Ten Rules for International Travel

The purpose of Travel Medicine is to help keep your trip free from illness or injury. By following these simple rules, the common hazards of travel may be prevented.

1. Seek pre-travel assistance from a certified Travel Medicine Clinic for required and recommended immunizations and medical advice. Health and safety conditions in the country of travel can change rapidly. Chronic medical conditions can be aggravated by international travel. Many health problems during travel are preventable with proper planning, education, and immunizations.
   
   
2. Take appropriate precautions against accidental injury and for personal safety. Statistically, accidental injuries due to automobile accidents are the leading cause for medical attention while traveling. Simple precautions (e.g. use of seat belts) can save a life overseas, as well as, at home. Remember do not drink and drive. Guard your valuables, passport, identification, medical information, and credit cards; also be aware of local "tourist" crimes and scams. Be informed about the latest State Department travel advisories and bulletins for your destination. Devise a contingency plan for emergency medical care during travel in the event of accidental injury or serious illness.
   
   
3. Take your Malaria chemoprophylaxis as prescribed. Malaria remains the world's top infectious disease killer and does not care what passport you carry. Typical antimalarial medication includes Mefloquine (Lariam), Chloroquine (Aralen), which are taken on a weekly basis, Doxycycline and Malarone which are taken on a daily basis. As with all medicines, the risk of side effects or interactions with current medications or health conditions must be considered.
   
   
4. Take personal precautions against insect bites. The use of repellent containing 25-35% DEET (N,N-diethyl-metatoluamide) has been shown to be the most effective. For your clothing, the use of permethrin (Permanone) can maintain, through repeated washings, a repellent barrier of your clothing for several weeks. In addition to repellents, stay in properly screened off areas, use bed netting, avoid outdoors nighttime activities, and cover as much of your exposed skin as possible.
   
   
5. Diarrhea illness remains a significant cause of travel related illness. Proper food and water precautions can prevent the majority of diarrhea illnesses, however this remains a significant cause of travel related illness. A Quinolone antibiotic (e.g. Cipro, Floxin, and Levaquin) should be carried for self-treatment of diarrhea associated either with fever or blood in the stool. Also rehydration with clear liquids and sports drinks (e.g. Gatorade, Power Aide) can replace needed electrolytes and fluids lost to dehydration. Simple diarrhea, which may occur only because of dietary changes, climate changes, or from the stress of travel, is often simply resolved with over the counter medicines (e.g. Imodium, Pepto-Bismol).
   
   
6. Take appropriate dietary precautions. All water should be boiled, bottled, or otherwise purified. The use of purification devices or chemical methods like chlorine or iodine tablets may be necessary. All raw fruits and vegetables should be peeled and washed in clean water or cooked. Be cautious of fruit cocktails or frozen drinks. Meats should be cooked well. Seafood can be a particularly deadly food even if prepared properly. Remember, "Peel it, boil it, cook it, or forget it".
   
   
7. Assemble a traveler's medical kit appropriate for your destination, length of trip and your medical conditions. Include needles and syringes if possible. Stock simple over the counter medicines for aches and pains, fever, diarrhea, dysentery, sinus and allergy problems. If you are on chronic prescription medicines ensure you have enough to cover your entire trip.
   
   
8. Avoid exposures to potentially contaminated blood or body fluids, do not engage in unprotected sexual contact. Avoid procedures such as tattoos, ear or body piercing and acupuncture.
   
   
9. Do not walk barefoot outdoors. Do not swim, bathe or wade in fresh water streams, rivers, or lakes. If it is not chlorinated, stay out of it. Remember to use sun block (SPF 15 or higher) when outdoors. Avoid the peak sun times, by limiting your activities to indoors.
   
   
10. Be prepared for emergencies. Insure you have adequate monetary resources to pay for emergency medical care and treatment. Your health insurance is typically not accepted overseas. Payment in cash or credit card is usually required at time of service and your departure from the country may be delayed until your medical bills are paid in full. If you are staying long term overseas or pursuing an adventurous itinerary consider supplemental travel medicine insurance.