The last thing you need when on vacation is to be struck with an illness. Yet that’s exactly what happens to many travelers each year worldwide.
Indeed, whether you’re planning a Mexican surf vacation, a business trip to India, a National Park tour, or a safari in Africa in the next few months, you may encounter travel-related illnesses that can be uncomfortable and disruptive, and sometimes even life threatening. These include but are not limited to altitude sickness, traveler’s diarrhea, mosquito-transmitted diseases, and sunburn.
The good news is that you can take certain precautions to protect yourself and your family from health hazards while traveling many miles from home.
The first stop should be your doctor’s office or, even better, a travel clinic that is able to administer travel-specific vaccines.
“When we counsel travelers, we ask about their itinerary so we know where exactly they’re going, how long they’re there for, whether they’ll be in rural or urban places, if they’re staying in a nice hotel, or are backpacking,” says Dr. Ole Vielemeyer, medical director of Infectious Disease Associates and Travel Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. “We also assess the health of the traveler, especially regarding any chronic conditions that may affect the immune system or the ability to travel freely. Once we have all the information, then we will discuss whether the itinerary is safe, what vaccines are needed, what’s safe to eat and drink, and how to avoid insect bite-related illnesses.”
Have a candid conversation with your doctor or a travel-medicine specialist about your travel plans at least 30 to 45 days before your departure, he suggests.
“Some vaccines require more than one dose,” says Dr. Vielemeyer. For example, the Japanese encephalitis vaccine that is used in the U.S. requires two separate doses 28 days apart prior to travel. Likewise, if you need protection from rabies, several shots over three to four weeks are needed for full protection. “Thus, you would need at least four to six weeks prior to travel to start that series so that you have full protection by the time you arrive at your destination,” he says.
Even if you don’t need an immunization or prescription medication, Dr. Vielemeyer says, there are other precautions you should take, depending on your destination.
“When we counsel travelers, we ask about their itinerary so we know where exactly they’re going, how long they’re there for, whether they’ll be in rural or urban places…”
— Dr. Ole Vielemeyer
The most common travel-related illnesses are food- and water-borne, says Dr. Vielemeyer. They can occur when you consume something, usually tap water, that has been contaminated by bacteria, parasites, or viruses. The ensuing disease usually presents with diarrhea, abdominal cramps, or pain that can be quite severe, and sometimes fever, blood, or mucus in your stool and, especially in children, dehydration.
“If you’re going to a country that is part of the [developing world], we always recommend that you stay away from drinking tap water,” Dr. Vielemeyer says. But there is no need to panic if a little unfiltered water gets in your mouth in the shower. “Most of the time you have to ingest several sips before you can get sick with a diarrheal illness.”
Ice cubes are often a hidden culprit. Avoid them by skipping alcoholic drinks made with ice, and by enjoying your soft drinks without ice. Dr. Vielemeyer also suggests using bottled water to brush your teeth to be safe. If you don’t have a bottle handy, it’s OK to brush with tap as long as you spit out all the water.
Since heat kills germs, “stay away from raw vegetable salads, and make sure the food that you consume is fully cooked and served steaming hot,” says Dr. Vielemeyer. Dry foods, like baked items such as cookies, bread, and chips, are safe to eat. Lukewarm or room-temperature dishes could be dangerous. That’s because you have no way of knowing if the meal was fully cooked prior to cooling or how long it has been sitting out, factors that could put you at risk of food poisoning, including traveler’s diarrhea common in many regions around the world, says Dr. Vielemeyer.
Going from near sea level to more than 8,000 feet above sea level (or from New York City to the high mountain regions of Colorado, for example) in one day and staying at the high altitude overnight could be jarring to your system since less oxygen to the brain at high altitudes may make you sick.
Thin air isn’t the only problem. You’re also dealing with low temperatures, low humidity, increased ultraviolet radiation, and decreased air pressure. Signs your body is struggling to acclimate include headaches, suppressed hunger, fatigue, and nausea, which could lead to vomiting.
“This is not related to how physically fit you are,” says Dr. Vielemeyer. “How many miles you can run or how far you can swim won’t affect how you react at high altitudes. It is a genetic predisposition.”
Unfortunately, there’s no way to screen for this susceptibility. To mitigate the effects of high altitudes, Dr. Vielemeyer suggests avoiding overexertion and alcohol for the first 48 hours of your trip to let your body adjust.
“For rare occasions in the Rockies, we do recommend medications, but we usually reserve that for people who’ve had symptoms of high-altitude sickness in the past,” Dr. Vielemeyer says.
For many, vacations include ample time in the sun. To avoid painful sunburns and exposure that can lead to long-term skin damage, apply sunscreen many times throughout the day. Make sure the sunscreen is labeled “broad spectrum” with both UVA- and UVB-absorbing/blocking ingredients, and has between 5 and 10 percent zinc oxide. Better yet, find shade, wear a hat and sunglasses, and use an umbrella when you can. And no matter how beautiful the sunset is, never look directly into the sun without appropriate protective gear.
Get the right bug spray. While scientists continue to develop new vaccines against mosquito-borne diseases, “the most effective way to avoid mosquito-borne illnesses remains to not be in an area where the mosquitoes can bite you,” Dr. Vielemeyer says, especially to those traveling to places known for Zika, malaria, dengue, West Nile, chikungunya, yellow fever, and Japanese encephalitis. “If you are currently planning a family and travel to a Zika-endemic country and it’s an absolutely required trip, you might want to stay indoors most of the time,” says Dr. Vielemeyer. “If you must be outside, wear long-sleeved clothing and pants pretreated with permethrin, which is a chemical that repels insects and mosquitoes. In general, use insect repellent that contains the active ingredient DEET and make sure that the place where you are sleeping is mosquito-free.”
Originally published at healthmatters.nyp.org