Q&A: Catching the Sights, Not the Bugs

Written By Unknown on Kamis, 27 Desember 2012 | 17.35

Friends and family so often asked Dr. Charles E. Davis, a specialist in microbiology and infectious disease, how to avoid getting sick when they travel abroad, he decided to put all of his advice in one place. The result is "The International Traveler's Guide to Avoiding Infections," released this year by Johns Hopkins University Press. Below are edited excerpts with Dr. Davis in a discussion about precautions international travelers should take before and after trips to far-flung destinations.

Q. What steps should you take before you depart?

A. If you're going to a developing country, visit a travel clinic four to eight weeks before you travel to get any immunizations you may need. You can find one on the Web sites of the International Society of Travel Medicine or the American Society of Tropical Medicine and Hygiene. Make an appointment with your primary care physician for a physical examination and for any routine immunizations like a D.P.T. update, hepatitis A and B and influenza; insurance companies generally do not cover travel-related immunizations, so if you get these done at travel clinics, you run the risk of paying out of pocket. Pregnant women, children and those with compromised immune systems should definitely consult their physicians; recommendations for immunizations and antibiotics vary for them. And check out the Centers for Disease Control and Prevention's Web site for travel notices about current disease outbreaks.

Q. What happens at the travel clinic?

A. You'll be asked your medical history and a number of questions about your trip's itinerary, duration and purpose, which lets the physician determine which immunizations you need. Going on a business trip to a large city in a developing country, you're at much less risk of contracting an infection than, say, doing a safari trip or aid work in a rural region.

Q. Is travelers' insurance worth getting?

A. Depends on your destination, your age, your health, what you're doing and whether or not you're a gambler. A good travel insurance policy, which can run from a hundred to several hundred dollars, provides you with medical treatment, assistance from a physician-supported, 24-hour emergency call center and, if necessary, emergency medical evacuation. Some good ones I recommend are FrontierMEDEX; International SOS; and CSA Travel Protection. You can comparison shop at TravelGuard.com or InsureMyTrip.com.

Q. What should you pack?

A. For any overseas trip, I recommend taking along self-treatment for traveler's diarrhea — loperamide, known by the brand name Imodium here, and an antibiotic, the most common being ciprofloxacin.

If you're going to a malarial area, the travel clinic should prescribe you malaria prophylaxis, the most common of which is Malarone, to take during your trip and seven days after it. That will kill off any parasites in your bloodstream, but two milder forms of malaria can continue to multiply in the liver. If you develop an unexplained fever six months, even a year, after your return, go to your doctor.

Other things to pack: Band-Aids and topical antibiotics to treat minor wounds; water purification tablets like Potable Aquaor Coghlan's or portable filters; sunscreen; and insect repellent with 30 to 50 percent DEET. Hikers should bring a full suture kit. If you're staying in accommodations that do not have good screens, I recommend getting mosquito nets and clothes impregnated with pyrethrum, a natural insect repellent.

Q. While you're visiting a country, what should you keep in mind?

A. Avoid tap water and ice in developing countries as well as salads and buffets, which bacteria just love. A good rule to follow: boil it, peel it or forget it.

Q. And once you return?

A. If you were away longer than three months in a developing country, had done aid work or were exposed to needles or fresh water, or had been ill or had sex, I'd recommend doing a screen for various infections at a travel clinic. If you were healthy during a short trip, there's no need.


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