Great adventures, new cultures, and exotic foods actively push you beyond your comfort zone. And while potential illnesses and injuries rarely outweigh the rewards of exploring a destination, visiting a different part of the world does mean exposure to unique health problems and an increased risk of even common injuries. Good travel health practices require a mix of common sense and practical preparation, read on to learn top tips from a pro.
“Motor-vehicle-accident injuries are one of the most common that travelers encounter,” says Dr. Erik McLaughlin, a.k.a. the “Adventure Doc,” who specializes in adventure travel health from his Tucson, Arizona, clinic. “The best prevention: Wear your seat belt, don’t travel at night, sit in the middle-aisle seats on buses, and use common sense.”
That last one—common sense—is key, for more than just road travel. Vaccinations and medications aren’t last-minute fix-alls. They are tools that responsible travelers should wield intelligently and purposefully. Here is our guide to helping you avoid the most common travel-health issues.
The first step in responsible travel health planning is to check the Travelers’ Health section of the Centers for Disease Control and Prevention (CDC) website, which provides up-to-date, destination-specific information on disease outbreaks, places to avoid, and a list of required or suggested vaccinations and medications.
Then, make an appointment with a doctor experienced in travel health at least two months before departure. Some preventive treatments, like certain anti-malaria drugs, need time to kick in or should be taken over a few weeks.
“If possible, provide the doctor with a copy of your vaccination records,” McLaughlin says. “Many of my patients haven’t seen or updated these since childhood, but usually their family doctors will have them on file.” Many American adults haven’t had the booster shots for their childhood vaccinations against illnesses like measles or mumps. And while most travelers won’t need a yellow-fever or Japanese-encephalitis vaccination, many haven’t been vaccinated against tuberculosis (TB), hepatitis A and B, or polio, which is nonexistent in the United States but still a factor in other countries.
Far and away the most common travel health issue, and one that pretty much every traveler will experience at some point, is travelers’ diarrhea (TD)—a.k.a. Montezuma’s Revenge, Delhi Belly, and any number of regional euphemisms. According to the CDC website, as many as 50 percent of travelers on a one- to two-week trip will experience TD, and while it most commonly happens as a result of eating food or water contaminated by E. coli, particularly sensitive people could get upset stomachs just from unusual foods or the general stress of travel.
The best preventive measures are regular hand washing and careful eating. Eat only well-cooked foods that are still hot, don’t consume salads or raw vegetables, and drink only bottled water unless tap water is explicitly safe. Unpeeled fruits should be fine.
The CDC also recommends regular doses of Pepto-Bismol—two ounces of liquid or two chewable tablets, four times a day, throughout the trip—to reduce the chances of getting TD. Even better, ask a doctor to prescribe antibiotics, and take them as soon as symptoms appear—the rumbling should subside within a day or two. The most common of these antibiotics is a drug called ciprofloxacin, and the typical dose is one tablet twice a day.
Once TD has set in, it’s best to let it run its course. “I believe in a ‘let it flow’ philosophy,” McLaughlin says. “Staying hydrated and letting your body get it all out will shorten the duration.” He adds that loperamide (Imodium) is a great temporary treatment, say for a long bus ride without toilet access. However, because loperamide physically clogs the bowels, it should be used sparingly.
According to the CDC, about 1,500 Americans contract malaria while abroad every year. It is one of the most prevalent health issues travelers have once landing back on home soil. Here are some facts about it and other common travel ailments, as well as tips on how to protect yourself.
While most of those cases happen in sub-Saharan Africa, malaria is present in many tropical areas, even in parts of the Caribbean. A doctor specializing in travel health can provide advice about particular destinations, but using strong bug spray—brands with DEET in concentrations of 30 percent or more, applied every six hours—and wearing long clothes during peak bug times usually make the most sense for visitors to tourist areas.
If medication is deemed necessary, the regimen should be started before departure to ensure there are no serious side effects, taken on a strict schedule throughout the trip, and continued after returning home, as malaria has an incubation period. It is important to know that the type of medication depends upon the area you are traveling to, so it is wise to always consult your doctor beforehand.
Dengue is on the rise and relatively common around the world’s tropics—cases occur in Central America, the Caribbean, and, recently, as close to home as Florida. A person’s first infection with this mosquito-borne disease usually goes undiagnosed or misdiagnosed as the flu or another common ailment. However, symptoms can become rather severe if untreated. And, as with chicken pox, the body builds immunity to dengue when infected. It’s important to note, though, that there are four varieties of dengue, and immunity to one does not protect against the others. “That’s when the trouble occurs,” McLaughlin says. “Dengue gets dangerous with the second or third infection.”
Unfortunately, there are no vaccinations or drug treatments for the dengue virus itself, just to treat the symptoms—like chills, headache, back pain, and intense fever. The best way to avoid it is to apply liberal amounts of bug spray and long clothes when the bugs come out, as well as avoiding swamp-like places where they lurk. Travelers in high-risk areas who plan to sleep outside or in a room without good screens should sleep under a mosquito net treated with permethrin.
Yellow fever is the last in the trifecta of widespread mosquito-borne illnesses, and also the least problematic for American travelers. That’s because yellow fever, which is mostly found in parts of Africa and South America, can be vaccinated against. In fact, at most yellow-fever hotspots, visitors can’t even enter the country without the shot. Double-check your medical records just in case and consult your doctor if you have any questions.
Despite posing no long-term risks, motion sickness can be a debilitating affliction. Essentially, motion sickness happens when the mind and body disagree about their current state of balance, and the feeling will go away almost immediately after the offending motion stops. Which isn’t always an option if you’re, say, on a six-hour bus tour through the Italian countryside.
Some people get motion sickness more readily than others, and those who know they have a predisposition must take preventive medications at least an hour before getting on the boat, plane, or bus. Motion-sickness sufferers often pop pills in desperation, but drugs like Dramamine or Bonine, which work by balancing things out before they go haywire, have no effect if taken after a sufferer already feels sick.
There are some alternative treatments. Ginger root (such as in ginger candies or ginger ale) helps settle the stomach. Specialized bands that apply acupressure to the inside of the wrist can also help. And for many people, scopolamine patches (brand name Transderm), which look like a small, round bandage that sticks behind the ear, have proven highly effective.
If motion sickness occurs despite these measures, stay outside or near a window (don’t go to the bus bathroom or below decks on the boat), breathe as much fresh air as possible, and stare at the horizon or any stationary object in the distance until your mind regains its bearings.
When to Buy Travel Health Insurance
Most domestic medical insurance policies provide little or no coverage abroad, and those that do rarely include the most vital aspect of travel health insurance: emergency evacuation and repatriation coverage. Depending on the severity of the illness or injury and your location, fast transport to a capable medical facility—or even back to the United States—can mean the difference between life and death. Without insurance coverage, the cost of services like a medical airlift can easily run tens of thousands of dollars.
A short-term travel insurance policy can provide a safety net for extreme circumstances, and the right coverage depends on the destination and even specific activities. For example, travelers to rural or wilderness areas may want to bump up evacuation coverage, while people visiting a modern city may prefer plans that cover on-location treatment. Plans can also focus on an activity—scuba divers, for example, can get diving-specific insurance and medical support through the nonprofit Divers Alert Network.
As with any policy, it pays to read the fine print when picking travel medical insurance. McLaughlin says to check if the plan covers any doctor, or just specified medical facilities, and regarding evacuation, find out if the policy specifies pickup or drop-off points. Some won’t cover evacuation from remote areas, and some may pay for evacuation only to the nearest medical facility, not back to the United States.
Travel Medicine Checklist
Depending on the destination, medical supplies, even basic ones like pain relievers or clean bandages, may prove hard to find. So it’s a good idea to pack some basic supplies—especially prescription medications, which should be packed in carry-on luggage in their original bottles. “Make sure you have an adequate supply of prescription meds to last the trip, and a little extra in case of delays,” McLaughlin says.
He also recommends bringing copies of shot records, emergency contact info, and a basic first-aid kit. “Personally, I’d recommend bringing about 45 pounds of medical supplies,” he jokes. “But it doesn’t do any good if you don’t carry it with you, so a lightweight kit that fits in your pack is better than a comprehensive one that stays at the hotel.”
Travel Health Checklist
- Pain relievers, both acetaminophen (Tylenol) and ibuprofen (Advil)
- Pepto-Bismol, Imodium, and possibly prescription antibiotics
- Antibiotic soap and/or alcohol-based hand sanitizer
- Orthodontic wax for dental emergencies
- Gauze and bandages
- Moleskin for blisters
- Rehydration powder (like Emergen-C)
- Bug spray with at least 30 percent DEET