especially after midnight and travel during this time should be avoided if possible. Traffic laws may be different, including traveling on the opposite side of the street in many former British colonies. It takes some deliberate attention to look in the proper direction when crossing the street to avoid disaster.

Finally, check with your health and auto insurance to see what coverage applies when traveling abroad. Supplemental coverage is available for both areas.  Following these simple steps will improve the likelihood of an enjoyable and rewarding trip.

Dr. Bradley Ihrig is a Family Practice Physician with an interest in travel medicine for Community Physician Group at Community Medical Center.