Ten Rules for International Travel
The purpose of Travel Medicine is to help keep your trip free from illness
or injury. By following these simple rules, the common hazards of travel
may be prevented.
- Seek pre-travel assistance from a certified Travel Medicine Clinic
for required and recommended immunizations and medical advice. Health
and safety conditions in the country of travel can change rapidly. Chronic
medical conditions can be aggravated by international travel. Many health
problems during travel are preventable with proper planning, education,
- Take appropriate precautions against accidental injury and for personal
safety. Statistically, accidental injuries due to automobile accidents
are the leading cause for medical attention while traveling. Simple
precautions (e.g. use of seat belts) can save a life overseas, as well
as, at home. Remember do not drink and drive. Guard your valuables,
passport, identification, medical information, and credit cards; also
be aware of local "tourist" crimes and scams. Be informed about the
latest State Department travel advisories and bulletins for your destination.
Devise a contingency plan for emergency medical care during travel in
the event of accidental injury or serious illness.
- Take your Malaria chemoprophylaxis as prescribed. Malaria remains
the world's top infectious disease killer and does not care what passport
you carry. Typical antimalarial medication includes Mefloquine (Lariam),
Chloroquine (Aralen), which are taken on a weekly basis, Doxycycline
and Malarone which are taken on a daily basis. As with all medicines,
the risk of side effects or interactions with current medications or
health conditions must be considered.
- Take personal precautions against insect bites. The use of repellent
containing 25-35% DEET (N,N-diethyl-metatoluamide) has been shown to
be the most effective. For your clothing, the use of permethrin (Permanone)
can maintain, through repeated washings, a repellent barrier of your
clothing for several weeks. In addition to repellents, stay in properly
screened off areas, use bed netting, avoid outdoors nighttime activities,
and cover as much of your exposed skin as possible.
- Diarrhea illness remains a significant cause of travel related illness.
Proper food and water precautions can prevent the majority of diarrhea
illnesses, however this remains a significant cause of travel related
illness. A Quinolone antibiotic (e.g. Cipro, Floxin, and Levaquin) should
be carried for self-treatment of diarrhea associated either with fever
or blood in the stool. Also rehydration with clear liquids and sports
drinks (e.g. Gatorade, Power Aide) can replace needed electrolytes and
fluids lost to dehydration. Simple diarrhea, which may occur only because
of dietary changes, climate changes, or from the stress of travel, is
often simply resolved with over the counter medicines (e.g. Imodium,
- Take appropriate dietary precautions. All water should be boiled,
bottled, or otherwise purified. The use of purification devices or chemical
methods like chlorine or iodine tablets may be necessary. All raw fruits
and vegetables should be peeled and washed in clean water or cooked.
Be cautious of fruit cocktails or frozen drinks. Meats should be cooked
well. Seafood can be a particularly deadly food even if prepared properly.
Remember, "Peel it, boil it, cook it, or forget it".
- Assemble a traveler's medical kit appropriate for your destination,
length of trip and your medical conditions. Include needles and syringes
if possible. Stock simple over the counter medicines for aches and pains,
fever, diarrhea, dysentery, sinus and allergy problems. If you are on
chronic prescription medicines ensure you have enough to cover your
- Avoid exposures to potentially contaminated blood or body fluids,
do not engage in unprotected sexual contact. Avoid procedures such as
tattoos, ear or body piercing and acupuncture.
- Do not walk barefoot outdoors. Do not swim, bathe or wade in fresh
water streams, rivers, or lakes. If it is not chlorinated, stay out
of it. Remember to use sun block (SPF 15 or higher) when outdoors. Avoid
the peak sun times, by limiting your activities to indoors.
- Be prepared for emergencies. Insure you have adequate monetary resources
to pay for emergency medical care and treatment. Your health insurance
is typically not accepted overseas. Payment in cash or credit card is
usually required at time of service and your departure from the country
may be delayed until your medical bills are paid in full. If you are
staying long term overseas or pursuing an adventurous itinerary consider
supplemental travel medicine insurance.