Travel Medicine: Seeing the World in Good Health //
Traveling to another part of the world is an enriching adventure. However; there are often significant medical risks to travel. The medical risks of travel are dependent on not only the destination country, but also the specific locations, activities, and duration of travel. Some health risks can affect all travelers regardless of health status. In addition, personal health issues can present specific risks to travel.
The first step to travel planning is to identify the entry requirements for the countries that you will visit. Yellow Fever vaccine is required for entry into many West Africa countries. A certificate of vaccination must be shown. The vaccine and certificate can be obtained as part of a travel medicine clinic visit with Dr. Van Camp, at Seward Community Health Center. Yellow Fever is prevalent in many countries in Africa, South America and Central America. Vaccination is often recommended for travel to these areas, but must be evaluated on an individual basis.
Malaria is a specific risk factor in many parts of the world, especially Central America, Africa, and Asia. Medication is often recommended to prevent Malaria, but must be specific for the area of travel and malaria resistance patterns.
There are many emerging throughout the world. Examples include Zika virus, Ebola virus and Dengue Fever, but there are many other diseases. These diseases do not have specific treatment or vaccines. Specific prevention measures can reduce the probability of infection. Many of these diseases can also be transmitted sexually and by exposure to other body fluids for up to six months, making them a risk for the traveler’s personal contacts when returning home.
Prevention of mosquito bites is important in many parts of the world. While mosquitoes cause painful bites in Alaska they do not currently carry any significant diseases. Mosquitoes can transmit many diseases, including malaria, Zika and Dengue Fever. Mosquito bites can be decreased by treating clothing with permethrins, using DEET on exposed skin and using mosquito netting at night if needed.
The food and water in many areas of the world are not safe. Typhoid fever, Botulism, E. coli and cholera and Shigella are examples of illness from food and water sources. Precautions to reduce the risk of disease include; eating only foods that have been completely cooked (above 170°F in the center), eating only vegetables that you have washed in clean water or peeled, drinking beverages only from factory-sealed containers or boiled, and avoiding ice. Antibiotics and anti-diarrheal medication can be prescribed for travel to some areas, to be taken if illness occurs.
The risks of typhoid fever can be reduced by vaccination, which is recommended for travel to Asia, Africa, Caribbean, South America and Central America. This vaccination can be accomplished by injection or pill form based on specific recommendations made for the individual. Proper immunizations and advance planning can spare the vacation from becoming a disaster.
Travel to specific environments must be considered. Alaskans often travel to warm sunny places and are at increased risk for sun burns and heat related illness. These risks are increased with certain medications and medical conditions. Travel to high altitude can be associated with life-threatening altitude sickness, so preventive measures should be considered before travel.
Air travel poses a risk for patients with lung disease or risk of blood clots. Oxygen use, when required, must be planned in advance and specifically authorized by the airline. You should not fly when sick because of the risk of infecting others and the risk of becoming worse during flight. Flying with a sinus or nose congestion, even from a common cold, can lead to the inability to equalize (clear) your ears when changing altitude and cause severe pain and damage to the tympanic membrane (ear drum). Many passengers carry a nasal decongestant (such as Oxymetazoline, Afrin™) to use if congestion develops during flight and should be used at least one hour before descent. Nasal decongestants should only be used occasionally because of the risk of rebound congestion and should not be used for children under six years of age. It is important not to fly within 12 hours of SCUBA diving, which can lead to decompression sickness. Some people are very fearful of flying and may need medication to help prevent panic.
People with a chronic disease need special consideration for any travel. It is important to personally carry with you all required medication in original labeled containers, and not place it in checked luggage. Everyone should carry a list of all their medications, medical conditions and allergies. Medication timing needs to be considered when traveling across multiple time zones. Specific diseases may increase the risk of an illness associated with travel or a specific geographic area.
Car accidents are the most common cause of death for U.S. travelers. Lack of familiarity of the local roads, driving customs, and rental vehicles make driving more hazardous.
Travel is safer with advanced planning. Most vaccines require at least two weeks for them to become effective and some vaccines require multiple doses. The best practice is to make an appointment to review your travel plans at least one month before leaving home. Seward Community Health Center providers can help you with the medical aspects of your travel plans.