People is travelling a lot nowadays, be it personal or business related. Gone are the times when people used to spend holidays at home or in the country with family. The business frontier has expanded beyond one's country too. You need to be able to pack and travel at a notice.
Brazil is the fourth largest tourist destination for Americans. Did you know that the eastern coast of Brazil is a hotspot for Schistosomiasis, more commonly known as Snail Fever?
Far from alarming you though, the vaccinations procedures are well-respected and infection cases are rare. Falls, accidents like drowning, health problems due to the age of the traveller are more common.
We must ask some questions before traveling with children, : Is the destination suitable for children? Is it really necessary to take them? What are the risks? Under what conditions will the trip occur? The same is true for pregnant women. Some destinations are not recommended because of certain infectious diseases. Preventive treatments are not always recommended; required immunizations are not always indicated for these women. If a person has a chronic disease, more common among the elderly, you should seek advice from their doctor before planning a trip: for example, the choice of a hot country as a travel destination can sometimes be detrimental to a person who suffers from heart disease.
Before Your Travel
You must take these health precautions before traveling to a new country:
- First know the health situation of the country where you intend to go: to know the diseases that exist and those that may emerge at the time of departure. The emergence of SARS in 2004, avian flu since 2005, the extension of chikungunya virus in certain african countries between 2005 and 2006 show how the health profile of a country can change within months.
- You must also learn about the existence or not of malaria. The mode of preventive treatment to prescribe will depend on its resistance to antimalarial drugs. Antimalarial drugs are distributed only on medical prescription. Your doctor who is sure to be informed about the evolution of malaria throughout the world, can advise you and prescribe the best antimalarial drugs.
- Health news across the world is available on various websites such as the Ministry of Health, Ministry of Foreign Affairs, the WHO web site and in all departments of infectious diseases and vaccination centers.
- In addition to compulsory vaccinations (polio, tetanus, diphtheria), mandatory vaccines will differ according to destination. The decision depends on the conditions under which the journey is going, risks taken, length of stay .... Beware! They should not be taken the day before because vaccines have to be made a number of days before departure to be valid, some require a period exceeding 40 days. For children, in addition to mandatory vaccinations, they must be vaccinated against measles, rubella, mumps, BCG at birth, or hepatitis B. Some immunizations are possible only from a certain age.
- Prepare a health kit.
- First aid medicines: anti-diarrheal drugs against pain and fever, or antibiotics.
- ORS (Oral Rehydration sachets) for the little ones in case of severe diarrhea.
- Antimalarial drugs adapted to malaria in the country of destination with sufficient drugs to treat an existing disease. (To take with you on the plane in case your suitcase is lost.)
- Condoms. (For men as well as women.) Trivia: Store condom in a cool, dry place to maintain quality. Wallet not recommended.
- Kits for small skin wounds: antiseptic, sterile pads, tweezers, ...Sun creams, mosquito repellent, eye drops (for hot and dry countries)
- Products to sterilize water
- Hydro-alcoholic solution to wash your hands if there is no water and soap.
- And of course the drugs needed for chronic illness.
Other precautions to take:
- Bring a mosquito net impregnated with repellent product if diseases carried by mosquitoes are present in the country of destination (generally all tropical countries).
- If a person has a chronic illness, it is reasonable to ask his doctor a written summary of health status and treatment in progress, written in the language of the country of destination or at least in English. It is necessary to take the necessary medicines for the entire stay, even more ifn case there are delays on the return journey. You should take them with you on the plane and not leave them in your suitcase. Sometimes the suitcases may stay at the airport for days.
- It is essential to have a repatriation assistance.
- Know the conditions of hospitalization, clinics or hospitals.
- Keep important telephone numbers which may be required on site with you: health centers, emergency services, a few physicians if necessary.
- Rules of basic hygiene are observed in both developing countries and other countries, but to avoid possible food-borne infections and the occurrence of diarrhea:
- Wash your hands frequently with soap and water especially before eating, after using the toilet. If there is a water shortage, use your hydro-alcoholic solution.
- Consume only bottled water which has been opened in front of you or boiled water or wated disinfected by tablets.
- Trivia: Hot water faucets are marked with a 'C' in some countries. This is because in Spain the word for hot is caliente, in France hot is chaud, and in Italy you say caldo when you mean hot.
- Do not eat fruits and vegetables with skin. Peel them before eating.
- Avoid dairy products and milk unless it is sterilized, pasteurized and boiled.
- Avoid eating shellfish and raw fish.
- Sexually transmitted diseases are everywhere. Some, such as AIDS are serious. Papillomavirus infection may develop into cancer of the cervix. Herpes is a mild illness except in newborns and in people in frail health. Syphilis still exists ... Whatever they are, they are contagious, infectious diseases, transmitted through sexual contact. The only effective, preventive measure is to use condoms (Maybe abstinence for some!).
- You should know that sexually transmitted diseases are not always visible and there are healthy carriers, ie persons who are not ill but carry within them the infective agent and can contaminate their (s) partner (s) without knowing it.
- Take your antimalarial treatment according to medical prescription. Do not forget that.
- Avoid insect bites (flies, mosquitoes, ticks, ...) and stings (scorpions, snakes, ...):
- Wear loose, covering clothing, in hot countries especially those in which mosquitoes transmit infectious diseases.
- Do not hesitate to use extensively the repellents against mosquitoes. regularly put on open areas. Set mosquito nets at night, to block all entry points for mosquitoes.
- Use shoes for walking, not only to avoid twisting ankles but also to avoid insect bites, animal bites. They are indispensable in muddy and wet terrains.
- Do not walk barefoot on the beaches or lie on the sand, particularly if there are stray dogs around.
- Shake before putting on clothes or shoes that have been lying on the ground. Return the sleeping bags before getting inside.
- Avoid contact with animals: birds in this period of avian influenza. Dogs and cats can transmit serious diseases such as rabies.
- Avoid swimming in fresh water. Ask if it safe before swimming in the sea.
- The risk of road accidents are everywhere but some countries are less respectful of the traffic regulations and rules. Cars are sometimes very old without any seatbelts.
After Your Stay
- It is essential to continue antimalarial treatment in the time frame provided by the physician even if you return home early.
- If a fever appears in the weeks following your return from a malaria-affected countries, see a doctor. Any unexplained fever in this context is considered as malarial fever and a blood test should be done to diagnose and treat without delay.
- If diarrhea appears and does not stop, especially if it is accompanied by fever or if it is bloody, you must also consult a doctor.
Travel is synonymous with vacation for most of us. Some basic rules are important to follow to ensure that pleasure does not turn into a nightmare: learn about the health conditions of the place of destination, weigh the pros and cons to traveling with children. Pregnant women and people with a chronic disease must also consider the potential health risks. Prepare a pharmacy kit. On site, avoid tap water and raw foods. Take regular medication for malaria if malaria is a threat. Using repellents and a mosquito ne to avoid mosquito bites. Wear covered clothing and footwear. Do not swim in fresh water. On return, continue antimalarial and consult a doctor if something is wrong.
References and Further Reading:
World Tourism Organization (2008). "UNWTO World Tourism Barometer June 2008". UNWTO. Retrieved on 2008-08-08. Data corresponds to 2007.
Travel Health Traveler's Health - CDC
International Travel and Health - WHO
Schistosomiasis, countries or areas at risk 2007