Travel Health

Content provided by Healthwise

Topic Overview

How can you stay healthy on your trip?

The best way to stay healthy on your trip is to plan before you go. If you are planning to travel to another country, see a doctor at least six weeks before you leave so you will have time for shots (immunizations) that you may need to get ahead of time.

Also ask your doctor if there are medicines or extra safety steps that you should take. For example, people who have heart failure may need to take shorter flights with more stops to avoid long periods of sitting. Or someone visiting Africa may need to take medicine to prevent malaria.

Where can you get the best information?

You can use the Internet to find general travel health information. Just make sure the information is up to date and from a reliable source. You can also find out if there are any problems with disease outbreaks in the places you will be visiting. Try these Web sites:

• www.cdc.gov/travel. This is the Web site for travel information from the Centers for Disease Control and Prevention (CDC).
• www.who.int/ith/en. This Web site lists information on travel, required immunizations, and disease outbreaks from the World Health Organization (WHO).

If you are taking a cruise, you can find your ship's sanitation inspection scores on this Web site: www.cdc.gov/nceh/vsp.

Find out where you can get the best medical care in the region you are visiting. The U.S. State Department’s Web site, www.usembassy.gov, lists every U.S. embassy worldwide and lists some doctors and medical facilities in those countries.

If you are traveling out of the country, take along the phone numbers and addresses of embassies in the areas you will visit. They can help you find a doctor or hospital. Find out if your insurance company will cover you. You may need special travel health insurance.

Which immunizations and medicines will you need?

Check with your doctor, the nearest health clinic, or your regional health department to see what kind of shots you should get. In the United States, most state health clinics can give you travel shots, some medicines, and healthy travel tips. If your state health clinic does not give shots for travelers, ask if there is a clinic nearby that does.

Hepatitis A vaccine is recommended for most people traveling to developing countries. Hepatitis A (or Hep A) is one of the most common diseases found in returning travelers. You can easily prevent hepatitis A by getting the vaccine.

Make sure that all routine shots are up to date for you and your children. These shots can protect you from diseases such as polio, diphtheria, measles, whooping cough, and rubella, which are still a problem in some developing countries.

If your doctor has told you that you should have the pneumococcal vaccine (to prevent complications of pneumonia) or a flu shot because of your age or a health condition, it is important that you have those shots before you leave.

The yellow fever vaccine is now required for travelers who plan to visit countries in South America and Africa where the disease is active.

You may need other shots, depending on where you are going, how long you will be there, and what you plan to do while you are there.

If you plan to visit an area where malaria is a risk, ask your doctor to give you a prescription for medicine to prevent malaria.

What precautions should you take while you travel?

Before you go, find out about the places you plan to visit. Is the water safe to drink? Do mosquitoes or other bugs carry disease? Is there air pollution? Will you be at a high altitude that could make you sick? Is it safe to swim in pools, lakes, or the ocean? Could you get heat exhaustion, sun stroke, or a sunburn?

Basic safety can prevent some illnesses:

• Many developing countries do not have safe tap water. When visiting these places, drink only beverages made with boiled water, such as tea and coffee. Canned or bottled carbonated drinks, such as soda, beer, wine, or carbonated water are usually a safe choice. Do not use ice if you don't know what kind of water was used to make it. And do not use tap water to brush your teeth.
• Do not eat raw vegetables, raw fruits (unless you wash them with safe—not tap—water and peel them yourself), or raw or undercooked meat and seafood. Avoid food or drink from street vendors.
• In malaria-infected areas, use DEET insect repellent on exposed skin, and use flying insect spray in the room where you sleep. Wear long pants and long-sleeved shirts, especially from dusk to dawn. Mosquito netting works well to protect yourself from bites while you sleep. Protect against ticks when you visit places where Lyme disease or Rocky Mountain spotted fever is present.
• When the weather is very hot, stay indoors during the hottest time of the day. And use sunscreen when you go outside to prevent sunburn and dangerous heatstroke.
• Air pollution in some large cities can pose a serious threat to those with asthma or other respiratory conditions. Avoid those cities when air quality is poor, or stay indoors as much as possible.
• Practice safe sex. One of the most common ways that travelers get infections is by having sex with an infected person. Using condoms can prevent sexually transmitted infections and diseases.

Getting a disease on your trip is probably what you think about when you hear about travel health. But it is important to know about other ways you can be hurt. Many travelers are hurt in car accidents. If you must drive, learn about local driving customs, such as driving on the left side of the road. Travel during daylight when you can. Always use seat belts. If you use hired drivers (such as in a taxi), don't be afraid to ask your driver to slow down or to drive more carefully.

What if you get sick while you are traveling?

Diarrhea is the most common illness to strike travelers. Travelers’ diarrhea is most common in developing countries where food and water are not as safe.

Travelers' diarrhea most often begins quickly with watery diarrhea, vomiting, cramping, and a low fever. Many doctors recommend trying to eat as normally as possible. If you are vomiting, try to drink water or other clear fluids. Watch for signs of dehydration, such as a dry mouth and dark-colored urine. If possible, drink rehydration drinks to replace lost fluids and electrolytes. Most cases of travelers' diarrhea get better in one to three days without treatment. But see a doctor if diarrhea lasts longer than three days. It is also a good idea to see a doctor if you have a high fever, blood or pus in your diarrhea, or signs of dehydration.

If you become seriously ill while traveling, your country's embassy or consulate can help you find medical care. If you become ill with a fever or flu-like illness while traveling in malaria-risk areas, get medical help right away.

Should you see a doctor when you return?

If you were healthy during your trip and you feel well when you return home, you probably do not need to see a doctor.

If you were sick with a fever or severe flu-like illness while traveling, see your doctor when you get home. Also, if you get sick with a fever or severe flu-like illness for up to one year after coming home, see your doctor. Tell your doctor the places you visited and whether you think you may have gotten a disease. Many diseases do not show up right away, and some can take weeks or months to develop. Many travelers who get malaria don't have symptoms until they get home.

Other symptoms to watch for after you come back home include:

• Diarrhea that lasts a long time or that keeps coming back.
• A skin rash or sores on the skin.
• Jaundice. (Do the whites of your eyes look yellow?)
• Losing weight without trying, or feeling tired and worn out.

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Last updated:	May 02, 2007
Author:	Monica Rhodes
Reviewed By:	Wajeeh E. Nasser, MD - Family Medicine, W. David Colby, MSc, MD, FRCPC - Infectious Disease
Editors:	Kathleen M. Ariss, MS, Pat Truman