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    Traveler's guide to avoiding infectious diseases

    Travelers' health; Infectious diseases and travelers

    Information

    The best way to stay healthy during travel is to prepare before you leave and take preventive measures while traveling. Most infections that you catch while traveling are minor, but in rare cases, they can be severe or even deadly.

    Different areas of the world have different diseases and require different steps for prevention. The following things affect health safety and should be considered:

    • Local climate
    • Insects and parasites
    • Sanitation

    The best public sources for up-to-date travel information are the:

    BEFORE TRAVEL

    Talk to your health care provider or visit a travel clinic 4 - 6 weeks before you leave for your trip. You may need a series of pre-travel vaccinations. Some vaccines need time to work.

    Depending on where you are going, you may need to update your vaccinations. Your doctor may say you need a "booster" vaccine. For example, you may need booster vaccines for:

    • Diphtheria, tetanus, and pertussis (Tdap)
    • Influenza (flu)
    • Measles - mumps - rubella (MMR)
    • Polio

    You also may need other vaccines for diseases that are not commonly found in North America. Examples of recommended vaccines include:

    • Hepatitis A
    • Hepatitis B
    • Meningococcal
    • Typhoid

    Certain countries have required vaccinations. You may need proof of vaccination to enter the country.

    Yellow fever vaccination is required to enter several Sub-Saharan, Central African, and South American countries. Meningococcal vaccination is required to enter Saudi Arabia for the Hajj pilgrimage. For a complete list of country requirements, check the CDC or WHO web sites.

    People who may have different vaccine requirements include:

    • Children
    • Elderly people
    • People with weakened immune systems or HIV
    • People who expect to be in contact with certain animals
    • Women who are pregnant or breastfeeding

    Check with your health care provider or local travel clinic.

    PREVENTING MALARIA

    Malaria is a serious disease that spreads by the bite of certain mosquitoes. The disease is a risk mainly in tropical and subtropical climates. Malaria can cause high fevers, shaking chills, flu-like symptoms, and anemia.

    If you are traveling to an area where malaria is co mmon, you may need to take medications that prevent the disease before you leave, during your travel, and for a short period after you return. How well the medicines work vary. You should take additional steps to prevent insect bites.

    PREVENTING INSECT BITES

    Mosquitoes and other insects can transmit malaria and a number of other infections to people. To protect yourself, wear insect repellant containing DEET or picaridin whenever you are outdoors. You may also need to use a bed mosquito net while you sleep.

    Other steps to help reduce mosquito bites:

    • Wear trousers and long-sleeved shirts, particularly at dusk.
    • Sleep only in screened areas.
    • Don't wear perfumes.

    FOOD AND WATER SAFETY

    It is possible to catch many infections by eating or drinking contaminated food or water. Undercooked or raw foods pose a significant risk for infection. Avoid the following:

    • Cooked food that has been allowed to cool (such as from street vendors)
    • Fruit that has not been washed with clean water and then peeled
    • Raw vegetables
    • Salads
    • Unpasteurized dairy foods such as milk or cheese

    Drinking water that is not chlorinated enough or that is from areas with poor sanitation can lead to infection. Only drink the following liquids:

    • Canned or unopened bottled beverages (water, juice, carbonated mineral water, soft drinks)
    • Drinks made with boiled water, such as tea and coffee

    Do not use ice in your drinks. Local water can be purified by boiling, or by treating it with certain chemical kits or water filters.

    OTHER STEPS TO PREVENT INFECTIOUS DISEASES

    Frequently clean your hands using soap and water or an alcohol-based cleanser to help prevent infection.

    Avoid standing or swimming in fresh-water rivers, streams, or lakes that are contaminated with sewage or animal feces because they can lead to infection. Generally, swimming in chlorinated pools is safe.

    WHEN TO CONTACT A MEDICAL PROFESSIONAL

    Travelers' diarrhea is the most common infection caught while traveling. Diarrhea can sometimes be treated with rest and fluids. Your health care provider may prescribe an antibiotic to have if you get sick with severe diarrhea while traveling.

    If the diarrhea continues or you develop a high fever or dehydration, seek immediate medical care. If you were sick with a fever while traveling, contact your health care provider when you return home.

    References

    Arguin P. Approach to the patient before and after travel. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsiever; 2011:chap 294.

    Basnyat B, Ericsson CD. Travel medicine. In: Auerbach PS, ed. Wilderness Medicine. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2011:chap 84.

    Fairley JK, John CC. Health advice for children travelling internationally. In: Kliegman RM, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 168.

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        Tests for Traveler's guide to avoiding infectious diseases

          Review Date: 2/25/2012

          Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc., and David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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