Travel Tip Tuesday

Did you know that road crashes are the single greatest cause of death for healthy Americans traveling abroad?  Americans are traveling increasingly to countries where the chances of being killed or seriously injured may be from 20 to 40 times greater than in the U.S. The Know Before You Go program offered by the Association for Safe International Road Travel provides tips so you won’t become a statistic. Oh yeah and don’t forget to buckle up, wear a helmet, look every which way when you cross and don’t drive distracted by anything!

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Hurricane Season

The Department of State alerts U.S. citizens to the hurricane and typhoon seasons in the Atlantic and Pacific Oceans, the Caribbean, and the Gulf of Mexico. Check out what’s happening to see how your travel plans may be impacted by weather.

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.

Dirty Needles?

Traveling in under developed countries poses some unique challenges. What if I get cut and need stitches? What if I have a dental emergency? Get diarrhea so bad I need IV rehydration? Will they have properly sterilized equipment?

You can purchase syringe and suture kits to take with you. These are not do it yourself kits. They are to be given to a trained health care provider to use on you in such emergencies.

Typically, these kits contain needles, suture materials, IV catheters, gloves and antiviral and antibacterial wipes to close wounds and start IV’s. They can be used to administer anesthetics for emergency dental procedures, too.

To help with going through customs,  get a note from your travel clinic provider that states that these items are being used for personal use only. One kit from Adventure Medical Kits has declaratory statements about use printed on the outside in 8 different languages.

Many travel clinics, including Travel Health of New Hampshire, have these kits available for purchase. Hopefully you will never need to use such a kit,  but in countries where blood borne diseases such as HIV and hepatitis are common, it is reassuring to know that if you the equipment used on you is definitely sterile.

Choosing a Travel Clinic

The American Travel Health Nurses Association (ATHNA) offers these guidelines for consumers to help them choose a travel clinic.

1. Look for a clinic that offers customized care. Your pre-travel visit should include an in-person assessment and focus on an individualized plan specific to your health history, destination, and potential activities.

2. Ask about counseling to reduce the non-vaccine preventable risks of travel. Pre-travel preparation is more than just immunizations. Your visit should include sufficient time to address issues such as malaria, altitude illness, dengue, jet lag, and traveler’s diarrhea.

3. Ask about clinic charges and payment. Charges vary widely and many travel health costs are not reimbursed by health insurance. Costs for vaccines continue to rise. Know that some clinics work on a commission basis and providers receive a percentage of the total bill. Be aware of potential conflicts of interest.

4. Inquire about the training and experience of your provider. Quality pre-travel care is offered by many health professionals, including MDs, NPs, RNs, PAs and pharmacists. However, there are few national standards for entry into practice. While membership in a professional organization, such as ISTM, ASTMH, and ATHNA, is no guarantee, it may suggest a larger commitment to the specialty.

5. Think about finding a clinic early, even before you make final payment for your trip. While most travelers need only one visit to prepare for their journey, others may require multiple visits. Ideally, you should start 4 to 6 weeks ahead of departure. However, it is never too late to receive pre-travel care. Travelers seen just hours before a flight can still reduce important travel risks.