Make Sure International Travel Is Memorable for All the Right Reasons

June 6, 2017

By Nicole Sleiman, MD
Mercy Clinic Infectious Disease – Joplin

You’ve spent much time planning your expensive overseas vacation. Don’t spoil it by being unprepared for unexpected medical problems.

When traveling internationally, prevent a variety of infectious diseases by taking precautions. First, go to the Centers for Disease Control and Prevention (CDC) website at wwwnc.cdc.gov/travel and search for where you will visit because medical concerns vary by country.

Second, consider an appointment with a medical professional to go over all travel health precautions. Most insurance plans cover an office visit for a consultation, but not travel medication.

The most common ailment while in another country is travelers’ diarrhea. It’s most commonly caused by enterotoxigenic Escherichia coli (E. coli). Other bacteria like campylobacter or shigella also can be the culprit. Another potential risk is giardia, a microscopic parasite found on surfaces or in soil, food or water that has been contaminated with feces from infected humans or animals.

The best prevention is to avoid tap water (only drink from factory-sealed containers and avoid ice). If bottled water isn’t available, have water purification tablets or a portable water filter and treatment system available.

Only eat cooked food served hot from a reputable restaurant. Eat raw fruits and vegetables only if washed in clean water or peeled. Also keep your hands clean.

It’s really about using common sense. If the source of water or food is questionable, try to avoid it.

If diarrhea occurs, drink lots of fluids to stay hydrated. Oral rehydration solution can be used to replace fluid. If you start developing high fever, unrelenting vomiting or abdominal pain and/or bloody diarrhea, seek medical care.

Treatment includes antibiotics, which vary depending on the infectious organism involved and the traveling area, and over-the-counter (OTC) drugs that decrease the frequency and urgency while waiting for an antibiotic to take effect.

While diarrhea can sidetrack an otherwise enjoyable trip, it’s normally not serious or life-threatening. That’s not the case for a variety of other infectious agents that can be picked up while traveling abroad.

The hit list, depending on the country, includes the Zika virus, malaria, yellow fever, typhoid fever, hepatitis, meningitis, encephalitis and more. Some are the result of being bitten by a mosquito carrying the infective agent, especially in countries with warm and/or humid climates.

Symptoms vary, but can include flu-like conditions such as fever, headache, nausea, and vomiting. Treatment also varies, but includes rest, staying hydrated and taking OTC pain medication like Tylenol. If symptoms are not improving within 48 to 72 hours or confusion, neck stiffness or pain occurs, seek immediate medical attention.

The Zika virus is a threat if travelling to Mexico, the Caribbean, Central and South America, central Africa, India, Southeast Asia and the Pacific Islands.

Yellow fever is a concern in many South American and African countries, where proof of a yellow fever vaccine is required unless waived for an approved medical reason.

Vaccines are available to prevent certain infections. Examples include hepatitis A, hepatitis B, typhoid, yellow fever and meningitis, among others.

If you’re traveling to a country where malaria is present, inform your doctor or a travel clinic. Preventive antibiotics will depend on traveling destination because antibiotic resistance is present in some areas.

Mercy Clinic Infectious Disease in Joplin has most of the vaccines commonly needed for international travel or can have them available within a day or two. Routine adult immunization will be reviewed and updated. Booster vaccines will be given as needed, like tetanus and pneumonia.

Vaccines aren’t available for every potential disease that a traveler can pick up while overseas, so prevention is important. Avoid mosquitoes by applying repellant, covering the skin by wearing long-sleeve shirts and pants and avoiding the outdoors during dawn and dusk hours.

It’s also a good idea to pack a travel medical kit with items you’d find in a typical first-aid kit, such as pain medication like acetaminophen and ibuprofen, anti-itch cream, 1 percent hydrocortisone cream, bandages, alcohol swabs, topical antibiotics ointment, oral rehydration salts, anti-diarrhea tablets and water purification tablets.

People with medical conditions or chronic diseases, pregnant women and children should see a medical professional before traveling abroad as they are more susceptible to infections.

In addition to advising and treating travelers to other countries, Dr. Eden Esguerra and I can identify and treat a variety of infectious diseases, advise on proper and effective antibiotic use and administer immunizations.

Nicole Sleiman, MD, is a board-certified physician with Mercy Clinic Infectious Disease – Joplin, 100 Mercy Way, Suite 470. Call 417-556-6813.