Summer is a popular time to skip town and venture into exotic locations -- something more people are doing than ever before. Mercy travel medicine doctor, John H. Brown, M.D., MHA, has the following advice.
Location Matters
“More people want an adventure and not just a touristy spot, so the first thing you’ll want to do is talk with your primary care physician to see if there’s any need for vaccinations. And do it early. Some of the vaccinations you may need to be fully protected can take up to two weeks to really reach maximum immunity. If you’re going to travel way off the beaten path and be exposed to animals that can carry rabies, you’ll need a rabies vaccination prior to travel. For example, if you’re going on a once-in-a-lifetime event like a safari or caving, you’ll be at high risk. That vaccine is three doses and can take up to four weeks to complete the series.”
More information on handling animals, from the CDC
“I prepare a lot of people going to Africa and Asia from the Midwest. If someone is going to Africa, depending on the country and risk, they need to consider the Yellow Fever, meningitis, typhoid and hepatitis A vaccines. Those are probably the most commonly needed vaccines for Africa, beyond the routine vaccinations with tetanus and MMR, flu vaccines and so forth.” In South America, many of the countries are endemic for Yellow Fever. “The vaccine is a requirement to enter several countries.” If you’re going to a lower-risk country like Cancun, Cozumel or a resort, you’ll likely need less preparation. “The same goes for the typical Caribbean cruise patient. That’s not to say there isn’t value is assessing risk, especially if you’re already on medications for chronic illnesses.”
Food and Water Precautions
“Even if someone has failed to get the vaccines they need for a country where there are disease risks, they may be okay if they practice good food and water procedures. Make sure water is filtered or bottled. As far as food, make sure it’s well cooked and not bloody or pink in the middle. Overseas, you want to make sure everything is well cooked. In terms of fruits and vegetables, the things we’d normally rinse or wash off with tap water could expose you to different illnesses that are carried in the water. As a general rule, I tell folks that are traveling overseas to avoid salads, fruits and berries that are rinsed off under water. If it’s cooked or you can peel it, it’s okay – like a banana or an orange, for instance. I wouldn’t grab a bunch of grapes and start eating them unless you can rinse them off in treated water. That’s usually iodine treated water.”
Click here for more food and water safety tips from the CDC
Insect Precautions
“That includes bug spray and mosquito spray, usually. Most of the time I’m recommending bug spray that contains DEET; 30-35 percent is the appropriate concentration. You’ll see some sprays that are 100 percent DEET, but that’s not necessary. They think they’re getting more protection, but they’re really getting more chemical. There’s no advantage to anything more than 30-35 percent. It’s just more irritating to the skin. And you’ll want to apply mosquito repellant twice daily – at dusk and dawn. One of the most effective things to do is pre-treat clothing with permerthrin spray. It’s not something you use acutely. You pre-treat your clothing or mosquito netting with it and let it dry. Once it dries, there is no smell or oil to it and it stays in the fabric for up to six months, even with washing of clothes. It can help with fly bites and ticks.
Click here for more from the CDC on avoiding bug bites
Safety and Security Precautions
“This varies based on where you’re going, but the number one killer of travelers abroad from U.S. is accidents – including auto accidents. Everybody thinks of illnesses and so forth, but really accidents are number one. You need to be very careful about street signs. Understand the languages and if you rent a car, the transportation is often not nearly to the same standard as it is here. So, mass transit may also not be as safe. Also, road conditions may be significantly diminished based on rainy season and things going on.”
