“As I see my job, it’s to enable people to travel.”
Travel health. It’s a topic that many don’t look into deeply enough. I’ve been known to let my fitness routine slip while on the road. Same goes for eating healthy. But beyond fitness, overall health and wellness is a hugely important issue while traveling. Of course, you’re going to want to try the local cuisine, drink the beer, and maybe even sacrifice an hour of sleep to stay up talking with new friends from the hostel. That’s all good – as long as you’re taking care of your body before, during, and after your trip.
Fortunately for travel nerds like us, Dr. Phyllis Kozarsky, MD, with the Center For Disease Control and Prevention (CDC) is here with some tips for approaching the health aspects of international trips the right way. Dr. Kozarsky is a self-proclaimed lover of both travel and infectious diseases, and found a way to mix the two through practicing travel medicine and tropical medicine. In 1988, she started a travel clinic at Emery University after becoming incredibly sick while in India.
Being healthy while traveling takes a bit of effort, but so did making extensive travel a priority in life, so when you look at it that way, there’s nothing to be afraid of – just plan ahead! “If people are armed with good information on how to prevent, or self-manage, some illnesses, they’ll continue to travel because they are traveling healthy,” Dr. Kozarsky says. Let’s start with the pre-trip basics:
Prepare before you travel.
“As we invade other territories, we have health risks that are associated,” Dr. Kozarsky says. To help minimize those risks, the first thing to do is to make an appointment with a travel clinic 4-6 weeks before the trip. “Especially when visiting developing countries.” Be sure any vaccinations are taken care of, and that you are aware of the health risk associated with the destination.
“It’s a painless experience,” says Dr. Kozarsky about travel clinics. Have your medical history ready along with a specific itinerary. “There are speciifics that are helpful to know in terms of itinerary and style of living, as well as seasonality.” Also, before leaving home, be sure to have proper clothing and gear for the region, and know how to use it!
Research recommended vaccinations for where you’ll be. Remember, the 4 to 6-week period accounts for preventing most diseases, even if additional doses or boosters are required further down the line. Heads up: Travel clinics often ask for payment at the time of service, which means certain care may not be covered by your insurance and in many cases, even if it is covered, you’ll have to be reimbursed.
Online resource: Visiting a travel clinic is a great way to make sure you are fully prepared. Visit istm.org for a listing of clinics around the world.
Prevention, prevention, prevention!
Let’s us malaria as an example here, because it is prevalent in many places frequented by Americans. It is a disease transmitted by mosquitos, and common in tropical areas such as northern South America and the Pacific. It can cause serious illness or death if not treated or prevented, so here are some Malaria prevention tips: Malarone is the most common medication taken by Americans. The pill is a combination of atovaquone and proguanil (I know, fortunately all we have to pronounce out loud is Malarone), and has the fewer side effects than other prevention methods. Most of these prevention techniques are simple and quick – no excuses for not taking these measures. Remember, the mosquitos tend to bite at night, so use mosquito netting and wear long sleeves.
“A very important thing is first looking at the geography and the season,” Dr. Kozarsky says. “If someone is going to live somewhere for three years or something like that, they will get to know the seasonality and the elevation a little more intimately. For most short-term travelers, if they are going to an area of intense malaria exposure, that’s not a time to just use insect repellant and long sleeves and long pants.”
Know your body and history (and don’t be fooled by semi-immunity).
What are you most at risk of catching? What diseases have you caught before? Know these things before you visit disease-prone areas. “It depends on the individual’s profile,” says Dr. Kozarsky. “People will often say to us, ‘Oh I grew up in such and such, I know what it’s like, I had Malaria as a child and I’m immune or semi-immune.”
Often, those at the highest risk are individuals with prior exposure to a disease who have been away from it for an extended period of time. “The interesting thing about semi-immunity is that when you leave that area, unfortunately your body stops remembering that stuff after several months,” she says. “If you were born in Nigeria, you come to the United States to go to school, you’re here for a year and you’re going home to visit, your body isn’t the same as it used to be.” The highest-risk travelers are those traveling home to disease-prone areas to visit relatives or friends.
Online resource: The CDC’s website provides recommended preventative measures based on country and region, and items that make a useful part of a travel health kit. Visit cdc.gov
Stay hydrated, and bring antibiotics or other prescribed pills on the journey if you need them.
In many parts of the world, tap water is not safe to drink. This also plays into ice that comes in drinks. As a general rule, carbonated beverages and bottled water are a good way to go. Dr. Kozarsky recommends sticking to hot foods that have just been boiled or are still steaming, or fruits that can be peeled such as bananas and oranges. The most common day wrecker while abroad is traveler’s diarrhea. “I don’t think it’s sufficient to say, take yourself to bed and drink oral rehydration salts or whatever,” Dr. Kozarsky says. “If someone has moderate to severe diarrhea, I think it’s reasonable to carry an antibiotic with you.”
If you do suffer from bacterial infections or stomach nausea, Cipro is the most common and is very inexpensive, but is not always as effective, particularly in South East Asia. Zithromax, containing, the drug azithromycin, is a stronger option, notes Dr. Kozarsky.
Another interesting fact to remember is that many travel-related deaths are the result of accidents, not illness. “Motor vehicle accidents are at the top of the list,” Dr. Kozarsky says. “We worry about Ebola, and we worry about all these exotic diseases, but the bottom line is accidents. We do things abroad that we would never do at home.”
To find a good doctor while on the road, start at home by asking your doctor for recommendations. “Often times, they will have connections to people,” Dr. Kozarsky says. For those with pre-existing conditions, however, the best thing to do is to prepare as well as you can in advance of the trip and get specific instructions from your doctor.
- Beware of counterfeit medicine, and buy in your own country whenever possible. “There is a huge and expanding industry of counterfeit medications in the world,” Dr. Kozarsky says. “I don’t want (to) point any one country, but Asia and South Asia have been prominent locations where counterfeiting comes from.”
- Get enough sleep.
- Get an annual flu shot. “I can’t say that strongly enough,” says Dr. Kozarsky.
- Beware of STDs. While traveling, “People tend to be more casual about unprotected sex,” she notes. If there are is a chance you’ll be ‘hooking up,’ bring condoms!
- Travelers who are pregnant, or planning on becoming pregnant (men and women), should not travel to any areas where Zika is ongoing. Visit gov for a list of these countries.
- Tips for exercise routine.
- Tips for diet.
- Kozarsky notes that upon returning home, travelers should not ignore persisting symptoms or fevers. “
Look for CDC Traveler’s Health on Facebook and Twitter. “If you’ve seen and connected with a travel health provider and felt comfortable, it’s a good idea to maintain that relationship,” says Dr. Kozarsky. “Often times that person can be helpful for you when you’re traveling and after you’ve traveled.”
Now, off to put all of this stuff into action . . .
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