Spring is here and the summer is nearly upon us, which means sun, fun, visiting
the coast, and traveling abroad. Vacationing, while usually considered a salubrious experience is, in fact, fraught
with opportunities for illness and injury.
The best precaution against such misadventures is to be prepared.
This newsletter will be devoted to some of the more common problems travelers face whether vacationing or traveling for business.
The most common illness while traveling, especially abroad, is diarrheal
disease. In the USA, this is usually viral but can also be the result of food poisoning such as salmonella, E. coli
and less commonly giardiasis. Although most water supplies are protected, in the USA there is ample opportunity to fall
ill from poorly prepared or improperly stored foods. This is even more common in the summer when picnicking and outdoor
activities are at their peak. Common sources of food borne illnesses are poorly refrigerated dairy products, raw seafood
and undercooked chicken and eggs.
Food is not the only source of travel related illness. In the USA,
particularly in coastal Eastern states, Lyme Disease is prevalent. There are reports of some coastal New England islands
on which more than half of the population test positive for antibodies to Borrelia burgdorferi, the agent which causes Lyme
Disease. There have also been increasing reports of rabid animals, (raccoons, bats, foxes) found in the wild and even
encroaching on exurban communities. Thus, getting the most out of your vacation clearly favors the prepared traveler
by means of adequate pre-trip vaccination and prudent preventive measures.
The international traveler often has to go to regions of the world for which
he or she is not physically conditioned and has no proper protection against local endemic diseases. It is imperative
for the business traveler to be healthy for many sound reasons. First and foremost, your life may depend on it!
Secondly, travel stresses such as prolonged inactivity, carrying heavy luggage and multiple time zone changes all play havoc
on the body's normal mechanisms that try to keep the body functioning properly and comfortably. The business traveler
should be moderately fit and adequately vaccinated against diseases that are common and endemic to the area of travel.
A sample itinerary from (recent experience) will serve as a demonstration.
Sample Itinerary: A business traveler plans to go to India to
investigate the possibility of using Indian engineers for software development. He then plans to fly to Thailand to
investigate a parcel of woodland near the Cambodian border. Then he plans to travel to Malaysia to negotiate with a
local computer manufacturer. His company wants him to return via Zaire to investigate an opportunity for the company
to invest in a mining operation. Although the reasons here for such travel are invented, it is common to see travelers
from the USA with itineraries as complex as this.
There are regional risks associated with all travel and this example
illustrates a few. Malaria, Yellow Fever, Cholera, HIV/AIDS, Hepatitis A and B are all diseases which pose risks to
the traveler in this itinerary. Yellow Fever vaccine is required to go to Zaire as well as proof of inoculation with
Cholera vaccine. Malaria is present in each of the countries to be visited and adequate medical prophylaxis is imperative
if one is to avoid contracting Malaria. Hepatitis B is prevalent throughout the third world and since medical facilities
as well as blood supplies are not as reliable as in the United States, it will serve the frequent traveler well to be immunized
against Hepatitis B. Hepatitis A is a food born illness and has a world wide distribution, even more so in this particular
itinerary. It would be wise for the traveler to be immunized for this also.
The prudent traveler should be prepared for common, irritating illnesses
such as traveler's diarrhea. The keystone of treatment here is prevention. One should always drink bottled carbonated
beverages or beverages prepared with boiled water. In the worst case scenario, one can adequately disinfect water with
iodine or chlorine preparations such as tincture of iodine, or Globaline or Potable-Aqua brands of water disinfectant.
Food should not be raw and salads are to be shunned; food not peeled by you, uncooked vegetables and fruit , raw meat
and shellfish should generally be avoided.
A travel kit with common medications such as Tylenol, Advil, Imodium
, cold preparations, topical antibacterials, band aids and a thermometer is a wise and convenient investment. For those
traveling in malarious areas, insect repellent and, (depending on how rural your stay is), mosquito netting are necessities.
Vaccines and antimalarial prophylactic medications can be obtained from
local public health authorities and more conveniently for the busy and harried traveler, from centers for Travel Medicine.
But remember, time is of the essence when you are required to get immunizations. The sooner you know your itinerary
the easier it will be to plan appropriate medical prevention. Many vaccines require a series of injections, or a span of several
weeks before they become effective. With the above precautions, even the most adventurous itineraries can be safely
navigated.
TICK TIME BOMB
"Prevention is the best medicine". This statement
is particularly pertinent in avoiding Lyme Disease. By preventing the bite of the deer tick, you can prevent Lyme
Disease. This is most easily achieved by refraining from frequenting heavily infested areas, such as coastal New
England states and their wooded areas and parks. When going into these areas wear long sleeve shirts and pants
and tuck pant bottoms into your socks. Light clothing helps to identify the pinhead sized tick nymphs on the clothing
so that they can easily be removed. The insecticide, permethrin, when used on clothing is an effective
tick repellent. Insect repellents that contain DEET will keep ticks off skin and clothing. (The latter must
be used with caution in young children since it has toxic effects on the nervous system in high concentrations). Pets
should be groomed to detect the ticks after going into wooded area. If you find a tick embedded in the skin, remove
by gently pulling with tweezers. You should consult your physician but he/she will most likely recommend keeping a keen
eye out for the red expanding bull's eye rash which is the only distinctive characteristic of the disease. If flu like
symptoms develop, consult your physician. (Size of the deer tick nymph)
KEEPING A SUNNY DISPOSITION
Summer fun is great, especially those long
hot sunny days. But all that solar celebration carries a price tag. Skin cancer is the most common form of cancer
and one of the most preventable. All forms of it are sun exposure related and some forms are burn-severity related.
People who suffer the highest incidence of skin cancer usually have occupations or avocations which require them to spend
a lot of time in the sun. This not only increases the chance of severe burn, but prematurely ages the skin. The
best p There are regional risks associated with all travel and this example illustrates a few. Malaria, Yellow Fever,
Cholera, HIV/AIDS, Hepatitis A and B are all diseases which pose risks to the traveler in this itinerary. Yellow Fever
vaccine is required to go to Zaire as well as proof of inoculation with Cholera vaccine. Malaria is present in each
of the countries to be visited and adequate medical prophylaxis is imperative if one is to avoid contracting Malaria.
Hepatitis B is prevalent throughout the third world and since medical facilities as well as blood supplies are not as reliable
as in the United States, it will serve the frequent traveler well to be immunized against Hepatitis B. Hepatitis A is
a food born illness and has a world wide distribution, even more so in this particular itinerary. It would be wise for
the traveler to be immunized for this also.
The prudent traveler should be prepared for common, irritating illnesses
such as traveler's diarrhea. The keystone of treatment here is prevention. One should always drink bottled carbonated
beverages or beverages prepared with boiled water. In the worst case scenario, one can adequately disinfect water with
iodine or chlorine preparations such as tincture of iodine, or Globaline or Potable-Aqua brands of water disinfectant.
Food should not be raw and salads are to be shunned; food not peeled by you, uncooked vegetables and fruit , raw meat
and shellfish should generally be avoided.
A travel kit with common medications such as Tylenol, Advil, Imodium
, cold preparations, topical antibacterials, band aids and a thermometer is a wise and convenient investment. For those
traveling in malarious areas, insect repellent and, (depending on how rural your stay is), mosquito netting are necessities.
Vaccines and antimalarial prophylactic medications can be obtained from
local public health authorities and more conveniently for the busy and harried traveler, from centers for Travel Medicine.
But remember, time is of the essence when you are required to get immunizations. The sooner you know your itinerary
the easier it will be to plan appropriate medical prevention. Many vaccines require a series of injections, or a span of several
weeks before they become effective. With the above precautions, even the most adventurous itineraries can be safely
navigated.
