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Travel Medicine

Travel abroad brings satisfaction, adventure, and personal reward. What if it also brings illness as well? Up to a third of people who travel abroad experience a travel-related illness, from as simple as traveler’s diarrhea or a respiratory infection, to more serious diseases such as malaria and yellow fever.  Medical advice and the proper precautions must be taken, and all must be based on the most up-to-date literature and expert recommendations.

Travel preparations should begin early, at least six to eight weeks before departure if possible in order to allow time to administer vaccinations and get the proper immunity as well as check for any adverse reactions to treatment. Each trip should have a detailed list of stopovers to determine how much time will be spent in an area and whether the time will be spent in a rural or urban area. Many times illnesses coincide with certain climacteric periods of the year, so that the rainy season in a given province will affect what is prepared in terms of infectious disease at that time or season. Another consideration is the length of time staying in an area - some vaccines are not necessary unless a longer length of stay in an endemic area (at least a few weeks) is anticipated.

While routine immunizations, such as hepatitis, tetanus, and influenza should be kept current no matter where the destination, medications for other anticipated disease problems should be recently refilled and carefully labeled. You can’t always rely on being able to medicate when you need it at certain points enroute when symptoms are disabling. Traveler’s diarrhea is perhaps the most important and frequent disease that can get in the way of enjoying a trip. A longer stay can multiply a risk that already can be as frequent as 20-30% among even short-term travelers.  Contaminated water may be the number one implicated source, but even a simple pathogen that the general population is used to and has immunity from but that is new to the traveler can cause significant symptoms. A single dose antibiotic as well as anti anti-diarrheal medication such as loperamide are very effective in most people.

Protection against insects is important in areas with vectors such as malaria, yellow fever, or tick borne encephalitis. Insect repellants with maximum concentration of DEET (diethyltolumide) should be applied to skin, in concentrations of 30% for adults and 10% for children. Applying sunscreen thirty minutes before applying the repellant helps maintain the effectiveness of the sunscreen.

The Center for Disease Control (CDC) maintains a list of advised and approved immunizations for travel to different parts of the world. The site is kept up to date to reflect the latest recommendation not only for countries, but for provinces within them where the disease vectors may be different or more toxic. Most tour groups will also specify what should be administered as they generally take their clients to the same places and have seen and experienced the risks firsthand.

Ask your doctor to recommend a practitioner trained or knowledgeable in the field of travel medicine if your trip is going to be either to exotic places or for a prolonged period of time. In that way all immunizations can be given, medication and prescriptions can be filled, and advice can be shared well ahead of any potential problems.

Authored by Dr. Bob Goldstone, M.D.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.