People differ considerably in whether or not they react to attitude changes. In general, travelers whose itineraries take them to altitudes above 6,000-8,000 feet should be aware of the risk of altitude sickness.
It is particularly important if you have any underlying medical conditions, sickle cell anemia, asthma, emphysema or other breathing difficulties to talk to your doctor before you plan a high altitude journey.
The most common type of altitude sickness is acute mountain sickness (AMS), caused by the effects of low oxygen to the brain. A dull and throbbing headache together with nausea, vomiting, loss of appetite, fatigue, dizziness or insomnia are characteristic of AMS. If your itinerary puts you at risk, we can give you more details about the condition and ways to minimize the effects of altitude sickness.
The effects of jet lag are due in part to your body’s biological clock (also known as circadian rhythm being out of sync with your activities. It takes about 24-hours for your body to readjust for each time zone crossed.
Common symptoms of jet lag include insomnia, fatigue, change in appetite and irritability. Many remedies have been promoted, with varying degrees of scientific evidence to support them. Some general recommendations include:
Deep Vein Thrombosis
A blood clot that develops in a vein in your arm or leg is called Deep Vein Thrombosis (DVT).
For the international traveler, the long airline flight(across the ocean or across multiple continents) can lead to prolonged periods of immobility. As per result, there is the opportunity for blood to pool in these veins allowing a clot to form.
Also at higher risk are patients who are:
Taking estrogen therapy (including oral contraception and hormone replacement therapy). For any traveler, it is a good idea to periodically get up and stretch your arms and legs. In addition, there are simple exercises you can do in your seat to stimulate blood flow through your extremities.
For travelers at higher risk for DTV, the use of compression stockings and /or anti-coagulant therapy can be an option.
Motion sickness is not a disease, but rather it’s an exaggerated response of the body to an unfamiliar motion.
Motion sickness can be triggered by the movement itself, or even the visual suggestion of the movement. Most people have heard about air sickness or sea sickness, but movement on land can also trigger motion sickness (e.g., riding on the back of an animal such as a horse, a camel or an elephant; downhill skiing; scuba-diving and snorkeling.) Common symptoms are nausea, sweating, salivation and vomiting. If vomiting occurs it is frequently followed by drowsiness and extreme tiredness.
It is better to PREVENT motion sickness rather than try to treat it after it occurs. It’s a good idea to discuss the various options with us or your primary care doctor.
Tropical sunshine can be very harmful. Be careful about exposing your skin to direct sunlight, especially at first. Sun exposure is clearly linked to acute sunburns, premature aging of the skin, pigmentary changes and worst of all skin cancer.
If sun is unavoidable, build up your exposure from 15-20 minutes a day and avoid the mid-day sun (11am-3pm).
Painful sunburns can be avoided by:
If you overdo the sun:
Sexually Transmitted Diseases, Hepatitis B, AIDS & HIV
The risk of sexually transmitted diseases, including Hepatitis B, HIV and AIDS, exists everywhere in the world. The same way you protect yourself at home, will provide protection when you travel. It�s important for you to use condoms PURCHASED IN YOUR HOME COUNTRY to assure reliability.
While the Hepatitis B vaccine provides a high rate of protection, IT IS IMPORTANT FOR YOU TO TAKE PERSONAL PRECAUTIONS AGAINST INFECTIONS. Avoid unprotected sexual relations with strangers, contact with potentially contaminated needles, medical equipment, blood products or tattooing equipment while traveling.
Travel & Pregnancy
For more information on pregnancy and travel; www.cdc.gov/travel/pregnant.html
Motor Vehicle Accidents
Traumatic injury accounts for more deaths in travelers than do infectious diseases. Motor vehicle accidents are the leading cause of these injuries. The majority of injuries and fatalities happen to pedestrians, motorcyclists, and bicyclists.
It is critical that travelers, as both occupants of a vehicle and as pedestrians, be aware of the rules of the road in other countries.
For more information about road safety:
For information on International Driving Permit (IDP):
If your plans include water recreation or sports such as scuba diving, snorkeling, kayaking or rafting, be sure to mention any activities you plan to do to us, even those that are just possibilities. Plan to bring your own equipment and use expert guides.
Travelers with Disabilities
Most individuals with disabilities are able to travel, depending on personal limitations. Within the US, recent legislation has been enacted to protect the traveler with special needs against unfair treatment and to improve accessibility to transportation of all types.
However, this is not necessarily the case in all countries. Proper advanced planning is essential for a fulfilling, enjoyable and healthy travel experience.
Your personal physician is the best person to determine if the trip is right for you. In addition, you should pay careful attention to travel health insurance and trip cancellation insurance.
For further information for travelers with disabilities:
www.sath.org (Society for Accessible Travel and Hospitality)
Adoptive parents who travel overseas to pick up their child need to be aware that unexpected complications in the adoption process may delay their trip. This becomes an issue with medications such as antimalarials and antibiotics for travelers diarrhea as well as routine medications. Plan accordingly.
Take extra medication with you and DO NOT rely on getting a refill overseas.
It’s also important to remember to protect your health by getting the proper rest, following the food-wise and water safe recommendations and paying attention to the personal protection measures (PMP).
For further information on International adoption traveling:
Travelers Medical Kit
Your travelers may include some areas where medical care is not readily available or the care that is available is sub-standard. Consequently, it is strongly recommended that all travelers carry at least a BASIC medical health kit including first �aid items.
Since the most common illnesses during travel to a developing country include diarrhea, respiratory tract symptoms, skin problems, high-altitude illness, motion sickness, accidents and injuries, and fever, your basic medical kit should cover these.
Keep in mind that all medicines, even over-the-counter ones, can have side effects. Be sure to read the labels and ask any questions you might have before using any medications.
Suggested BASIC kit for the short-term traveler (2-4 weeks):
You need to remember:
Personal Protective Measures
You against Mosquitoes and Other Biting Insects
Yes, there are vaccines against some mosquito-borne diseases (i.e. yellow fever, Japanese encephalitis) and you can take medication to help prevent malaria. BUT you should also take precautions to avoid getting bitten in the first place. Your first line of defense against mosquitoes and insects are known as personal protective measures (PPM):
While it’s a fact that a single bite by an infected mosquito can cause a serious disease such as malaria or yellow fever, you know that ANY BITE from a mosquito or other pesky bug can make you miserable.
So the best action is to try to avoid getting bitten.
Further information on the safe use of DEET is available at the EPA-sponsored National Pesticide Information Network:http://npic.orst.edu
Proper clothing does provide a physical barrier to biting insects. However using a chemical to treat that clothing will dramatically increase its ability to protect.
Research shows that sleeping under a mosquito net, especially one impregnated with Permethrin, is highly effective against night-biting insects.
Be Food-wise & Water-smart
The familiar advice of Boil it, or forget it is easy to remember and it makes good common sense.However, many travelers don’t find this slogan practical when they travel. IT IS IMPORTANT TO KEEP IN MIND THAT THE FOOD AND DRINK CHOICES THAT YOU MAKE WILL AFFECT YOUR LIKELIHOOD OF GETTING SICK OR NOT.
Following some simple and logical precautions will ensure that your travel �culinary� experiences are pleasant.
Eating contaminated food is more likely to get you sick than drinking contaminated water!
Be sure to think before you eat.
Your safest bet is to consider all water in all lesser-developed countries to be unsafe. This includes water from well, streams, ponds, and irrigated areas. In other words, think before any water gets near your mouth.
You can make the water safe
If the local water is unsafe, there are ways to make sure the water available for you to drink doesn’t contain infectious agents:
Water should be brought to a boil for 1 minute (depending on altitude) and allowed to cool at room temperature without adding ice. This will kill most viruses, bacteria and parasites.
When it is not possible to boil water, chemical disinfection is an alternative method. Iodine or chloride tablets are available from most pharmacies and sporting goods stores. Follow the manufacturer�s instructions. However, it is best to both purify AND filter your water. There are combination systems available.
There are a number of commercially available water filters.
NOTE: THESE ARE DIFFERENT THAN THE WATER FILTERS YOU MIGHT USE AT HOME.
For detail discussion on water purification methods and products:www.cdc.gov/travel/food-drink-risks.htm
Safety and Security
Unfortunately, you can be a victim of crime anywhere, home or abroad. However, your risk may increase when you travel, particularly in lesser-developed countries.
There you leave behind the basic protections you have in the US; where automobiles are subject to stringent safety laws, hotels have sophisticated sprinkler systems, restaurants are routinely inspected by health department, and where crime and violence are policed according to standard laws and ordinances.
Everyone hears stories and statistics about tourist crime and misfortunes. To be fair, you need to balance these against the staggering numbers of tourists wandering around the world at one time. At the same time, these reports should serve as a warning to you that you do to keep your safety in mind at all times!
Here are some general guidelines and safety tips worth considering:
USE COMMON SENSE – If you wouldn�t go out at night in an unknown neighborhood at home, DON�T DO it while traveling overseas.
BE AWARE – Be aware of your general travel environment, as well as social, political or medical conditions in the countries you are visiting.
BLEND IN – Don’t dress like a tourist,leave the baseball hat, team jackets and Hawaiian shirts at home. Know where you are going.Get directions at your hotel.
For detailed information on the current events of each country, check the US Department of State Travel Warnings and Consular Information: www.travel.state.gov/travel.
Travel Health Insurance
Before you travel, make sure to check your existing health policy to determine whether coverage applies to:
Whether or not medical evacuation from foreign countries is included. Although some insurance companies will pay Customary and reasonable medical cost abroad, very few will pay for medical evacuation, whether back to USA or another Western medical-practicing country.
It is also important to find out if there is telephone phone access to your insurance provider 24- Hours-a-day, 7 days a week. If so, be sure to pack the telephone number with your passport.
Ask your insurance carrier what they will do for you if you break a leg or get in a car accident while overseas. If they cannot provide you with the advice and assistance, you may need additional coverage.
Apart from your regular health insurance, there are TRAVEL HEALTH insurance policies you can purchase to provide specific protection during trip. There are various types of policies available to fit the variety of travelers needs. Just remember, READ THE FINE PRINT BEFORE PURCHASING ANY POLICY.
For more information on dealing with illness and injuries while travelling:
For list of travel insurance companies:www.travel.state.gov/travel/tips/health/health_1185.html
The Responsible Traveler
It is important for you to know about the countries you will be visiting. Understanding cultural, hygienic and ethical differences will help avoid unintended conflicts or disrespect toward the people of the host countries.
You can help by:
The events of September 11/2001 have changed international travel. American travelling abroad, now more than ever need to be more concerned about personal safety. Visibly marking yourself as an American by the way you dress or your public behavior can be unsafe in many countries.
Dress comfortably, but conservatively. This is particularly true for women, in light of cultural and religious traditions toward women in many societies.
Minimize the amount of jewelry you wear, whether it is real or costume. The poverty of many countries increases the temptation for crime.
For more information on being a responsible traveler visit the international Society of Travel Medicines web-site: www.istm.org
Much information on travelling healthy and smart is available on the internet. Reliable sources include:
US CDC Traveler’s Health Home www.cdc.gov/travel
Who On-line International Travel and Health www.who.int
US Department of State Travel Warning and Consular Information www.tripprep.com
International Association for Medical Assistant to Travelers www.iamat.org
Lonely Planet Health www.access-able.com
International SOS (overseas assistance)/travel medical insurance www.internationalsos.com
HTH Travel Insurance www.hthtravelinsurance.com
Association for Safe International road travel www.asirt.com
Travel Medicine, Inc. (supplies such as repellants, bednets, filters, apparel) www.travelerssupply.com
In addition to internet resources, there are numerous books on travelling healthy:
International Travel Health Guide, 13th Edition. Rose, S.R Northampton, MA: Travel Medicine Inc., 2006.(Downloadable in sections from http://www.travmed.com)
Travelers Health — How to Stay Healthy Abroad, 4th Edition. Dawood R. Oxford University Press 2002.Bugs, Bites and Bowels, Healthy Travel, 4th Edition. Wilson-Howarth, J.Cadogan Guides, 2006. (www.wilsob-howarth.com)
Travelers Tales: Safety and Security for Women Who Travel. 2nd Edition. Laufer, P & Swan, S, CA: Travelers Tales, Inc., 2004.Gutsy Women: Travel Tips and Wisdom for the Road. Bond, M. San Francisco, CA: Travelers Tales, Inc., 2007. (www.travelerstales.com)
Travelers Tips, Ist edition. Ed. Tom Hall, Lonely Planet Travel Series; 2003.
Travel with Children, 4th Edition. Lanigan, C. Lonely Planet Publications; 2002