Worldwide travel can expand health risks

From vaccinations to driving, know what to expect when you land in foreign countries

From vaccinations to driving, know what to expect when you land in foreign countries

May 29, 2006|by JULIE E. GREENE

Travelers' diarrhea, malaria, typhoid fever and driving - yes, driving - are all health issues people should consider when traveling internationally.

"I do not advise people to drive in a foreign country," says Dr. Ted Sofish, a doctor in occupational and environmental medicine who has worked at travel clinics for more than 10 years.

Sofish is thinking not only of the physical dangers of driving but the legal consequences of getting in an accident in a foreign country.

What could be considered involuntary manslaughter here could be homicide in another country, he says.

Several years ago an American citizen he knew was in an accident in Mexico and was in jail for 12 hours with a broken femur and pelvis before someone could clear him of responsibility, Sofish says.


Other health concerns people should prepare themselves for or try to avoid might be more obvious, though not always.

In addition to getting the proper vaccinations for their destination, Sofish recommends travelers be wary of swimming in certain recreational waters.

"You want to go swimming in a chlorinated pool that is well-maintained or you want to go swimming in the ocean, away from any sewage being discharged there," he says.

In Africa, there are some beautiful streams with cold, clear water, but there also might be the danger of coming into contact with a parasite that causes river blindness, says Sofish, who works at Occupational Health Associates in Chambersburg, Pa.

Some freshwater lakes contain flukes, a parasite that can cause delayed symptoms, he says.

Also, be wary of petting animals abroad.

Rabies is common throughout the world, and most Third World countries do not vaccinate animals for it, Sofish says. Little cuts around your fingers could be enough to let the rabies virus enter.

Vaccinations for malaria and yellow fever can help prevent contraction of diseases caused by flying insects, but there are other diseases insects can carry, Sofish says. Those include dengue fever, a mosquito-borne illness; West Nile Virus, which is present in the U.S.; and sleeping sickness carried by tsetse flies.

Travelers who are going to be in buggy areas, should take DEET sprays or towelettes, Sofish says.

As for avoiding travelers' diarrhea, there is a saying for what food to eat abroad - "Peel it, boil it or forget it," Sofish says.

"To that, I say, 'Well, that's good, but good luck,'" he adds.

Most travel diarrhea cases are caused by normal bacteria, just a different strain than what the traveler is used to. Even travelers to the U.S. can get it, he says.

Sofish suggests riding it out rather than immediately taking an antidiarrheal medication. It's also important to stay hydrated. If you have a more serious bacteria and you take the medicine, the infection could get worse and last longer. Also, the antibiotic could cause diarrhea.

Hold off on the medicine unless the illness becomes prolonged or is accompanied by bloody stools or fever.

Sofish also recommends avoiding drinking tap water and making sure any water you drink is in a factory-sealed bottle so you know you're getting clean water and not just bottled tap water. Otherwise, drink carbonated beverages or fruit juices from a factory - something that has been purified.

The chances are small that travelers would run into a serious illness abroad, given most circumstances. However if they do, it could become a serious problem, Sofish says.

Among travel tips:

· Get vaccinations

· Check health insurance

· Be aware of infectious diseases

· Consult your doctor

· Is your prescription drug illegal?

· Get checked out when you get back

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