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Traveler's guide to avoiding infectious diseases

Alternative Names

Travelers' health; Infectious diseases and travelers

Information

The best way to stay healthy during travel is to prepare before you leave and take appropriate preventive measures while traveling. Different areas of the world have different diseases and require different precautions. Factors that contribute to these differences include:

  • Local climate
  • Native insects
  • Parasites
  • Sanitation

The best public sources for up-to-date travel information are the:

BEFORE TRAVEL

Talk to your health care provider or visit a travel clinic 4 - 6 weeks before you leave for your trip. You may need a series of pre-travel vaccinations. Some vaccines need time to become effective.

Depending on the destination, updating or "boosting" routine vaccinations is sometimes recommended. Examples of routine vaccinations include:

  • Diphtheria
  • Measles - mumps - rubella (MMR)
  • Polio
  • Tetanus

You also may need other vaccines for diseases that are not commonly found in North America. Examples of recommended vaccines include:

Certain countries have required vaccinations. You may need proof of vaccination to enter the country.

Yellow fever vaccination is required to enter several Sub-Saharan, Central African, and South American countries. Meningococcal vaccination is required to enter Saudi Arabia for the Hajj pilgrimage. For a complete list of country requirements, check the CDC or WHO web sites.

People who may have different vaccine requirements include:

  • Children
  • Elderly people
  • People with weakened immune systems or HIV
  • Pregnant or breast-feeding women

Check with your health care provider or local travel clinic.

MALARIA PREVENTION

Malaria is a blood parasite transmitted to people by the bite of certain mosquitoes. The disease is a risk mainly in tropical and subtropical climates.

If you are traveling to a region where malaria is common, you may need to take medications that prevent the disease before you travel, during your travel, and for a short period after you return. The effectiveness of these medications can vary, and you may also need to take additional insect precautions.

INSECT PRECAUTIONS

Mosquitoes and other insects can transmit malaria and a number of other infections to people. To protect yourself, wear insect repellant containing DEET or picaridin whenever you are outdoors. You may also need to use a bed mosquito net while you sleep.

FOOD AND WATER PRECAUTIONS

It is possible to catch many infections by eating or drinking contaminated food or water. Undercooked or raw foods pose a significant risk for infection. Avoid the following:

  • Cooked food that has been allowed to cool (such as from street vendors)
  • Fruit that has not been washed with clean water and then peeled
  • Raw vegetables
  • Salads
  • Unpasteurized dairy foods such as milk or cheese

Drinking water that is not chlorinated enough or that is from areas with poor sanitation can lead to infection. Only drink the following liquids:

  • Canned or unopened bottled beverages (water, juice, carbonated mineral water, soft drinks)
  • Drinks made with boiled water, such as tea and coffee

Do not use ice in your drinks. Local water can be purified by boiling, or by treating it with certain chemical kits or water filters.

ADDITIONAL PRECAUTIONS

Frequently clean your hands using soap and water or an alcohol-based cleanser to help prevent infection.

Avoid standing or swimming in fresh-water rivers, streams, or lakes that are contaminated with sewage or animal feces because they can lead to infection. Generally, swimming in chlorinated pools is safe.

Practice safe sex and use condoms to prevent sexually transmitted diseases.

Always use seat belts when driving or riding in a vehicle.

OUTLOOK

Most infections acquired while traveling are minor, but in rare cases, they can be severe or even fatal.

WHEN TO CONTACT A MEDICAL PROFESSIONAL

Travelers' diarrhea is the most common infection caught while traveling. Diarrhea can sometimes be treated with rest and fluids. Your health care provider may prescribe an antibiotic if you get sick with severe diarrhea while traveling.

If the diarrhea continues or you develop a high fever or dehydration, seek immediate medical care. If you were sick with a fever while traveling, contact your health care provider when you return home.

References

Arguin P. Approach to the patient before and after travel. In: Goldman L, Ausiello D, eds. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsever; 2007:chap 308.

Hill DR, Ericsson CD, Pearson RD, et al. The practice of travel medicine: guidelines by the Infectious Diseases Society of America . Clin Infect Dis. 2006;43:1499:1539.

Ericsson CD. Travel medicine. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 77.


Review Date: 1/10/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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