What to Know Before You Go

March 2020 Issue
By Donne Paine, Travel Medicine Nurse

When planning international travel there
is a recommended check list...

#1 Research: learning a little about where you are going is always to your advantage. Researching the country, their customs, culture and what is currently happening. Learning a few phrases in their language like “Hello”, “Thank you” and “Where is the bathroom” are helpful, as well.

#2 Be Prepared: Make sure your passport and driver’s license is valid for at least six months. Make copies of them on your phone, and hard copies to tuck in your luggage and leave a copy with someone at home.

#3 Money: Try to bring some of the currency of the country you are visiting. Make sure you notify your credit card companies where you will be and when.

#4 Luggage: To check in or not to check in: Luggage can be a burden if too big and heavy. Rick Steves, travel guru, never allows anyone on his tours to check in luggage. You would be surprised how much you can pack into a 21-inch carry on.

#5 STEP Program: The US State Department has a service titled STEP (Smart Travelers Enrollment Program). It is a free enrollment service at step.state.gov The enrollment allows you to list where you will be and when. The information is sent to the appropriate US Embassy or Consulate. In the event there would be an evacuation in the area you will be visiting, the state department would be aware of your location.

#6 Health and Wellness: When traveling outside of the United States, especially to exotic lands or third world countries, it is important to take time to look at your health, and protecting it so your vacation won’t be interrupted, and you can minimize the risk of coming home with something that could be avoided.
> Prescriptions: Make copies of your prescription drugs labels and make sure you have enough to last through your trip with a few extra days in case of unforeseen layovers.
> Food: Travelers’ diarrhea happens to 60 percent of international travelers. It is defined as three to four loose stools, with or without belly cramps, within 24 hours. Ways to avoid it: Wash your hands frequently, use hand sanitizer, eat hot, well-cooked food. No salads, no fresh fruit unless you have peeled it yourself. Eat hot soup and always go for the hottest. If you are at a buffet and the food that should be hot isn’t, avoid it.
> Water: Always drink bottled water. No exceptions. No ice in drinks. Make sure the cap of bottle water has not been compromised. Bring a few straws to insert into cans so not to touch the cans with your lips. Brush your teeth with bottled water and maybe bring a few extra toothbrushes in case you forget. Avoid purchasing food from a street vendor, eat food from sealed packages, eat fruits and vegetables you can peel yourself, or wash with bottled water. Avoid salads and condiments made with fresh ingredients, like salsa.
> Mosquitos: If you are traveling to Africa, India or some parts of South America, you need to put thought into good mosquito protection. Mosquitos come out at dusk and dawn and hang around small puddles of water. The malaria-carrying mosquitos are different than those in the Lowcountry. You need a stronger insect repellent than you can get at your local drug store. If you are visiting malaria zones, protect your exposed skin with loose clothing and an insect repellent with Deet or Picardin in it.

You’ve taken care of your passport, your foreign currency, your luggage selection, you’ve learned about food and water precautions, and you’ve bought your strong insect repellents! Now it’s time to take care of your health regarding immunizing yourself.

The CDC has a great app for smart phones CDC Travel Well, or www.cdc/travel, both provide information on recommended vaccines, depending on where you are going and when.

These informational apps and websites have current updates on world health alerts, as well.

Here in the United States we are fortunate
to have many vaccines available to us:
> MMR Measles, Mumps and Rubella are serious and highly contagious viral diseases. Who should be vaccinated? All children, adults born after 1957 and international travelers.
> Tdap: Tetanus, Diphtheria and Pertussis occur worldwide but are more common in under resourced countries and communities. A Tdap vaccination is recommend every 10 years if you are a domestic traveler, and every five years for international travelers.
> Influenza (Flu): Influenza is a contagious respiratory illness and is transferred from person to person through the air as a result of coughing, sneezing, or touching infected objects. And as we currently are experiencing with the corornavirus, different strains come out every year or two. What is most important is that you receive an annual flu shot.
> Chicken Pox and Shingles: Travelers who are uncertain if they had chicken pox can have a blood test to check for immunity. Non-immune travelers should receive 2 doses of the chicken pox vaccine before travel. For adults over 50 years old, a two dose shingles vaccine is available.
> Meningitis. Meningitis is an inflammation of the protective covering of the brain and spinal cord. People living in large groups like dormitories, military and pilgrims going to mecca are at increased risk. Travelers going to countries in the meningitis belt of Africa should consider this vaccine.
> Hepatitis A and B. Hepatitis is a disease of the liver. The A strain is transmitted from person to person and also by ingesting contaminated food or unsafe water, inadequate sanitation and poor personal hygiene. The B strain is transmitted through contact with blood or body fluids.
> Polio: Because of childhood vaccinations only small areas of polio transmission still occur, primarily in under resourced countries in Asia and Africa. A lifetime adult booster is recommended for international travelers.
> Typhoid Fever: Typhoid fever is most often acquired through consumption of water or food that has been contaminated by feces of an acutely infected person. Taking the vaccine and practicing safe food and water precautions are critical while traveling.
> Cholera: Cholera is an acute diarrheal illness caused by a bacterium. This vaccine is recommended for international healthcare workers and travelers visiting rural areas of countries where Cholera is active.
> Yellow Fever: Transmitted by a mosquito, yellow fever is primarily found in the tropical and subtropical areas of Africa and South America. The YF vaccine is a one-and-done lifetime coverage vaccine.
> Japanese Encephalitis: It is a brain infection caused by the JE virus and transmitted by a mosquito. It is endemic throughout most of Asia and parts of the Western Pacific.
> Rabies: The United States, Canada, Europe and the UK are the few countries that vaccinate their pets, therefore, when traveling abroad, no matter how cute and cuddly, stay away from animals! Rabies vaccine is available proactively.

The CDC and WHO (World Health Organization) provide recommendations for vaccines that can prevent important travel related infectious diseases.

Stay Healthy and Safe Travels!