So we book that bucket list trip with a great flight deal, find the nicest hotel, go shopping for Instagram worthy bathing suits and outfits, and plan a bucket list dream itinerary full of snorkeling, hot air balloon rides, and safaris. Yet we neglect to do our due diligence where our health preparation is concerned. Then we find our trip interrupted by burdensome diarrhea and vomiting, pesky sand flies and mosquito bites or we are denied entry into a country due to lack of yellow fever vaccination, or we return home with a near-death case of malaria.
Sometimes you just don’t know what you don’t know, but pre-trip planning and on the trip precautions are just as important as buying a flight, booking a hotel and planning an amazing itinerary. Here are my top 10 tips for staying healthy while abroad.
#1 Research: Pre-Trip Planning
For any new destination, the first thing to do is review the Centers for Disease Control (CDC) website (https://wwwnc.cdc.gov/travel) for the most important and up to date health related recommendations for a particular destination. The CDC website is utilized by travelers and health care providers all over the world. When you visit a travel clinic, this is the website most use to prepare you for your trip and make recommendations on vaccinations and other precautions. A savvy traveler has already reviewed this information before visiting any travel clinic.
The only absolute vaccination that most travelers need to be aware of is Yellow Fever. If you travel to a country where yellow fever vaccination is required, you must be able to present proof of vaccination with the universal yellow fever card or you may be denied entry into that country or you might be required to get the yellow fever vaccination on site, in a foreign airport.
While yellow fever may be the only required vaccination, be mindful that water and food safety standards are not as rigid in many developing countries. Therefore, vaccine protection from preventable food and water-borne infections such as Hepatitis A and Typhoid are highly recommended. Also, make sure your Tetanus vaccination is up to date in case you obtain a wound or laceration while traveling. A pre-packaged first-aid kit is a good idea as well.
#3 Mosquito-Borne Diseases
The CDC website is one of the most important resources for information on mosquito-borne diseases such as Malaria, Dengue Fever, Chikungunya and Zika viruses. The presence of these diseases should prompt travelers to pack plenty of DEET containing mosquito repellant and seek a healthcare provider to obtain a prescription for anti-malarial prophylactic medications in regions where malaria is endemic. Be mindful that Malaria prophylaxis recommendations are region specific. What is recommended in parts of Africa may not be the drug of choice in Southeast Asia.
#4 Chronic Medications
What are your regular medications? Do you need refills on your prescriptions? Where is your asthma inhaler, hypertension medicine, insulin for your diabetes and your migraine or allergy medications? Be sure to travel with these medicines in your carry-on in case your checked luggage is lost and always take extra medicine in case your flight is delayed. Who knew a volcano would erupt in Bali and force you to stay three extra days?
#5 Other Medications
Other medications you should think about traveling with include pain and fever reducer medications like Ibuprofen (Advil, Motrin) or Acetaminophen (Tylenol), antihistamine allergy medications such as Diphenhydramine (Benadryl), the anti-nausea Ondansetron (Zofran), and the anti-diarrheal Loperamide (Imodium AD). Depending on the destination and activities you may also want to include medications for motion sickness or altitude sickness. It would be disastrous to get to Peru and not be able to enjoy Cusco and Machu Picchu due to altitude sickness and yes yacht week for the motion-sensitive people would be nonsensical without motion sickness medications.
Do you have death inducing allergies to certain foods? Ensure your travel buddy is aware of your death-by-peanut allergy while you travel through Thailand, in which peanut containing dishes are as ubiquitous as temples. Have your allergies written out on an index card in the local language to show at restaurants. Don’t forget to travel with an antihistamine like Diphenhydramine (Benadryl) and an Epi-pen if you have a history of severe allergic reactions.
Does your travel partner know how to contact your emergency contact if necessary?
Travel health insurance is one of the most underrated necessities for travelers abroad. Travelers are going bungee jumping in Johannesburg, paragliding in Nepal, skydiving over Dubai yet don’t have travel insurance. Don’t leave your family in a crisis if something happens to you while traveling. Preparation and planning for the unknown are just as important as that fun-filled itinerary. Many people are unaware how crucial good travel insurance is until you are in need of it. Medical evacuation is one of the critical components of solid travel insurance. Check with your credit card company for coverage and consider an annual policy if you are a frequent traveler.
#8 Emergency Contacts
Before you travel abroad make sure to dedicate an emergency contact person. Who will come see about you in an emergency? Do they have a passport? Do they have your travel insurance information if needed? Does your travel partner know how to contact your emergency contact if necessary?
#9 Eat properly, stay hydrated and exercise
Traveling abroad can lend itself to irregular eating habits, junk food, and unhealthy snacking which can cause fatigue, bloating, constipation and an overall unwell feeling. The key to feeling your best is to eat properly and stay hydrated. Excessive sun and water activities can have a dehydrating effect. Drinking plenty of water will keep you feeling refreshed and renewed. Also, try to start your day with exercise and utilize the gym or fitness classes at the hotel.
#10 Stay Safe
After arriving at your destination, water and food safety should be the priority to staying healthy while abroad. Traveler’s diarrhea is one of the most common illnesses that many travelers will encounter. It is the result of contaminated water and food sources with bacteria. Bottled water is your best friend in developing countries. Avoid ice and tap water unless it is filtered or boiled. In regards to food safety, the rule of thumb is to eat cooked foods and cooked vegetables as heat kills most bacteria. Also, eat fruits that you peel to avoid contamination with unclean water. Eat street food at your own risk.
Road Safety is an under-discussed danger. We always think about vomiting, diarrhea, malaria and other illnesses while traveling, yet according to the World Health Organization, “road traffic collisions are the most frequent cause of death among travelers.” Traffic accidents may be more common and present more morbidity and mortality for travelers, be it unsafe motorcycles without helmets, car accidents or an attempt to cross the streets of chaotic cities.
Practicing safe sex at home or abroad should go without stating. However, the importance of this topic can never be overstated. Be sure to pack condoms or obtain them on arrival to your destination. The risk of HIV and other sexually transmitted infections can be prevented with proper use of condoms. Never go skydiving without a parachute. Risky behaviors are not worth the consequences. Be safe, wrap it up.
Happy travels from a traveling Doc,
Dafina M. Good, MD
Centers for Disease Control and Prevention (CDC). https://wwwnc.cdc.gov/travel Travelers’ Health. Vaccines. Medicines. Advice.
World Health Organization (WHO) www.who.int International travel and health. Other travel health risks. Injury and violence.