STAYING HEALTHY ON THE ROAD
Stay healthy by being proactive: before, during and after a trip.
by Family Practitioner and medical consultant, Dr. Steven Levinson
I was born somewhere between Mozart and Madonna, and not only have I changed a lot, but so has travel. Global tourism has been very kind to viruses, bacteria and parasites. They may not get to collect air miles, but they do love to travel. Remember, the Boy Scouts got it right; the secret to healthy traveling is to be prepared for everything from Creeping Eruption to Traveller’s Diarrhea. Here are a few tips:
BEFORE YOU GO
• Consult one or more of the many travel and health websites that offer safety tips for travel. Examples are:
Centers for Disease Control and Prevention
www.cdc.gov
International Society of Travel Medicine
www.istm.org
WHO (World Health Organization)
http://www.who.int/ith
The Travel Clinic
www.drwisetravel.com
Have a peek at the following short interview with my pal Dr. Jay Keystone, from the University of Toronto. Jay is not only brilliant but very, very funny. http://www-hsd.worldbank.org/symposium/428-2-keystone.htm
• Consult a Travel Clinic in your area (ask your doctor) and make an appointment, if possible, several months before you leave, as full protection against some illnesses can take time. Don’t be afraid; dangerous reactions to shots are rare, especially if compared to the mortality rates of the diseases being prevented. Besides the “usual” vaccines (such as Hepatitis A and B, Typhoid, Tetanus, etc.) consider getting the Flu shot, Chickenpox Vaccine (if susceptible) and Pneumonia Vaccine for those over the age of sixty-feve.
• Call IAMAT, the International Association for Medical Assistance to Travelers (http://www.iamat.org/). This wonderful association has been serving travellers for 45 years, and provides you with a list of English-speaking physicians in every corner of the world.
• Make sure you have enough medications to last you, and that they are in their original prescription bottles. If you are carrying narcotics or other controlled drugs, ask your doctor for a note verifying that you have been prescribed these medications.
• Children have unique problems when travelling. Your Travel Clinic, GP, or Paediatrician should be able to give you advice.
• If you are going to certain countries (such as Southeast Asia, Africa, and the Eastern Mediterranean,) carry your own needles and syringes. Surprisingly, unsterilized needles are still being used in many parts of the world. Again carry a note verifying that these have been legitimately supplied.
• Consult your Dentist and Ophthalmologist/Optometrist before you leave, and carry spare glasses/sunglasses.
• Make sure your travel insurance is adequate for your needs.
• If you are going to a high-altitude area, consult your doctor first, especially if you have heart or lung disease.
• Carry a First-Aid Kit and a kit against Traveller’s Diarrhea. The latter kit could contain Imodium (an antidiarrheal), a three-day supply of antibiotics and an electrolyte replacement drink such as Gastrolyte. Preventive antibiotics include Ciprofloxacin, Levofloxacin, or Azithromycin available by perscription.
ON YOUR TRIP
• On the airline, follow the tips elsewhere on this site for avoiding jetlag. Do not drink a lot of alcohol, but do drink a lot of water. On long flights, walk around frequently to avoid blood clots.
• Sedatives or decongestants for flights can take an hour to “kick in.” Avoid alcohol if you are taking these medications.
• Naturally, avoid tap water, peeled fruits, vegetables, and ice cubes. Do not eat from street stands. (97% of travellers will ingest contaminated food or water within 72 hours of arrival!)
• If you have sex )with someone you meet during the trip), use a condom! Sex without a condom can expose you to Hepatitis B or HIV.
• The most common causes of death in travelers involve accidents and injuries, primarily road accidents and drownings. Cardiac deaths are more frequent in the elderly. Avoid overcrowded buses, ferries and motorbikes, and never travel by road in rural areas after dark.
• Do not swim in fresh water and don’t walk around in bare feet.
• Many infectious diseases are spread by mosquitoes and ticks… Use repellents and remember that they can wear off quickly. Also, don’t forget sunscreen protection…SPF 15 or higher.
FOLLOWING THE TRIP
• Report to your doctor if you have persistent diarrhea, a rash, swollen glands, genital sores, or any other unusual symptoms when you return. If you have a fever, even weeks after a trip, see your doctor right away. Common infections (which may include “ordinary” diseases) include: Malaria, Influenza, Respiratory Diseases, Urinary Infections, Dengue Fever, Typhoid, Hepatitis, and many other hard-to-pronounce conditions.
• After visiting some countries, it might be a good idea to test for parasites, malaria and, if applicable, Hepatitis B and HIV, even if you have no symptoms. Remember that if you picked up one of the approximately 25 transmissible sexual diseases, you may infect your usual sexual partner when you return home. Believe me, your partner would rather get a postcard!
• Finally, remember the words of Dr. David Smith, who advises, when on vacation:
• Don’t get bit
• Don’t get hit
• Don’t get lit
• Don’t do “it”
• Don’t eat s_ _ _ ! (Hmmmmmm. I wonder if he means strawberries?)
Ontario-based Dr. Steven Levinson has been practising family medicine for 35 years. Currently he has a family practise in Port Hope, Ontario, is Medical Direct of the Rosedale Wellness Centre in Toronto, and is a medical consultant to a number of private organizations. He is also available as an advisor in the areas of medical education, corporate wellness and public relations. Contact at slevinson@rosedalewellness.com
