The previous installment provided information about common travel-related diseases. This article will help you prepare for your trip. Here are some initial steps to follow.

Consult with your family physicians about whether you and your family are up to date on your routine immunizations. These vaccinations include measles, mumps and rubella; tetanus, diphtheria and pertussis; influenza; chickenpox (if you have not had chickenpox); shingles and pneumococcal.  

A polio booster as an adult is recommended for a number of countries. Meningococcal meningitis is endemic disease in some countries, so a single vaccine is protective.

For current travel requirements, restrictions, and mandated immunizations, consult with the Centers for Disease Control, the World Health Organization and the state departments of the countries where you will be spending time. Your requirements may vary if you will be spending only a short time in a city versus a longer time in a rural area, and whether you will in physical contact with animals in that area.   

Your family doctor might have expertise in travel medicine or could refer you to an infectious disease consultant or a travel service like Passport Health in this area. The doctor will inform you of the required vaccinations to get into a country and those that are recommended. You will need to set up an appointment early in your planning, because it could take six to nine weeks to complete the vaccine series, and often travel specialists are booked up, especially during the prime spring, summer and fall travel season.

Not all vaccines are available through your doctor’s office or pharmacy.  An example is the yellow fever vaccine, which is only dispensed through licensed locations because of storage requirements.

International travel is educational and exciting. Because of the COVID-19 pandemic, there are many different testing and immunization policies around the world. Careful investigation and planning will avoid unexpected delays and potential denial of entry into a country.   

Some tips to keep you healthy

To prevent against bites, apply repellent in the morning and late afternoon. In malaria-designated areas, always sleep with a bed mosquito-net. Wear trousers and long-sleeved shirts, especially at dusk. Do not wear perfumes.

If you are taking daily antimalarial medication, do not skip or forget to take your medication as prescribed.

To prevent water and food contamination, avoid eating food from carts and other street vendors on the street, because of the risk of eating undercooked raw foods.  

Avoid eating raw, unpeeled vegetables or salads unless they have been washed with clean, sterilized water. Avoid unpasteurized dairy. Drink only from sealed water and beverage containers. You can drink tea or other beverages made from boiled water. Do not use ice in drinks unless you know that the water has been purified or boiled.

Avoid swimming in lakes and streams if there is known contamination with sewage or animal feces. Chlorinated pools are generally safe.

It is important to remember there are insects besides mosquitoes that can transmit human diseases or have poisonous stings. Some examples include tsetse flies, which can transmit sleeping sickness, sandflies spreading leishmaniasis, and fleas causing plague.  

Pregnancy is usually not a counter-indication to travel, but many of the vaccines and antimalarial drugs cannot be used. Pregnant women or women trying to become pregnant are discouraged from traveling in areas with Zika virus.

What should I bring on a trip?

What and how much of an item depends on whether your travel will be in urban/suburban locations or in more isolated areas.  Generally, you can purchase most over-the-counter health aids, certain antibiotics and other prescription items at a local pharmacy without a doctor’s prescription. Pharmacists are licensed to prescribe and dispense in many countries.  

Medical supplies

• Bring a spare set of eyeglasses
• Contact lenses
• Needles and syringes (for diabetics) along with a doctor’s note explaining the need.
• Diabetic testing strips or battery-powered meter—you may be in an area with limited electricity.
• Insulin, extra inhalers, EpiPens. Check on storage requirements.
• Medical alert bracelet or necklace for severe allergic reactions  

Over-the-counter medications

• Antacids—the pill form works best
• Diarrhea medications like Imodium or Pepto-Bismol
• Allergy and decongestant medications
• Cough medicine—syrups or in pill form
• Pain and fever medication that you use at home
• Sleep aids
• Saline nose spray

Supplies for preventing illness

• Alcohol-based hand sanitizer or wipes
• Insect repellents with 20 percent DEET. Bug spray for your tent is often helpful.
• Permethrin for treating clothing pre-trip and after each sixth washing.
• Sunscreen with >15 SPF
• Bed net if traveling independently
• Sunglasses and wide-brim hat
• First-aid kit consisting of hydrocortisone cream, antifungal ointment, antibacterial ointment, aloe gel for sunburn, insect bite cream, bandages, gauze and tape,
• Moleskin for blisters, compression bandage wrap, disposable gloves, digital thermometer, scissors, safety pins, tweezers, eye drops and oral rehydration salts.

Documents

• Health insurance cards, including supplemental travel health insurance plan cards  
• Proof of required immunizations documented on an International Certification Vaccination card (yellow card).
• Copies of all prescriptions (include generic names)
• Identification card with name and contact information of next of kin/family member remaining in U.S. and the home primary care physician.  
• Card with name of hospital or emergency service in the area(s) you are visiting.
• U.S. embassy or consulate in destination countries.