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Travel Tips: Health & First Aid

In most destinations, the major health risk is nausea and diarrhea, which may just as easily be caused by stress and changes in diet as by actual contamination of your food or water. In general, common sense prevails. Get plenty of rest, eat balanced meals, and don't stay in the sun too long. Stay away from ice, uncooked food, and unpasteurized milk and milk products and drink only bottled water or water that has been boiled for at least 20 minutes.

If you begin to feel ill, drink plenty of purified water or tea -- chamomile is a good folk remedy. Mild cases of intestinal upset may respond to Imodium (known generically as loperamide) or Pepto-Bismol (not as strong), both of which can be purchased over the counter; paregoric, another antidiarrheal agent sometimes requires a doctor's prescription. In severe cases, rehydrate yourself with a salt-sugar solution (half-teaspoon salt and 4 tablespoons sugar per quart of water).

The following suggestions apply generally to travelers planning to visit less-developed regions. Check with the U.S. Government's National Centers for Disease Control (CDC) International Travelers website or the hotline at 877-FYI-TRIP for region-specific recommendations on disease risks and immunization. For news on current outbreaks of infectious diseases, ask your physician and check with your state or local department of health.

Tetanus-diphtheria and polio vaccinations should be up- to-date. If you haven't been immunized since childhood, consider bolstering your tetanus vaccination. You should also be immunized against (or immune to) measles, mumps, and rubella.

In areas where malaria and dengue fever, both of which are carried by mosquitoes, are prevalent, use mosquito nets, wear clothing that covers the body, apply repellent containing DEET, and use spray for flying insects in living and sleeping areas. Be especially vigilant at dusk and at night, when mosquitoes are most active.

Also consider taking anti-malarial pills. Depending on your specific itinerary, your personal medical condition and history, and the presence of drug-resistant strains of malaria, the CDC recommends mefloquine (Larium), doxycycline, or chloroquine (Analen) as an anti malarial agent. No vaccine exists against dengue, so if it is in the area, travelers should use aerosol insecticides indoors as well as repellents against the mosquito.

If you plan to visit rural areas, where there's questionable sanitation, you might want to get an immune-serum globulin vaccination as protection against Hepatitis A. If you are staying for longer than three weeks and traveling into rural areas, anti malaria pills and a typhoid vaccination may be recommended. If staying for a month or more, you should consider vaccinations against rabies and Japanese encephalitis; for six months or more, against hepatitis B as well.

Do not be afraid to call the hotel doctor. Many overseas doctors are trained in the US or Europe and are up-to-date on illnesses in their local areas, including malaria. If you feel uncomfortable wit h the local doctor, find another.

There's nothing more miserable than getting sick while you're away from home. Some simple precautions -- from watching what you eat to having the appropriate immunizations -- can make your travels healthier and happier.

Resources

The Pocket Doctor: A Passport To Healthy Travel, by Stephen Bezruchka, M.D. pub: The Mountaineers 2000.

Medicine Planet Country-specific health information, email alerts, news, and health related articles for travelers.

Travel Health Online Get general info on staying healthy while traveling, or check out individual country profiles to get a sense of health concerns for that destination.

CDC National Center for Infectious Disease: Travelers' Health CDC's webite for Travel Health topics, news, contact information, and more.

Water Purification

If you're not certain your water source is safe, it's best to drink bottled water. If you are not able to carry enough water for your needs, for example, hiking into a wilderness area, you will have to purify water for drinking. Do this no matter how crystal clear the water looks.

The easiest way to purify water is to add a water-purification tablet to it. The most widely used brand is Potable Aqua; 50 tablets are good for 50 quarts of water. However, iodine tablets of this sort can build up in the body and are not recommended for long-term trips; a better option is to filter your water through a water-purification pump, available at camping equipment stores. Boiling water is the least favorite method since it takes time and uses fuel, but, if it is the only method available to you, use it; bring the water to a boil for at least 10 minutes, longer at high altitudes.

Resources

Water Filters and Giardia: DistilledWisdom. For a complete discussion of Giardia, tiny water-borne organisms that can turn your stomach inside out, and of various purification methods, see this low-tech but informative site.

First Aid Kit Suggestions

A first-aid kit may add nothing to your trip but extra bulk. However, in an emergency you'll be glad to have even the most basic medical supplies. Prepackaged kits are available, but you can pack your own from the following list:

• a first-aid manual
• aspirin
• antiseptic
• antibacterial ointment
• antihistamines
• cortisone cream
• an antacid such as Alka-Seltzer
• something for diarrhea (Pepto-Bismol or Imodium)
• insect repellent
• Calamine lotion
• sunscreen
• adhesive bandages
• butterfly bandages
• sterile gauze pads (2" x 2" and 4" x 4")
• 1"-wide waterproof adhesive tape
• an elastic bandage
• moleskin for blisters
• a thermometer in a sturdy case
• razor blades (remember to pack these and the next items listed in your checked luggage-not your carry-on bag!)
• tweezers
• a needle
• scissors

Resources

Active First Aid Online This Australia-based site is a comprehensive guide to treating all sorts of injuries, from broken bones to animal bites. Print it out and take it along on your next adventure!

Depending on the health conditions in your destination, you might also ask a doctor for a general antibiotic. If you're prone to motion sickness or are planning to use particularly rough modes of transportation in your travels, take along some Dramamine. Women: If you're prone to yeast infections, over-the-counter medications, such as Monistat or Gynelotrimin, can save you grief on the road.

Medical-Assistance Companies

No one plans to get sick while traveling, but it happens, so consider signing up with a medical-assistance company. Members get doctor referrals, emergency evacuation or repatriation, 24-hour telephone hot lines for medical consultation, cash for emergencies, and other personal and legal assistance. Coverage varies by plan, so review the benefits of each carefully.

Resources

International SOS Assistance Emergency evacuation services and referrals for people traveling more than 100 miles from home.

Health Warnings

CDC Travel Information This invaluable government site tells travelers of possible health risks in foreign countries, as well as necessary inoculations, prophylactics, and treatments. An excellent and up-to-date resource.

Health Canada Information for Travellers Health warnings and travel-health advice from the Canadian government.

Animal & Snake Bites

Some animals, especially rodents, carry dangerous diseases. If you are bitten by a wild animal, it's important to see a doctor as soon as possible. Many animal bites require a tetanus shot and, if the animal could be rabid, a rabies shot.

Snakes will do everything to avoid you, but in the event you have a run-in and are bitten, it's necessary to act quickly. If it's a harmless snake, ordinary first aid for puncture wounds should be given. If it is poisonous, the victim should remain as still as possible so as not to spread the venom through the body. He or she should lie down, keeping the wound area below the rest of the body, and another person should seek medical help immediately.

Bite Resources

First Aid for Snake Bite The Brazos River Rattlesnake Ranch offers step-by-step emergency instructions.

Lyme Disease

This potentially debilitating illness is caused by a virus carried by deer ticks, which thrive in dry, brush-covered areas. When walking in woods, brush, or through fields in areas where ticks may be found, wear tick repellent and long pants tucked into socks. When you undress, search your body for deer ticks -- which are no bigger than a pencil point -- and remove them with tweezers and rubbing alcohol. Watch the area for several weeks. Some people develop a bull's-eye-like rash or flu like symptoms; if this happens, see your physician immediately. Lyme disease can be treated with antibiotics if caught early enough.

Resources

Lyme Disease & Related Disorders See some lovely illustrations of the deer tick and the tick-removal process.

Plant Poisons

If you touch poison ivy, poison oak, or poison sumac, wash the area immediately with brown soap if available, or soap and water. A variety of ointments, such as Calamine lotion and cortisone cream, may relieve itching.

Resources

Poison Plants The American Academy of Dermatologists has produced a useful primer that includes pictures of the dangerous weeds, gruesome photos of plant-poison sufferers, and prevention and treatment tips.