Vacation Safety

By Diane M. Yoakam, R.N., M.S.N., C.E.N., HealthAtoZ contributing writer

Vacation time is usually a period when we want to relax and let our guard down. But we really need to become more vigilant, as we encounter unfamiliar settings.

Safety tips to consider when planning your vacation

What first aid supplies do I need to take with me on vacation?

• Various size bandages and an antiseptic lotion or ointment
• Alcohol-based hand wash
• A commercially available first aid kit may be handy
• Tweezers (to remove splinters)
• Tylenol® and ibuprofen for pain relief (both adult and children's preparations)
• Cold pack or ice bag for treating bruises and sprains
• Thermometer (for taking children's temperatures)
• Antihistamine like Benadryl® (in case of allergic reaction)
• Nasal decongestants (especially when traveling by air)
• Insect repellent
• Suntan lotion (SPF of 15 to 30 is recommended)
• Hydrocortisone cream or lotion (for insect or bug bites)
• Phone numbers of pediatrician and family doctors
• Any prescription medications you are taking (bring original bottles or record exact names and dosages of each drug)
• Pepto Bismol® or other antidiarrheal agent
• Prescription medication if recommended by your doctor for traveler's diarrhea
• Antacids

How will I know if I will require special immunizations for travel?

No special shots are required to enter or leave the United States. But other countries may require certain immunizations before you enter. Requirements change from time to time but you can obtain the latest information by contacting the Public Health Service (listed under United States Government: Health and Human Services). Information also is available at the CDC Web site. You may also want to consult a travel medicine specialist in your area.

If you do need immunizations to cross borders, the shots must be recorded on an approved form. These International Certificates of Vaccinations are available at passport offices and public health centers. If you travel to developing countries, protection against typhoid, cholera or yellow fever may be advised. You may come into contact with malaria if you travel to tropical regions, especially in remote areas. Your doctor may recommend taking preventative drugs as a precaution, even if immunizations are not mandatory.

Will my health insurance give me enough coverage during my vacation?

Talk to your health insurance administrator before you leave to find out if you:

• Will need to pay out of pocket for health care expenses
• Will be reimbursed upon your return
• Can authorize direct payment to the doctor or hospital and leave forms with them. Either way, be sure to get itemized statements describing your treatment, illness, medications and costs. This will come in handy later on if there are disputes or questions regarding the care that you received.

If you find that your health insurance is inadequate (especially if you are leaving the U.S.), a number of organizations provide health-related services to travelers. Your travel agent or AAA club can direct you to them.

How can I best safeguard my home while I am on vacation?

The most obvious signs that you will be away from home are the most critical to avoid.

• Have someone gather your mail and keep it until your return (or you can have the post office hold it for you).
• Stop newspaper delivery.
• Arrange for someone to mow your lawn and water your plants.
• Lock all doors and windows.
• Close curtains to prevent anyone from peering through the windows.
• Put your lights on an automatic timer or leave some commonly used lights on in the kitchen, bathroom or living room.
• Activate your security system if you have one.
• Do not leave a message on your answering machine that tells everyone that you are away.
• Unplug appliances and computers, because violent storms could create a power surge that could start an electrical fire.
• Give your itinerary to a trusted friend or relative, so that you can be contacted in case of emergency.
• Be sure that your homeowner's, life insurance and automobile insurance policies are paid up until your time of return.
• If you are leaving for an extended period, your banker can make arrangements for paying your bills during your absence or you can set up automatic bill payments with each participating company.

How can I identify a poison ivy plant and prevent my family from contracting a rash?

Poison ivy may not always look the same. It can grow as a bush, vine or a spreading ground cover.

1. Poison ivy plants contain three-parted compound leaves. The leaves are joined by a common stalk. "Leaves of three, let them be."
2. The base of the center leaf does not touch the base of the side leaflets.
3. The tip of the leaf is pointed.
4. Leaves are arranged alternately on the stem and no two leaves grow exactly opposite each other, as they do on many other plants.
5. The plant contains waxy white berries in fall and winter.

The rash occurs when you come in contact with the sap of the plant or anything that has touched it. The chemical in the sap, called urushiol (pronounced oo-roo-shee-ohl) is a long-lasting oil that penetrates the skin within a few minutes, after even the mildest contact with the plants leaves or stems. The first step after being exposed is to cleanse the exposed skin with isopropyl (rubbing) alcohol. Do not use soap and water first, as the soap can pick up the sap and move it around on your skin. Next wash thoroughly with water only. Then shower using soap and water. If possible, complete the first two steps outdoors. Any clothing, shoes and anything else that has come in contact with the sap should be wiped down with the alcohol and water as well. Be sure to wear protective gloves when cleaning these items and discard the gloves when done.

A topical lotion approved by the FDA to prevent poison ivy, oak, and sumac rashes is available at drugstores. Ivyblock®, as it is named, should be applied to exposed skin at least 15 minutes before you head outdoors. The active ingredient in this lotion, betoquatum 5%, creates a visible shield against sap.

Over-the-counter topical hydrocortisone creams such as Cortaid® and Lanacort® can be used to relieve the itching. There is also a new topical solution called Zanfel®, which washes away the urushiol and can be used any time after exposure.

How can I protect my family from rabies, and what should I do if someone is bitten by an animal?

The number of rabies-infected animals in the U.S. has nearly doubled, from fewer than 5,000 in 1960 to more than 8,000 in recent years, according to statistics at the Centers for Disease Control and Prevention. Rabies is a fatal disease involving the central nervous system. It occurs when a human is bitten or scratched by an infected animal, such as a dog, raccoon, skunk, squirrel, fox or bat.

Although most household pets should be vaccinated against rabies, dogs in many tropical countries may carry this disease. To avoid rabies, never approach a strange animal and reinforce this with your children. If you are bitten or scratched, wash your wound repeatedly with soap and water and immediate seek medical attention. Be sure to let your doctor know what type of animal bit you. If the animal cannot be found or tested, you may be inoculated as a precaution (rabies vaccine and rabies immune globulin). Your doctor will determine this. Do not try to trap a wild animal that has bitten you. Instead, contact the local animal control for assistance.

How can I know if the water and food are safe to drink and eat while on vacation?

All food and water contain bacteria and other organisms, and in areas far from home, they will be different from what your body has grown used to. This can result in an upset stomach, diarrhea, abdominal cramps, or in more serious instances hepatitis or parasite infections. Generally speaking, water in Canada, Northern Europe, Australia, New Zealand and the U.S. is of excellent quality. If you are in the Caribbean at a highly developed resort, you may not need to be as concerned as if you were in rural parts of the same country. For parts of the world less traveled by Americans (Africa, Asia, South America and Eastern Europe), you need to be more careful.

• Do not brush your teeth, drink or otherwise ingest tap water (this includes using ice in beverages).
• If you must use local water, boil it for five to 10 minutes or add tincture of iodine or iodine tablets (available at drugstores) according to the package directions.
• Drink soda or brand name bottled water. (Be sure the seal is intact when it is served to you.)
• If you are in a region where sanitation is poor, be choosy about the food that you eat.
• Do not eat raw fruits unless they can be peeled.
• Do not eat food from a roadside stand.
• Avoid raw vegetables, especially lettuce and salads.
• Eat well-cooked foods that are still hot. Avoid anything that has been cooked and has stood for a period of time.
• Be careful about seafood, especially shellfish that may have been caught in polluted waters. They can cause hepatitis. Avoid raw seafood, especially if you have liver disease or problems with your immune system.

If you develop diarrhea:

• Drink plenty of bottled liquids to prevent dehydration.
• Rest (avoiding excessive heat exposure) and eat a bland diet until symptoms improve.
• Be assured that most bouts of traveler's diarrhea are over in three to four days.
• Consult a doctor if symptoms persist, or you feel that you are becoming dehydrated (usually accompanied by weakness, dizziness or fever). Severe abdominal cramping and either blood or mucous in the stool should prompt a visit to the doctor.

What can I do to avoid or treat motion sickness?

A number of over-the-counter motion sickness medications are available, but check with your doctor before taking them, especially if you take other medications, are pregnant or are treating a sick child. Other suggestions for avoiding motion sickness:

• Eat light meals before departing.
• Avoid reading, as reading in motion can contribute to nausea.
• The back seat of the car is worse for motion sickness than the front and an open window may help control the symptoms.
• If you are in a small boat, stay in the center because you will move less than either in the front or the back.

Once symptoms begin, try the following:

• Lying flat may help.
• Stopping the car for frequent short rest breaks can help you feel better.
• Flat coke, ginger ale or crackers may help to settle an upset stomach.
• Be prepared with a plastic bag or other container if you vomit.

External Sources Centers for Disease Control and Prevention United States Public Health Service American College of Emergency Physicians (ACEP) National Center for Infectious Diseases: Travelers' Health U.S. Food and Drug Administration. Outstanding Poison Ivy and Its Cousins. Accessed April 17, 2007.

This article was reviewed and updated June 2007.

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