Saturday, July 2, 2011

How to Avoid 5 Health Travel Mistakes

Summer’s here and it’s time to hit the beaches, lakes or mountains for some well-deserved R&R. But don’t ruin your trip as millions of other vacationers do by falling sick, getting burned or bitten. Here’s the lowdown on how to avoid the top 5 health travel mistakes, plus safety tips so you can enjoy your vacation…

You packed your killer bikini and instant-dry cargo pants – you even remembered your ear plugs. Time to say “bon voyage”?

Not so fast!

“If you forgot to consider the health risks at your destination,” you could be asking for a travel-related illness, warns Bert Lopansri, M.D., medical director of the Loyola University Health System’s International Medicine and Traveler’s Immunization Clinic in suburban Chicago.

For example, if you’re planning a camping trip in the mountains, you’ll need to take special precautions to protect yourself from sunburn, insect bites, poison oak and contaminated water, says Lopansri.

“Even if you’re staying at the Ritz, you’re not out of the woods when it comes to travel illnesses and injuries,” says former cruise ship physician Robert Wheeler, M.D., in-house medical director for On Call International, a global medical and travel assistance provider based in Salem, N.H.

“You still have to watch what you eat and drink, be careful not to get too much sun and protect yourself against insect bites,” he says.

To learn how to avoid these top 5 common health travel mistakes, read on.

Health travel mistake #1: You drank out of a stream while camping!
That sparkling mountain stream couldn’t possibly be anything but pristine, right?

In fact, it’s probably harboring Giardia, a common microscopic parasite found in backcountry streams, lakes and rivers and even in hotel swimming pools, says Charles Ericsson, M.D., professor of medicine at the University of Texas in Houston and director of UT’s Travel Medicine Clinic.

Swallow just a gulp of infected water, and you’ll soon be racing to the bathroom with watery diarrhea, vomiting, abdominal cramps, bloating and nausea, he says.

Travel Safety Tips:

Don’t drink water from streams, river or lakes or questionable springs. Don’t brush your teeth with it either, warns Ericsson.

Drink tap or bottled water instead. All tap water in the U.S. is regulated by the Environmental Protection Agency (EPA) and must meet strict purity standards. Bottled water, which is regulated by the Food and Drug Administration (FDA), is subjected to equally stringent requirements.

“Pack over-the-counter anti-diarrhea tablets, like Imodium,” says Ericsson.

Drink plenty of water to replace lost fluids from diarrhea and vomiting, he says.

If you’re hiking or camping, boil water for at least 10 minutes before drinking it or cooking with it to kill Giardia. Or buy a water filter that kills the parasite, says Lopansri.

“Pack sanitizing wipes rather than gel so you can wipe off eating utensils as well as your hands before eating,” Lopansri says.

Wash your hands after using the outhouse or toilet, changing diapers, before preparing or eating meals and after sex.

Don’t wash dishes in ponds, rivers, streams or lakes. It’s bad for the environment and your tummy. Instead, wash them in water that’s been boiled for 10 minutes.

Keep your mouth closed when swimming in pools, ponds, rivers lakes or streams to prevent swallowing.

Ask your doctor for a prescription for the antibiotics metronidazole, tinidazole or nitazoxanide, which can clear an infection, and pack it along in case you get Giardia, says the Centers for Disease Control and Prevention (CDC).

Travel health mistake #2: You ate a bad tuna salad sandwich on the plane.
You raced to catch your flight and had just enough time to buy a to-go lunch at the airport restaurant. By the time you remembered it was in your carry-on bag, you were four hours and 2,000 miles away from home – and ravenous.

Before you wolf it down, ask yourself: Do I really want to spend the rest of my vacation in the bathroom with food poisoning?

It’s one of the most common travel-related illnesses, affecting more than 50,000 travelers in the U.S. and abroad, says the CDC.

It’s caused by eating contaminated or spoiled food infected by bacteria, viruses or parasites. The most common culprits are the bacteria campylobacter (found in undercooked chicken or food contaminated with juices from raw chicken), salmonella (found in poultry, milk, eggs and meat that hasn’t been thoroughly cooked and/or properly refrigerated), and a strain of E. coli found in cow feces and transmitted to people who eat contaminated food.

“Diarrhea and vomiting usually begin a few hours after you’ve consumed the suspect food,” Wheeler says. “Most healthy people recover within a few days, even without treatment.”

Travel Safety Tips:

Thoroughly cook meat, fish and shellfish. Make sure shellfish is piping hot when served to you, advises Wheeler. That ensures that it destroys a bacterium called vibrio, which can cause food poisoning.

"Avoid unpasteurized milk or milk products,” because they can harbor bacteria, he says.

“Eat hot foods hot and cold foods cold,” says Wheeler. Bacteria multiplies quickly in the lukewarm “danger zone” between 40-140° Fahrenheit, so avoid hot food that’s cooled off or cold food that’s no longer cold.

"Avoid buffets, even on a luxury cruise,” Wheeler says. “You never know who’s touched the food or how long it’s been sitting out.”

Health Travel Mistake #3. You got bit!
A mosquito, tick or dog bite could turn a good vacation bad.

“In the U.S., mosquitoes can [transmit] West Nile disease, deer ticks carry Lyme disease, and wild animals and dogs can carry rabies,” he says.

West Nile disease is found throughout the continental U.S. About 20% of women bitten by a mosquito carrying the disease develop a mild infection; the rest have no symptoms at all, says the CDC. Symptoms include fever, headache and muscle aches. There’s no vaccine or treatment for West Nile fever and it usually goes away on its own in a few days. In rare cases, it can kill, and elderly people and babies are most at risk of complications.

There’s also no vaccine against Lyme disease, which is prevalent in the Northeast, Midwest, along the northern California and Oregon coasts and in most European countries.

If you’re bitten by a tick, see a doctor immediately. A single dose of the antibiotic doxycycline (Vibramycin, Adoxa, Alodox) is 87% effective at preventing Lyme disease if taken within 72 hours of the bite. For more info, visit cdc.gov/lyme.

Travel Safety Tips:

When camping or hiking, apply a DEET-containing insect repellent (Off!, Cutter, Sawyer, Ultrathon) to exposed skin and permethrin spray or solution to your clothing and gear. Hate the smell of DEET?

“Other effective insect repellents include products with picaridin, an odorless plant-derived chemical, or oil of lemon eucalyptus,” says Jeffrey Band, M.D., director of Infectious Disease and Interhealth Travel Medicine at Beaumont Hospital in Royal Oak, Mich. You’ll find picaridin in Cutter Advanced or Skin-So-Soft Bug Guard Plus, or products containing synthesized oil of lemon eucalyptus (Repel or Skin-So-Soft Bug Guard Plus Expedition).

Avoid grassy and vegetated areas at dawn, dusk and after dark, when mosquitoes are most active.

If you’re staying in a lodge or cabin without screens or air conditioning, prevent nighttime bites by surrounding your bed with a bed net treated with permethrin. They’re sold by many camping supply stores.

Wear long-sleeved, tucked-in shirts, long pants, hats and closed-toe shoes with socks instead of sandals when enjoying outdoors activities.

Check yourself for ticks while outdoors and at the end of the day. To remove a tick, use tweezers to grasp the creature near its head or mouth and pull gently without twisting or “unscrewing” it. This will extract the tick without crushing it or leaving parts of it inside your skin, which could cause infection.

Never approach stray dogs or wild animals. Rabies is rare in the U.S., and only 55 cases have been diagnosed since 1990, says the CDC. (Bats are the most common transmitter.) But if you’ve been bitten by an animal that you suspect is rabid, get medical help immediately. Left untreated, rabies is usually fatal, says the Mayo Clinic.

Health travel mistake #4: I got too much sun!
Planning on hitting the beach and working on your Jersey Shore tan?

Think twice, says Carolyn Dean, M.D., N.D., a Maui-based physician and beach-lover.

“Too much sun will not only give you a nasty burn, but also dramatically increase your risk of skin cancer,” she says.

Skin cancer is the most common form of the disease in the U.S., with more than 1 million new cases diagnosed each year. The deadliest type, melanoma, accounts for just 4% of skin cancer cases but more than 75% of deaths.

Getting burned five times as a child doubles the risk of getting skin cancer as an adult, so protect children from sunburn, as well, advises Elizabeth Hale, M.D., an assistant professor of dermatology at the New York University School of Medicine.

Still not convinced to seek the shade? This may send you running for the nearest beach umbrella: Sun exposure causes 90% of wrinkles, fine lines and sun spots, says the Skin Cancer Foundation.

Travel Safety Tips:

Wear a broad-spectrum sunscreen with a sun protective factor (SPF) of 15 or higher that offers UVA and UVB protection. Reapply after two hours or after swimming or sweating.

Use sunscreen even on cloudy days, as 80% of ultraviolet rays pass through clouds, says the American Melanoma Foundation (AMF).

Wear a hat with a wide brim to protect your face, neck, head and ears; avoid straw hats and baseball caps.

Wear wrap-around sunglasses that ideally block 100% of UVA and UVB rays. Even eyes can get damaged by the sun.

Opt for loose-fitting long-sleeved shirts and long pants made from tightly-woven fabrics, or clothing with Ultraviolet Protection Factor (UPF) protection.

Be careful in the mountains too: Ultraviolet rays increase 4% for every 1,000-foot increase in altitude, so don’t forget your sunscreen, says the AMF.

Be especially sun-savvy between 10 a.m.-4 p.m. daylight savings time, the most hazardous time for ultraviolet (UVA and UVB) ray exposure in the continental U.S., according to the CDC.
Health travel mistake #5: You’re covered in a rash!
Many plants cause skin rashes, but the most common culprits are poison ivy (which thrives across the U.S., except in California, Alaska and Hawaii); poison oak (found in the Southeast and West Coast) and poison sumac (indigenous to the Mississippi River area and in boggy areas of the Southeast), says the CDC.

All three plants release urushiol, an oil that triggers an itchy red rash, bumps or blisters, even with an amount the size of a salt crystal, says Ericsson.

Common in forests, fields and along streams, the unholy trio also grows along road sides and in city, state and national parks, says Ericsson.

For more information on poison plants, visit the CDC.

Travel Safety Tips:

Know what the plants look like and avoid them.

Wear long sleeves, long pants and boots when hiking.

Think you touched something? Rinse your skin with rubbing alcohol or special washes for poison plants, or use a degreasing soap like dishwashing soap. Rinse with lots of water and don’t forget to scrub under your nails.

Apply calamine lotion, hydrocortisone cream or special creams for poison ivy, oak or sumac on to the skin to ease itching and blistering. (Avoid putting it on open blisters.) Take a warm oatmeal bath (commercial preparations, or make your own by grinding dry oatmeal in a coffee grinder). Or try antihistamines like diphenhydramine (Benadryl).

See your doctor if the rash is severe, shows signs of infection with fluid leaking from the blisters, or has spread to sensitive skin areas, like your face or genital region, says the National Institutes of Health.

Are You a Travel Pro?
Have you taken the time to check into helpful travel tips to ensure that you have a safe and enjoyable time? Even if you have decided to engage in a bit of last-minute travel planning, remember that some essentials are too important to forget.

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