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You're finally on your way. By now, you should have taken all recommended precautions for the area you're visiting. These eight tips are good general advice for anyone who is traveling abroad.
Packing
Be sure to pack all prescription medications and other health-related supplies and documentation in a carry-on bag in case your luggage gets lost or stolen. Carry the medications in their original containers, and keep a copy of the prescription if emergency refills are needed. This may sound like common sense, but keep your destination(s) in mind as you pack. Sunny, warm climates require sun-protective eyewear and clothing (hats, lightweight long-sleeved shirts and pants) and maximum SPF sunblock. If insect-borne diseases such as malaria are common, long sleeves and pants and closed shoes are a must. And don't forget to take your preventive anti-malaria medication as prescribed if recommended for your area of travel and a bug spray containing DEET. For colder climates, be sure to pack sufficiently warm clothing. Consider asking your doctor for prescriptions to fill in case of diarrhea, depending on your area of travel. This may include an antibiotic and a prescription-strength anti-diarrhea agent. Also, bring a first aid kit containing antibiotic cream and sterile bandages.
Air travel
On long international trips, be sure to get up and walk around the cabin every hour or two. This helps prevent the formation of blood clots in the legs, a condition known as deep-vein thrombosis. Squeezing the muscles of your calves and thighs as you sit may also help. You can also try to drink lots of water, avoiding alcohol, don't wear tight clothing, keep your legs uncrossed and use support stockings.
Crossing Time zones and medication schedules
Just as crossing time zones can throw off your sleep patterns, it also can complicate medication schedules. Ask your doctor's advice about dealing with this problem.
Foodborne and water-borne illnesses
Taking precautions when you drink and eat overseas can help guard against traveler's diarrhea and more serious conditions such as cholera, typhoid and hepatitis A. Sanitation standards overseas often aren't as rigorous as they are in the U.S. Some developing countries even use human waste as fertilizer. Thus, the usual advice to "not drink the water" isn't sufficient because foods can be contaminated, too. The following tips should help you guard against illness:
- Canned or bottled carbonated drinks are safest. If you have to drink tap water, make sure it has been boiled or that you filter or purify it yourself using carry-along equipment. Ask questions when you buy filters or purification tablets. They're not foolproof. Bottled water can be risky because you don't know the actual source. When you order bottled water, have the waiter open the sealed bottle at your table rather than accepting an open bottle.
- Do not ingest ice cubes or tap water in any amount. Do not brush your teeth with tap water or drink any water accidentally while showering.
- Avoid street vendors. When eating out, your best choices are well-cooked, very hot entrees; pasteurized dairy products; and fruits you can peel yourself. Avoid pre-prepared salad items, warm or homemade dairy products, seafood and pre-made foods that have been reheated, such as casseroles and lasagna. Roadside stands serving meats should be scrupulously avoided. Raw seafood such as cerviche or sushi should only be consumed in the most stellar of upscale tourist resorts if at all.
Realize that even the most careful travelers can develop diarrhea. If that happens, use the medications and rehydration solutions in your first aid kit and drink plenty of fluids. If your symptoms are severe, seek medical attention immediately in case you have something more serious than traveler's diarrhea, such as cholera or typhoid. Worrisome signs include lightheadedness with standing, fever, severe abdominal cramping, and blood or mucous in the stool.
Seek medical attention
Don't let fear keep you from seeking medical attention overseas if you have symptoms that indicate a possibly severe illness. What you think is the flu or a stomach bug could be something more serious and even life-threatening, such as malaria or cholera. Make sure that your traveler's dictionary contains a section for "In the Hospital."
Traveling by car and bus
Motor vehicle accidents are one of the leading causes of death among international travelers. Always wear your seatbelt, and avoid taxis or buses that seem unsafe or too crowded.
Water safety
If you are visiting an area that has a risk of water-borne infections, avoid swimming or even dipping your feet and hands in freshwater lakes or ponds, which can lead to infection by water-borne parasites. One of the most common examples is schistosomiasis, which occurs when the eggs of the blood fluke Schistosoma penetrate the skin. It is treatable, but it can damage internal organs.
Also, be careful when swimming or boating. Drowning actually causes more fatalities among international travelers than infectious diseases. Be aware of local weather conditions. Winds and currents can change rapidly and swimmers and boaters should watch for dangerous waves and signs of rip currents. A strong current can carry even an expert swimmer far from shore. Be aware of marine life such as biting and stinging fish, corals and jellyfish. If injured in the water be sure to thoroughly clean any wounds as soon as possible. Wear protective gloves and footwear in the water whenever possible.
Avoid insect bites
This is absolutely essential for preventing diseases such as malaria, yellow fever, Japanese encephalitis, dengue fever and leishmaniasis (also called sand fly disease). You should take preventive measures throughout the day to decrease your risk of infection.
The most effective insect repellents contain diethyltoluamide (DEET) as an active ingredient. This is a powerful chemical. So use it sparingly as directed, on all exposed skin (avoiding cuts and sores) and only when outdoors. Do not use full strength preparations on young children and do not use at all on children under 2 months of age. Be sure not to put it on children's hands or around the eyes or mouth. Wash it off when you return indoors, and use a non-DEET repellent such as permethrin for clothes and other surfaces. When outdoors, particularly at night, wear long pants and long sleeves. Protect yourself overnight by draping mosquito netting over your bed, although your need for this may be determined by your accommodations. Enclosed, air-conditioned rooms are generally considered safe.
Don't pet the animals
Many cases of human rabies seen in the United States are acquired abroad. Even animals that seem friendly may bite.
Don't go barefoot
While going barefoot on the beach is usually safe, the same cannot be said for other areas. Parasites can burrow into your skin if you walk barefoot on soil.
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This article was reviewed and updated June 2007.
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