Awareness key to healthy travel

Most of these illnesses are preventable. And the key to prevention, says Mark Wise, family doctor and founder of the Travel Clinic in Toronto, is awareness.

Disease prevention for travellers falls into three basic categories:

– Food and water. Traveller’s diarrhea (TD), caused by contaminated food or water, is the most common ailment to hit travellers. The onset of TD usually is swift and unforgiving. The cause can be bacterial, viral or due to parasites. But TD always is a result of improper handling of food and drink.

Wise’s five-point strategy for food and drink while in foreign climes: “Boil it, bottle it, peel it, cook it or forget it.”

You might think only adventure travellers need worry about food safety, but even guests at high-end resorts can get sick, says Wise: “The resort might be ‘five stars,’ but you don’t know what’s going on behind the scenes.” Avoid swallowing untreated water, he adds, and find out how the kitchen washes its fruit and how well it cooks meat.

Carrying an over-the-counter medication such as Imodium to treat TD might be enough, depending upon your risk level. Risk factors include location, the time of year, planned activities and your age. Your doctor can help you map out a multi-pronged plan, which might include an oral vaccine that targets the most common cause of TD (which would be taken in several doses weeks before you travel) or carrying emergency antibiotics for more severe cases.

Hepatitis A, a viral infection of the liver transmitted through contaminated food and water, can be avoided with proper food and drink handling. To be safe, many travellers choose to be inoculated beforehand.

– Mosquito-borne illnesses. The most common insect-borne illnesses you could pick up in the tropics are malaria, dengue fever and the chikungunya virus – all of which are carried by mosquitoes. The usual advice to avoid malaria is to wear long, light-coloured clothing in the evening and to use a mosquito net for sleeping to avoid being bitten.

But dengue fever and chikungunya are transmitted by mosquitos that feed during the day, according to Wise, so precautions should be taken during these times as well. With the resurgence of both of these illnesses in Central America, the Caribbean and Mexico, Wise says, it’s imperative that even people taking weeklong escapes pay attention to the risks.

Dengue and chikungunya won’t necessarily affect your trip because they can take weeks to reveal themselves. Both feature the sudden onset of high fever, severe headaches and muscle and joint aches.

Although covering up exposed skin with long-sleeved shirts and pants can help to prevent bites, that isn’t always practical in hot, humid climates. An insect repellant containing DEET or icaridin (also known as picaridin) should be applied to exposed skin at least 20 minutes after the application of sunblock, Wise says. DEET is available in concentrations of 5%-30%. As with SPF numbers, the concentration of DEET is not indicative of its strength; rather, the number indicates the length of time you can take before reapplying it. According to Health Canada, a 30% DEET repellant should be applied every six hours, while a 10% concentration will last half that time. However, if you notice mosquitoes are overly interested in you, it’s time to reapply.

– Vaccinations. Your routine vaccinations – such as measles/mumps/rubella and tetanus/diphtheria/polio – should be up to date, Wise says. Depending upon where you are travelling, further vaccinations against other illnesses, such as hepatitis A and B, typhoid and Japanese encephalitis may be recommended.

Some countries require visitors to show proof of vaccination – for example, against yellow fever, a viral infection common in Africa and South America. Without that proof, you may be held for a few days to receive inoculation in that country. Check Health Canada’s travel health advisories and speak to your doctor about potential risks.

It also might be prudent to get a rabies vaccine. If you are bitten by an unknown animal while you are away from home, flush the area with soap and water for 15 minutes and seek immediate medical treatment. Then, upon returning to Canada, tell your family doctor about your exposure.

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