Make a Travel Clinic Part of Your Vacation Plan

By David Mathison, M.D., Scripps Health

Planning a surf trip to Mexico, a sightseeing vacation in Africa or backpacking adventure through remote Asian countries? Travel to developing countries can be exciting, especially in places that haven’t yet been commercialized and still feel unspoiled and authentic.  Unfortunately, such destinations often present an increased risk of travel-related illnesses. According to the Centers for Disease Control, most travel-related health problems are mild, self-limited illnesses such as diarrhea, respiratory infections, and skin disorders. However, approximately 8% of the more than 50 million travelers to developing regions, or 4 million people, are ill enough to seek medical care, either while still traveling or upon returning home.

Before you head off to a foreign destination—especially one that is unindustrialized or remote—make an appointment with a travel medicine clinic.  Often affiliated with hospitals, these clinics specialize in preparing travelers for the viruses, bacteria and other health risks they may encounter while traveling to foreign lands.

The most common complaint is traveler’s diarrhea, which results from the ingestion of harmful bacteria in food or water. Infection can lead to diarrhea that lasts several days and is often accompanied by painful abdominal cramps, vomiting and fever. In severe cases, travelers may have to be treated for dehydration. Learning what to foods and drinks to steer clear of can help travelers avoid this illness (and it doesn’t hurt to pack medication just in case).

Hepatitis A, a serious disease that attacks the liver, is caused by a virus and spread through ingestion of contaminated food.  Immunizations can help protect against Hepatitis A, and anyone traveling to a developing country should receive this vaccine.

In the United States, mosquitoes may spread West Nile virus. In other countries, especially much of the second and third world, mosquitos may carry malaria and yellow fever. The diseases are spread through the bites of infected mosquitoes and can be quite serious.  Malaria prevention medicines are recommended for travel to much of the second and third world; yellow fever immunization is required for travelers visiting certain parts of South America and Africa.

Meningococcal disease is a serious bacterial illness which is spread from person to person through saliva and respiratory secretions; for example, coughing, sneezing, kissing and sharing utensils.  The vaccine is required for travel to Mecca and recommended for certain countries in Africa.

Site-specific vaccine-preventable diseases are recommended for travel to specific areas that are known to have a higher risk of certain illnesses.  For example, an adult polio booster is recommended for travelers to India and Africa; travelers to rural Asia should be vaccinated against Japanese encephalitis.

Even if you aren’t headed to a developing country, you may still encounter some travel-related health risks. Influenza can be contracted almost anywhere and is more easily spread in confined spaces, such as airplanes, trains and ships. During flu season, you should receive an influenza vaccine to help protect them from the most prevalent viruses, and wash your hands often or carry anti-bacterial wipes or sprays.

Altitude sickness results from a lack of oxygen in the air at higher altitudes and most often occurs when travelers ascend quickly from a low altitude to a higher one. Symptoms include headache, loss of appetite, nausea and dizziness. In severe cases, altitude sickness can affect the lungs or brain and the victim requires immediate medical attention.  Medication can help prevent altitude sickness by making it easier for the body to adjust to rapidly increasing heights.

Based on your travel plans and individual health history, a travel clinic’s medical specialists can provide immunizations, medications and other recommendations to help prevent illnesses. Travel medicine specialists also can help people with chronic medical conditions such as diabetes and heart disease adjust medications to travel across multiple time zones as well as decrease the risk of complications. For example, people who have an increased risk of deep vein thrombosis, a potentially life-threatening condition caused by blood clots deep inside the veins, may benefit from anti-clotting drugs to keep the blood flowing during long, cramped plane rides. Diuretics may be recommended for some patients who have problems with fluid build-up in the lungs, as changes in altitude and cabin pressure can affect fluid retention.

For a referral to a travel medicine clinic, contact your physician or local hospital. Schedule an appointment at least four weeks in advance of travel, and bring itineraries, immunization records and any prescription medications for all travelers. For more information about staying safe while traveling, visit http://wwwnc.cdc.gov/travel.

David Mathison, M.D., is an immunologist and allergist with Scripps. For more information or a physician referral, call 1-800-SCRIPPS or visit www.scripps.org.