Common Travel Health Issues and How to Beat Them

Individuals planning international travel should visit their health care provider and a specialized travel vaccine clinic. The visit provides an opportunity to discuss the specific details of travel. This information is necessary to formulate personalized travel-related medical advice:

• Duration of travel.

• Season of travel.

• Countries and regions that will be visited.

• Planned activities during travel.

• Place of residence during travel (for example, a modern hotel, rural home, or hutment).

There’s a tool available through Massachusetts General Hospital that lets you enter your age and where you plan to travel. It also provides tips including a checklist of things to do before, during, and after your travel. The information is based on recommendations from the Centers for Disease Control and Prevention (CDC).

Travel-Related Medical Advice:

Once a clinician has assessed your travel plans and overall health, he or she can provide information about the health risks that could be encountered and give advice for minimizing these risks.

Vaccines — Vaccines recommended for travel.

Food and water precautions — Several infections can be acquired by ingesting contaminated food and water, including infectious diarrhea (travelers’ diarrhea), hepatitis A, typhoid fever, and, less commonly, trichinellosis.

In areas where sanitation and personal hygiene are poor, food and water precautions are essential for reducing the risk of these infections. These precautions will be most effective when they’re used on a daily basis.

Tap water that looks safe to drink can carry infection-causing organisms, but boiling the water for three minutes, followed by cooling, can kill these organisms. Alternatively, a number of filtration devices or chemical disinfection agents (e.g., iodine or chlorine tablets) can be used.

Travelers can reduce the risk of infection by using the following precautions:

• Don’t drink or brush your teeth with unboiled tap water.

• Don’t drink beverages that contain ice made from unboiled tap water.

• Drink only boiled tap water, drinks made from boiled tap water, carbonated beverages, beer, and wine.

• Be cautious of locally bottled water, because safety and bottling conditions might not be reliable. Other drinks are presumably safer.

Food can also contain infection-causing organisms. Reduce the risk of infection by following several food precautions:

• Don’t eat unpeeled fruit. Peel any fruit yourself before eating it.

• Don’t eat raw vegetables.

• Don’t consume or drink unpasteurized (“raw”) dairy products.

• Don’t eat raw or rare meat, fish, or shellfish (including ceviche).

Insect and tick bites — In certain areas of the world, insects (mosquitoes, sandflies, fleas, bugs, and lice) and arthropods (ticks and mites) can transmit a number of potentially serious infections, including malaria.

Before you leave, you should buy insect repellents to bring with you. The best ones are DEET, permethrin, and picaridin; sporting and camping goods stores frequently sell these products.

You can lower your risk of infection by following these precautions every day while you’re traveling:

• Whenever possible, avoid insect- and tick-infested areas.

• Wear protective clothing, including long-sleeved shirts and pants; if you can, treat your clothing with permethrin.

• Use insect and tick repellents that contain DEET or picaridin.

• Use mosquito netting over your bed; treat the netting with permethrin.

• Check your skin regularly and remove any insects or ticks promptly.

• Whenever possible, minimize time spent outside after dark.

Malaria prevention — Malaria is a serious infection that’s spread by the bite of an infected mosquito. The above suggestions can reduce the risk of being bitten. Anti-malaria medicines are also recommended for people who travel to certain areas. These medicines should be taken exactly as specified, starting before traveling to affected areas and continuing for up to four weeks after returning. The dosage and schedule depend upon which antimalarial drug is used.

Infection-causing organisms — Open water, soil, and sand can harbor infection-causing organisms in some areas of the world.

In countries where schistosomiasis (a water-borne parasitic infection) is common, travelers should avoid swimming in fresh water. Even brief exposure to infested water (for example, during rafting) can result in infection. In contrast, swimming in salt water or chlorinated water in these countries is safe.

When you’re traveling, do not walk barefoot on soil or sand that could be contaminated with animal or human feces. This can lead to hookworm or strongyloidiasis infections (worms that can enter the skin and cause itching, stomach symptoms, and other problems).

Sexually transmitted diseases — Studies of travelers’ behavior indicate that many people are more sexually active during travel. The hepatitis B virus and the human immunodeficiency virus (HIV; the virus that causes acquired immunodeficiency syndrome (AIDS)) as well as more common infections such as gonorrhea, chlamydia, and syphilis are all transmitted by sexual contact and are often more prevalent in resource-limited countries.

Avoiding sexual contact eliminates the risk of acquiring a sexually transmitted disease during travel. Use of barrier methods, such as a latex condom or diaphragm, reduces the risk of disease transmission, although they don’t eliminate the risk.

Personal medications — Medications available in the United States may not be available in other countries. Thus, travelers who must take medicines regularly should bring enough with them for the duration of their travel. Medicines should be taken on the airplane in a bag or other carry-on bag, rather than packed in luggage, to avoid loss or theft. Travelers who require syringes to administer medicines should carry those syringes along with a letter from a health care provider establishing a medical need for them.

Avoiding accidents — Accidents, especially motor vehicle accidents, account for about 25 percent of deaths in American travelers. The risk of accidents, injury, and death may be reduced by taking several precautions:

• Avoid driving at night, which can minimize exposure to alcohol-impaired drivers.

• Familiarize yourself with the local driving conditions.

• Wear a seat belt at all times.

• Avoid drinking alcoholic beverages and driving.

• If using motorized cycles, wear helmets and be especially cautious.

Tuberculosis testing — Travelers who are planning travel to regions where tuberculosis (TB) is common may be advised to have a test for tuberculosis before and after their travel.

Anyone who is exposed to or becomes infected with tuberculosis will require treatment if testing is positive. The risk is higher for traveling health care workers compared with other types of travelers. The risk of tuberculosis exposure may be reduced by avoiding close contact with people who are coughing or sneezing, although this isn’t always possible.

Transportation Advice:

Travel-related health problems can be related to the type of transportation used during travel.

Ships — The United States Centers for Disease Control and Prevention (CDC) inspects all cruise vessels that dock at ports in the United States. This ensures that vessels meet strict sanitation guidelines. Information about the past record of a specific cruise ship can be obtained from travel agents or state health departments.

Air travel — Air travel can be associated with several problems.

• Lower-oxygen environment — Aircraft that fly at low altitude may not pressurize the cabin. Jet aircraft that fly at higher altitude pressurize the cabin, although the pressure is lower than that on the ground. Under both conditions, the air in the cabin contains less oxygen than the air on the ground, which reduces the amount of oxygen in the blood.

  Exposure to a lower-oxygen environment can lead to problems in people with certain medical conditions, including chronic obstructive pulmonary disease (COPD) and some heart conditions. A patient may feel short of breath, which could require the use of supplemental oxygen.

  A lower-oxygen environment can also be a problem for people who suffer a heart attack while abroad. Such individuals can generally make a return flight home two to three weeks after the heart attack, as long as a health care provider accompanies them.

• Ear and sinus symptoms — The change in air pressure during flight may cause ear and sinus symptoms, especially for travelers with upper respiratory tract infections. These symptoms may include difficulty hearing and pain in the ears or sinuses. In most individuals, the symptoms can be prevented by taking an oral (pseudoephedrine) or nasal (oxymetazoline) spray, decongestants, or antihistamines (diphenhydramine).

• Blood clots — Sitting for prolonged periods during air travel causes blood to pool in the legs, which can increase the risk of forming blood clots in the legs, especially in individuals who have clotting or vascular diseases. People with these conditions may be advised to take certain medicines, to stretch regularly, and to wear compression socks during long flights to reduce the risk of blood clots.

  All travelers should consider the following recommendations for flights longer than six to eight hours.

• Motion sickness — Individuals who suffer from motion sickness can take medicine before a flight (or before sailing if on a cruise ship) to help prevent this condition. Over-the-counter medicines work for most individuals; a clinician can recommend a prescription-strength medicine if needed.

• Jet lag — Travelers who cross several time zones may experience jet lag. In general, it takes longer to recover from jet lag after flying west to east than east to west. Adult travelers crossing five or more time zones are likely to benefit from melatonin, especially if they’ve experienced jet lag on previous trips. It’s also reasonable for people making such a trip for the first time to take melatonin, if jet lag might seriously interfere with work or rest activities at their destination. Travelers crossing two to four time zones may also try melatonin.

  The recommended dose of melatonin is 2 or 3 mg about 30 minutes before bedtime on the day of travel and for up to four days after arrival; a dose of 0.5 mg has less effect on sleep but can help the person adapt to the new time zone. A test dose taken at home before travel may help determine which dose is most appropriate. Alcohol should be avoided with melatonin.

Traveling with Medical Conditions:

Extra travel considerations are necessary for pregnant women, people with human immunodeficiency virus (HIV) infection, and people with diabetes.

• Pregnant women — Most women can travel safely during pregnancy, although the type of travel and possible health hazards must be considered on an individual basis. Air travel doesn’t have any known negative effects on a pregnant woman or the baby. Women who have had complicated pregnancies in the past (premature delivery, late-term complications, high blood pressure, or other issues) should avoid extensive travel during their current pregnancy. In addition, pregnant women should be sure to follow precautions to avoid blood clots since pregnancy increases the risk of clotting.

• HIV infection — Human immunodeficiency virus infection can pose several problems during travel.

  • People with HIV may not be allowed to enter some countries; check with consular services when planning international travel.

  • People with HIV should try to locate adequate medical facilities in the planned destinations.

  • People with HIV may not be able to receive certain travel immunizations. HIV-infected travelers should carry all necessary medicines with them.

• Diabetes — Travelers with diabetes who take insulin should seek expert advice on modifying timing of insulin doses if traveling across multiple time zones.

  Syringes, blood glucose testing supplies, insulin and glucagon or oral medicines, and snacks should be packed in a carry-on bag and available at all times. People who require syringes should carry a note from their health care provider, explaining the need for diabetes-related supplies. In addition, the person should wear a bracelet or necklace that lists their medical condition and a phone number for emergency contact information.

Special Activities and Recommendations:

A few activities have specific recommendations to ensure the safety of the traveler during and after the activity.

• Scuba diving — Individuals who scuba dive while traveling should wait 12 to 48 hours (depending on the length of dives) before boarding a jet airplane. This measure is important for avoiding decompression sickness (also called “the bends”).

• High-altitude exposure — Individuals who will be traveling to mountainous or other high-altitude regions should talk with their health care provider about preventing and treating high-altitude illnesses. These include mountain sickness, high-altitude pulmonary edema, and high-altitude cerebral edema.

• Wilderness travel — Individuals who plan travel to remote areas that lack medical facilities should discuss preventative measures with their clinician, especially if they will be exposed to extreme climates or physical stress (for example, mountain climbing or long-distance bike tours).

📞 To book an appointment just call us on 0161 213 0394 or book online.

adminvaccine