Travel Medicine

 When people are going to be traveling outside the country I always recommend they go to the CDC.gov website and research the places they are going, to see what immunizations they need and if malaria prophylaxis is recommended for their destination. The CDC site also lists travel safety information and warnings for the area and gives the contact information for the embassy in that country. It is best to start this process several months prior to a trip rather than just a few weeks ahead of time because sometimes there are shortages of some vaccines.

Hepatitis A vaccine is recommended for almost all countries. This is a series of two shots six months apart but you get about 90% protection after the first shot. Hepatitis A is a virus that is transmitted by contaminated food and water especially in warmer months. It can make you quite ill several weeks after exposure. All kids should have gotten this vaccine now but most adults did not get it with their childhood immunizations.

MMR, measles, mumps, and rubella, vaccine is now recommended for most countries as well unless you had two of these as a child. Most adults over 25 have not had two doses of this and a booster is recommended.

Typhoid is a salmonella bacterial infection from contaminated food and water that can cause high fever and severe illness. There are both oral or injectable vaccines for this and vaccination is recommended for most countries outside of Europe especially if you are going to be eating outside of a city or resort.

Malaria is a small parasite that infects red blood cells and can cause severe illness. It is transmitted primarily by mosquito bites in warmer climates. Usually you are safe in major cities or resorts but if you are traveling outside these areas, preventive medicine is recommended. Medication is usually started a week before you travel and continued through until a week after you get home again.

You always have to remember that health care in other countries is not like being in the US. There isn’t Christiana Care with its huge Emergency Room and level 1 trauma center a few minutes down the road. You have got to think about doing adventure type activities in a rural third world country. Help may be hours or days away. Overall I have been amazed at the good care people receive overseas, but I have heard my share of horror stories too. Just be prepared. Make sure you have a backup supply of your medications and carry them with you not checked in your luggage. Think about food safety especially be wary of eating from street vendors.

Personal safety is also an issue for many areas of the world. Know the legal age for drinking and the countries you are visiting outlook on drugs if you plan to sample while there. Think about how you would communicate with police in an emergency. Other countries traffic laws are not as good as ours here and your risk of motor vehicle accidents is much higher. It is not safe for women to travel alone in a third-world country.