Six to Eight Weeks Ahead

Now that you've done some preliminary research, it's time to take action. You should schedule an appointment with your primary care doctor. Or, depending on your destination, you may want to consider a doctor who practices what's known as "travel medicine." These doctors typically can be found through travel medicine clinics, which specialize in helping travelers take proper health precautions based on their itineraries. Ask your doctor for recommendations or check out the resources below.

Finding a travel medicine physician or clinic

Travel medicine clinics specialize in providing pre- and post-travel medical services and consultations. Because this is their specialty, they are likely to know more about regional risks than a family doctor. They also have access to current information about vaccination requirements and the necessary forms.

• The Centers for Disease Control and Prevention Travelers' Health: Yellow Book is a great source of information for all your travel questions.

• American Society of Tropical Medicine and Hygiene in Northbrook, Ill. offers a list of doctors who provide consultations and clinical services related to tropical medicine.

Schedule a complete dental checkup just to make sure that any problems are taken care of before you go.

Now's also the time to investigate whether or not your health insurance plan would cover emergency medical care in a foreign country.

Your pre-travel doctor's appointment checklist

Whether you see your regular doctor or a travel medicine specialist, there are several things you should accomplish.

• Review your itinerary. Discuss your travel plans thoroughly, including destinations, means of travel, planned activities, accommodations, length of stay and any health concerns they may raise either because of risks in the area you're visiting or your own health situation (or both). Be prepared to review your health history, including vaccination records, allergies, medications, and present and past medical conditions.

• Complete required paperwork. If the countries you're visiting require any vaccinations, get them done and have your doctor complete the certification papers you'll carry. For example, a yellow fever vaccination is required for entry into most countries of sub-Saharan Africa and South America.

• Ask about recommended vaccinations or preventive treatments. Ask the doctor about getting vaccinated against diseases that may be prevalent at your destination, such as hepatitis A (the most common vaccine-preventable disease acquired by overseas travelers). The decision whether or not to vaccinate is made on a case-by-case basis. If malaria is a risk, you should be prescribed a regimen of anti-malarial drugs to take before and during the trip. Also, you may need to update certain childhood immunizations you've already had, such as diphtheria, tetanus, polio or measles, or get an influenza shot. Finally, ask about medications you can take if you develop travelers' diarrhea; some doctors supply antibiotics in advance.

• Make sure medications are in order. Request refills now so that you will have a more-than-adequate supply for your trip. Find out the generic and foreign trade names of medications available in the Merck Index, which your doctor should have access to. Bring prescriptions with you in case there's a need for an emergency refill overseas. If you'll be carrying a large amount of drugs or any controlled substance, federal authorities recommend you have a letter from the doctor explaining why and how the drugs are used. Make sure you carry your medicines in properly labeled bottles from the pharmacy and not mixed together in one container. And if you need any other medical supplies, now's the time to stock up for your trip. Persons with diabetes or hemophilia and others who require routine or frequent injections should travel with a supply of syringes, needles and disinfectant wipes that last their entire stay abroad. There is no way to make sure that supplies in other countries are sterile. Carry your medications on the flight in case your luggage is lost. Check with airlines early for any special arrangements that may need to be made.

• Complete a brief health history with the doctor's help. Carry it with your passport and other important documents. The International Association for Medical Assistance to Travelers offers a useful passport-size record including sections for emergency medical data, an immunization record, information about preexisting medical conditions and allergies, and your doctor's name and phone number. A medical alert bracelet that indicates you have diabetes, a pacemaker or other conditions are not just useful in the United States but also abroad.

Dealing with health insurance issues

You never know when you might need emergency medical care overseas. It's a good idea to find out whether your current health insurance plan would cover these services or even pay for you to travel to the nearest American-run facility. Review the policy carefully, and call the insurance company to clarify if there's any uncertainty. Be sure to get their response in writing.

If your coverage is inadequate, you might consider purchasing travel health insurance. A number of companies offer short- and long-term policies for international travelers. Some of these plans give you access to a 24-hour multilingual helpline, a network of physicians and even emergency evacuation services. Your needs really depend on the length and the nature of your trip.

Related Articles Two to Four Weeks Ahead Eight Ways to Stay Healthy While Traveling Upon Returning Home Dealing With Jet Lag Healthy International Travel Two to Three Months Ahead (or as Soon as You Know Your International Destination)

External Sources The International Society of Travel Medicine American Society of Tropical Medicine and Hygiene, Northbrook, IL The International Association for Medical Assistance to Travelers The Centers for Disease Control and Prevention

This article was reviewed and updated June 2007.

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