Safe Travels: What To Know Before You Go Abroad
by Dr. Richard Larew, Founder, The Travel Clinic at Larew Internal Medicine
If you are planning international travel, we want you to enjoy the thrill of exploring the globe, meeting new people, and experiencing new cultures. As much as possible, we hope you can avoid the not-so-fun parts – lost luggage, missed connections and even worse, getting sick. Let us help you with that last point. Before you say ‘bon voyage,’ we can help reduce your risk of experiencing medical problems abroad with these tips from the Travel Clinic at Larew Internal Medicine. A bit of judicious pre-planning with us or your primary care physician can literally make a world of difference!
If you’re traveling to a First World country e.g. Europe, Australia, Japan: No special vaccines or precautions may be needed in these highly industrialized countries, which have high public health standards, easily accessible healthcare providers, and more than adequate medical facilities and supplies. There are some exceptions to consider: if you are traveling to high altitudes in these countries and you have experienced altitude sickness, you may want to consider bringing a prophylactic (preventive) prescription for mountain/altitude sickness. Additionally, if your routine immunizations are not up to date you should catch up before you leave.
If you’re traveling to a Second World country e.g. Russia, eastern Europe, parts of Mexico, or a Third World country e.g. developing countries of Africa, Asia, Latin America: Careful preparation is important prior to visiting more impoverished, lesser developed countries, especially Third World locations, as they can lack fundamental healthcare access and/or a public health infrastructure. Here is how to begin:
- Six to eight weeks prior to your departure date, make an appointment with a travel physician who is knowledgeable about current global health conditions. This can be your primary care physician, a travel medicine specialist or the Travel Clinic at Larew Internal Medicine.
- Bring a copy of your itinerary with all the destinations and accommodations listed for your physician to review and ensure you are adequately prepared for conditions throughout your trip. For example, if you’re traveling to Mexico, a Second World country, but staying onsite at a five-star, all-inclusive resort in Cancun for a brief vacation, you will most likely not need to prepare with vaccines or bring medications. However, if you’re traveling to Belize or Rumania, also Second World countries, and you have planned the trip yourself and not every detail is certain, we advise consulting with your healthcare provider before you go, as you may need to consider taking medical precautions. The same advice applies if you are traveling with a formal tour group, a medical or religious missionary trip, a school-sponsored trip, study abroad or a business trip. If the tour company, sponsoring organization or leader is unable to answer your specific medical questions or address your health concerns, schedule an appointment with your travel
Vaccines and prophylactic medications that may be recommended include:
- Antimalarial medications if you are traveling to areas where malaria is a concern – there is no vaccine for malaria. If you are traveling to destinations that bring you in contact with mosquitoes potentially carrying malaria, you’ll need to start prophylactic prescription medication before you leave the US, continue to take it throughout your trip, and then continue to take it one to four weeks (depending on the medication) after you return home.
- Hepatitis A and B vaccines
- Typhoid vaccine
- Meningitis vaccine, if visiting the “meningitis belt” of Africa or Saudi Arabia
- Antibiotics for traveler’s diarrhea, which is usually caused by E. coli bacteria in food or water. While not life-threatening, it is certainly unpleasant and uncomfortable and can lead to dehydration, malaise and fatigue. Antibiotics can reduce the severity and shorten the duration of symptoms. Hopefully, you will not get traveler’s diarrhea and may never need to even open the medication bottle, but you will be well-prepared to cope with a bout of “tourista.”
- Yellow fever vaccine. Please note this is currently not available in the US and is in very limited supply across the globe due to a worldwide shortage. Should you absolutely need to travel to areas of the world where yellow fever is endemic and need protection against yellow fever, a CDC-licensed alternative is available at a limited number of clinics in the US; if you live in Iowa City, the closest location is in Bettendorf,
No matter where you’re visiting, make sure you’re up to date on routine but vital immunizations, including:
- Influenza vaccine: Influenza/flu is transmitted year-round on a global basis. It is not just a seasonal illness if you are traveling internationally.
- Tetanus shot
- Pneumonia vaccine: Pneumococcal 23 or Prevnar 13.
If you like to travel, I hope you have a trip overseas in your future. If you are traveling to first world countries and have medical and health concerns, such as altitude sickness, consider contacting your physician. If you’re visiting Second or Third World countries, do not leave before you check in with a physician well-versed in travel medicine or visit a travel clinic. Have peace of mind that you have taken all precautions possible to protect yourself against illness and enjoy your journey.
We wish you safe – and healthy – travels!
For more information, call The Travel Clinic at Larew Internal Medicine, 319-338-1535, or visit www.larewinternalmedicine.com. Our office is located at 2557 N. Dodge St., Iowa City, Iowa, 52245.