"In wine there is wisdom, in beer there is Freedom, in water there is bacteria.” – Benjamin Franklin
It’s summertime, a time when many people like to take their vacations. Some stay close to home, others want an adventure to more exotic locales. You want to have fun and stay healthy. Depending where you plan to go, it is important to educate yourself about the area where you’ll be staying, any travel alerts for the country, required immunizations, and some basic hygiene tips for eating and drinking away from home.
Before setting off it is a good idea to check in with the World Health Organisation and local government advice to see if there are any health issues to be aware of, or other dangers that may be happening in the particular country. Currently there is a Level 2 Alert issued by the CDC which calls for ‘practice of enhanced precautions’ due to the outbreak of Zika virus (1). There is an
outbreak of Zika virus in parts of S. America, Central America, Caribbean, and now Florida. It is transmitted to people through a few different ways: through the bite of an infected mosquito, pregnant woman to fetus, and sexually transmitted have all shown the ability to transmit the virus. Most people infected will not experience serious symptoms. They may notice some joint pain, fever, rash, and red eyes. The gravest concern is for women who are pregnant and get infected with the virus, or those who have traveled recently to an area where there is a Zika outbreak, and then become pregnant. The virus causes birth defects called microcephaly. There is no specific treatment, just rest, hydration, and pain reliever/ fever reducer. The best prevention for Zika is mosquito prevention. If you know you will be traveling to an area within the CDC level 2 alert region, make sure you have mosquito repellent, mosquito netting for sleeping, and stay in places with air conditioning and screened doors and windows, if possible. Use condoms to prevent sexual transmission. If you are pregnant, the advice is to postpone travel to these areas.
Aside from news breaking outbreaks, there is always some level of risk in traveling to exotic, third world nations. Areas of concern include: poor water quality, availability, and sanitation. Unsafe water kills 1.7M people each year; the same number of deaths that a country the size of the U.S. sees from healthcare-associated infections. The third world and first world both see significant mortality, yet they are at polar opposite ends of the health-care spectrum. Interesting. Water in and of itself is one issue. What may be lurking in the water, another. So you decide you’ll take the risk, and have an adventure. But before you set out to see the ruins at Machu Picchu or go on safari in the Serengeti there are a number of things to prepare 4-6 weeks before getting on a plane.
So, let’s see what bugs are out there just waiting to get a ride back to first world living. We have the vector-borne: Malaria, Yellow Fever, Zika, Plague, African Sleeping Sickness, Chagas, Dengue; and the Bacterial and Viral: Cholera, Typhoid fever, Hepatitis A and B, Polio, Meningococcal disease, Leptospirosis, SARS, Tb, Rabies (5). It’s a long list. And these are just the most common ones. So, your first stop should be your physician or travel medicine clinic. Having your immunization record is helpful so the healthcare worker can make sure you’ve had all your basic immunizations. Then, depending where you’ll be traveling, recommend others and give you the required ones.
In addition to eating and drinking safely, practicing good hand hygiene is an important piece to remaining healthy while abroad.
There are Mobile apps from the CDC that are available to install on your phone to access information at your fingertips: TravWell, Can I Eat This?, 2016 Yellow Book. The Yellow Book is the CDC book on health information on international travel (3).
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