I recently had the good fortune to go on a trip to Puerto Rico with all of my PGG compatriots! Of course we had lots of trip prep, from bathing suit shopping, scouting out the best sunscreen, trying to pack everything into a carry on, and figuring out how to transport wine! However, we also had discussions about what medications to bring, and what, if any, diseases we needed to be concerned about during our travels. I thought it was a good opportunity to share some tidbits about travel medicine, so that the next time you are jetting away you can be prepared for anything!
I get lots of questions from patients about traveling. From anxiety about flying to wondering what vaccines may be necessary, there are certainly things to think about before you embark on a trip. I will cover a few topics below, but it’s important to remember that for the vast majority of travelers, there is not much to be worried about. If you are traveling to the US, Europe and other western countries, major cities, or even the major resorts in the Caribbean and Mexico, much of our risk is minimized. It’s important to take precautions, but most of us can enjoy our vacation or business trip without much concern. If you will be traveling to developing countries or will be “off the beaten path” ie in the rainforest, hiking, etc then you should consult with your doctor or with a travel medicine clinic to discuss what precautions you should take.
This is probably the biggest topic that I address with my patients who are traveling. First, you want to be sure that you are up to date with all of your routine vaccinations ie Tetanus, Measles, Mumps, Rubella, Flu, etc. Your doctor should be able to tell you about your vaccine status. Next, depending on where you are traveling, there are some vaccines that you may need, and some that may be recommended. The CDC has a great website for travelers, https://wwwnc.cdc.gov/travel/, where you can enter in the country and region you will be traveling to, and they will give you a nice summary of the recommended vaccines. I often recommend Hepatitis A (which is a food-borne illness) and Hepatitis B vaccines for travelers, particularly for those who travel frequently overseas. For those traveling to tropical and sub-tropical areas like Central and South America, Africa, and Southeast Asia, a vaccine for Typhoid is advised. Many countries in Africa require a vaccine for Yellow Fever to be admitted to the country. For those traveling to certain areas of Asia a vaccine for Japanese Encephalitis is also recommended.
Malaria is a disease that is transmitted by a mosquito in many tropical and sub-tropical climates. Prevention of this disease is key, as treatment is difficult and the disease can be fatal. Certainly being diligent about preventing mosquito bites is important, but for those who are traveling to Malaria prone areas, it’s also recommended to take medication to prevent this disease. The most commonly used drug is called Malarone. It’s a pill that is taken daily starting a few days prior to travel, for the duration of travel, and for a week after return. Depending on the region there may be other medications recommended; you should talk it over with your doctor and decide on the correct treatment.
I read somewhere recently that the mosquito is the most deadly animal on the planet, due to the numbers of diseases that are transmitted by these pesky insects. Malaria, Dengue fever, Zika, Chagas disease, and Chikungunya are just a few diseases that can be transmitted by insect bites. So, when traveling, it’s important to try to prevent bites when possible. Again, the CDC website has tons of info based on the region you are traveling to and specific recommendations for prevention. In general, I travel with insect repellent (one containing DEET). Many insects are more active in the early morning and evening hours, so avoiding outdoor activities during this time can be helpful. Netting over the bed and screening can also help to keep insects out!
This is a common malady in traveler’s, no matter how careful you are! Exposure to foreign water and food products, even within our own country, can result in gastrointestinal distress! The best way to avoid this problem is to drink bottled water. I also give my patients a prescription for an antibiotic, ciprofloxacin, to use if they develop traveler’s diarrhea.
Other Common Medical Problems and considerations
-Yeast infections and bladder infections are common in women during travel. Ask your doctor about a prescription you can take with you just in case.
-Many people experience anxiety during flying, and you can ask your doctor for a prescription anxiety medication which can help calm your nerves during travel.
-If you are going to be on a cruise or boating excursion, there is a patch (Transdermal Scopolamine) which is worn behind the ear and which can help prevent sea sickness.
-Of course you should take any prescription medications with you, and any over the counter medications you think you may need. No one wants to have to go to a pharmacy or local medical clinic when traveling!
-If you have a pacemaker or any other implanted medical device, be sure you have documentation from your doctor, as these can set off metal detectors.
-Remember to take steps to keep yourself healthy. Drink lots of water, wash your hands frequently or use hand sanitizer, eat well, and stay active!
-If you are on a long plane flight it’s recommended to get up, move around, and exercise your legs to help prevent blood clots.
Most important, relax and enjoy! There is nothing better than traveling and seeing the world, and with a few simple precautions above you can ensure that you stay healthy and happy!
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