Bugs and Bowels

No one likes having diarrhea or vomiting but it can be really miserable when you are far from home. Despite following food and water precautions, you might still get sick when you travel especially to Mexico and under developed countries.

If you are having significant diarrhea without vomiting and you have a prescription for an antibiotic such as ciprofloxin or azithromycin, start it. You may feel much better after one dose.  Prescriptions such as these are given at your pre travel consultation.  (Didn’t go to a travel clinic before your trip? Don’t make that mistake again.)

If you are vomiting, start with about a tablespoon of bottled water, tea, soda, or juice every 10 -15 minutes.  If that doesn’t stay down, try a teaspoon every 10 minutes. If you have access to ice made with bottled water, suck on some ice chips. Some fluid can get absorbed through your mouth and feels good. If you have oral rehydration solution, mix that with bottled water to replace electrolytes. Avoid sports drinks as they are designed to replace fluids lost from perspiration not the stomach tract. Gradually add fluids and food as you feel better. If you just have water, add some foods with  salt such as potato chips or pretzels.

The blue areas indicate countries with high risk of traveler’s diarrhea.

Staying hydrated is very important , especially in a hot humid climate. If you have severe abdominal pain, a fever, or can’t hold anything down, develop blood in your stools, get very thirsty and continue to feel worse, seek health care.

Be sure to plan ahead for treating vomiting and diarrhea when away by bringing a prescription for an antibiotic, a thermometer, and oral rehydration salt packets.

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They’re back…

Black flies, mosquitoes and ticks are upon us here in New Hampshire. Although we only have these pests seasonally, they exist year round in many places you may travel to. 
So what’s the best way to protect yourself from bites?  Covering up with clothing and tucking pants in to shoes will help.  But ticks still manage to find you. Using products with 25% DEET or higher also work but have limitations. They need to be reapplied and product duration varies so you have to check the label and make sure you comply with the directions. If you are swimming or sweating, you will need to reapply even more often. They smell and you will want to wash it off when you are no longer worried about the bugs.  
You can treat your clothing to make them insect repellent by spraying on or soaking them with permetherin. Permetherin is a man made version of a natural insect repellant found in chrysanthemums. It is inexpensive and after treatment they are insecticidal for 6 weeks or 6 launderings, whichever comes first.
Recently a new line of clothing has been developed with permetherin impregnated into the fibers that lasts for 70 washing which equals the life of the garment.  Insect shield clothing is available at outdoor clothing companies, travel clothing companies and  on amazon. The clothing is odorless and repels mosquitoes, ticks, fleas and flies. They are a bit more expensive and you will still need to use some insect repellent on your exposed skin but together they provide the most protection.  Remember to also perform a tick check every day and if you find any, remove them properly

Malaria in the Bahamas 2012

The Centers for Disease Control and Prevention (CDC) has recently received an official report of a confirmed case of malaria in a U.S. traveler who visited the island of Great Exuma, Bahamas in February and March of this year. The last documented case of malaria there was in 2008.  Malaria control measures and increased surveillance have been started.
If you have traveled to the Bahamas this winter and develop flu like symptoms, especially fever, see your health care provider and tell them you’ve been to a malaria area. You could develop symptoms for up to a year after exposure. Malaria can be detected by a special blood test. Treatment is most effective if started early.  Do not donate blood for a year after possible malaria exposure.
If you are planning on going to the Bahamas, be sure to use insect repellent with 30% DEET, cover up exposure skin and sleep in air conditioned rooms or with screens or be nets. For more info on malaria prevention go to the CDC and www.malariahotspots.co.uk/

Questions about Vaccines?


Getting shots to protect you from disease when you travel is a big part of a visit to a travel clinic. You may be getting shots for diseases you may have never even heard of before. Your travel health specialist can help you decide which shots make sense for you get based on where you are going, when you are going and what you might be doing while you are there. The Center for Disease Control (CDC) produces handouts called Vaccine Information Statements or VIS’s for every vaccine for kids and adults. These are available in over 35 languages.

VIS explain what the disease is, who should get it, and when it is given. It lists who should not get the vaccine and what the risks and possible reactions might be. This way you can weigh the risks and the benefits and decide how to best protect yourself from vaccine preventative diseases when you travel.

Heading South Soon?

Dreaming about a warm, sunny beach in a tropical paradise? If you are heading south this winter, I bet you are not dreaming of traveler’s diarrhea, dengue fever , or malaria , which can be found in Paradise, too.

To prevent diarrhea, don’t drink the water, brush your teeth in it, have drinks with ice cubes or frozen blended drinks. Don’t eat food unless it is piping hot and thoroughly cooked. No fresh fruit or vegetables unless they are peeled. Mangoes, papaya, pineapple and banana can all be peeled. It’s a very good idea to get vaccinated for hepatitis A, a viral infection of the liver, transmitted from contaminate foods and water. Staying at a resort that tells you their water is filtered? Still don’t drink the water and follow all the precautions because you don’t know what kind of filtration system is used and how well it is maintained. It is a good idea to bring a prescription antibiotic to self treat diarrhea just in case.

Avoid mosquito bites day and night. One bite from one mosquito can result in a case of dengue fever or malaria. Dengue fever, nicknamed broke bone fever, is increasing in the tropics. There is no treatment or vaccinations, so the only protection is by covering up and using 30% DEET insect spray all day and night. Find out whether you need to also take malaria pills before you go.
To get information, consult a travel clinic and the CDC web site on travel health. A visit to a travel clinic will be sure your immunizations are current and will provide you with prescriptions for traveler’s diarrhea or malaria. Don’t want to worry about malaria or dengue fever? Consider talking to a travel clinic before you book your trip for advice.

So, when you are laying on that beach , the only thing you’ll need to worry about is getting sunburned. Then the only things you’ll bring home will be great photos, good memories and a few souvenirs.