Travel Medicine

Travel and tourism have increased over the last decade. Out of thirty million Americans traveling abroad each year, eight million are traveling to less developed countries. Diseases like malaria, meningitis, cholera, typhoid, other infectious diarrheas and yellow fever are quite prevalent.

Consulting a physician specializing in travel medicine at least six weeks prior to departure will enable the traveler to:

  • Receive necessary information regarding preventative measures since most travel related diseases are preventable.
  • Receive vaccinations
  • Prophylactic antibiotics
  • Completing an immunization schedule before departure is one of the most important step you can take to prevent travel related diseases.

Travel Immunization Guidelines:

  • Tetanus/Diphtheria: After initial series, booster every ten years
  • Hepatitis A: Consider for all travelers over age two including those traveling to Canada, Europe, Japan and New Zealand
  • Hepatitis B: Recommended for all frequent travelers
  • Typhoid: For travelers going to areas with substandard sanitation.
  • Polio: One time polio booster after primary series prior to international travel.
  • Yellow Fever Vaccine*: Recommended at least ten days prior to departure to endemic areas which include tropical South America and most of Africa between 15 N and 15 S.
  • Meningococcal Vaccine: Recommended for tourists traveling to endemic areas between December and June
  • Japanese B Encephalitis: Most common cause of mosquito born encephalitis in Asia and Western Pacific. Vaccine is recommended for travelers spending thirty days or more in rural areas

*Vaccine is available only in the centers designated by State Health Department, including Diagnostic Clinic of Houston.

Travel Related Diseases:

Traveler’s Diarrhea: (Turista, Montezuma’s Revenge, Pharaoh’s Revenge)

Causes:

  • Contaminated water and ice
  • Contaminated fresh fruit and vegetables

Symptoms:

  • Watery diarrhea
  • Nausea and vomiting
  • Abdominal cramps
  • Low grade fever

Prevention-Food and Water Safety:

  • Drink bottled water or carbonated drinks without ice
  • Avoid dairy products
  • Eat foods which are steaming hot and served in a clean container
  • Avoid salads and fruits that cannot be peeled
  • Cooked vegetables and fruits are safe
  • Hot beverages are generally safe
  • Avoid eating foods from street vendors
  • These rules include food, ice and water on ships and planes leaving endemic areas

Treatment:

  • Fluids
  • Peptobismol
  • Imodium
  • Antibiotics (discuss with physician prior to travel)

Malaria:
Malaria is endemic in tropical and sub-tropical countries. It is a serious disease which can be fatal. It is transmitted by female anopheles mosquitoes. These mosquitoes feed from dusk to dawn.

Cause:

  • One of four protozoan species of genus Plasmodium.

Symptoms:

  • Severe flu like symptoms
  • Shaking chills followed by high grade fever, lasting 2-6 hours
  • Pain in joints and muscles
  • Pains in chest and stomach

Prevention: (Measures to prevent mosquito bites)

  • Protective clothes-long sleeve shirts and trousers, especially in the evening
  • Insect repellent containing DEET
  • Mosquito net, treated with permethrin

Preventative Medication*

  • Chloroquine
  • Mefloquine
  • Doxycycline
  • Azithromycin

*Consult your physician regarding appropriate chemoprophylactic agent

Treatment:

If you suspect that you have malaria, seek medical care immediately

Other Travel Tips:

Motion Sickness:

  • Scopolamine drugs such as Transderm ScoP, Scopace
  • Antihistamines such as Antivert, Dramamine, Phenergan

Jet Lag:

  • Limit alcohol and caffeine intake.
  • Do not drink too much coffee
  • Drink plenty of fluids
  • Melatonin
  • Ask your physician about taking sleeping pills
  • Adjust sleeping times prior to departure

Ears and Sinus Problems:

  • Antihistamines, such as Claritin, Zyrtec and Allegra
  • Nasal decongestants, such as Sudafed, Actifed
  • Cortisone nasal spray, such as Flonase, Nasonex, Vancenase
  • Topical decongestants, such as Afrin, Neosynephrin

Take adequate supply of prescription medicine and carry with you:

  • Sun screen lotion
  • Extra pair of prescription glasses or contact lenses
  • Medical Alert bracelet/card
  • Check health insurance coverage for your travel destination

Authored by: Nizar Dholakia, M.D.

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