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  • Healthy TravelTips for Healthy Travel

    Maria Mileno, MD, director of the Travel Medicine Service at The Miriam Hospital advises travelers how to have a safe and healthy vacation.

    Every year millions of Americans embark on vacations to exotic destinations unaware of infectious bacteria that may be lurking in everything from swimming holes to food and drinking water.

    Although malaria and meningitis have typically been the major players in serious international health concerns, avian flu and even a resurgence of the mumps in the United States have caused health officials new anxieties.

    Despite heightened concerns from health care professionals worldwide, only a fraction of travelers will seek travel health advice prior to their departure. Most tend to rely on alternate sources of information that can be misguided and inaccurate, such as friends and neighbors.

    “Medical information provided by travel agents, non-specialists and word-of-mouth is often outdated and unreliable,” says Maria Mileno, MD, director of the Travel Medicine Service at The Miriam Hospital, the largest travel medicine clinic in the state. “Consulting with a travel medicine physician prior to a trip can provide travelers with the most up-to-date information on particular destinations to ensure a healthy trip.”

    Tips to Take With You

    Travel medicine physicians have access to specialized computer programs with detailed information on overseas locations including specific outbreaks, illnesses, and dangers often before it becomes public knowledge. Mileno and her staff are trained in tropical medicine and international health and tailor recommendations for travelers by considering their health status, vaccination records and specific destination.

    Mileno recommends that travelers review their itinerary with a specialist, and provides the following general tips for healthy travel.

    • Stay current on vaccinations
      Physicians can counsel travelers on how to avoid the risk of contracting an infectious disease, but vaccines remain the most reliable tool. Serious and potentially fatal diseases such as hepatitis A and B, yellow fever and typhoid can be easily avoided by being vaccinated.

    • Don’t forget that when it’s summer in the U.S., it’s winter in Southern hemispheric locales such as South Africa and Australia, and the height of their flu season. If you didn’t receive a flu shot during winter in the U.S., get vaccinated before you depart.

    • See a physician four to six weeks in advance so vaccinations have time to take effect.

    • Hepatitis A is the most common vaccine-preventable illness, although a recent outbreak of the mumps in Iowa has prompted physicians to remind travelers to make sure they are fully vaccinated against mumps, measles and rubella.

    • Insect bites—more than an itch
      Insect bites remain a large source of disease transmission in several countries worldwide. Malaria and yellow fever can be transmitted through mosquitoes, while sandflies and Tse Tse flies can infect travelers with a variety of unpleasant diseases.

    • To avoid being bitten, wear clothing that has been sprayed with Permethrin, an insecticide that kills bugs before they reach your skin, and use DEET on any exposed skin. In locations where it is nearly impossible not to be bitten, medication can be prescribed beforehand to prevent diseases such as malaria.

    • Montezuma's Revenge?
      Although not usually life-threatening, travelers’ diarrhea is one of the most common and uncomfortable ailments travelers experience. The best means of prevention is to avoid any questionable foods or beverages.

    • Travelers should not drink tap water unless they know it has been boiled, filtered or chemically disinfected.

    • Avoid milk, unbottled beverages, or those with ice.

    • Regarding food—if it hasn’t been boiled, cooked or peeled—don’t eat it.

    • Seek a physician specializing in travel medicine who can provide precautions for food in specific areas and instructions on how to self-treat travelers’ diarrhea if it is contracted.

    Additional helpful hints

    • Although human-to-human transmission of the avian flu has not been proven, it is wise to avoid exposure to poultry farms, bird markets and other places where live poultry is raised or kept. Be sure that any chicken or poultry products being consumed are well-cooked.

    • Drink extra water, avoid alcohol, and take periodic stretching breaks to avoid deep vein thrombosis (DVT) or "economy class syndrome”—a potentially fatal condition where people develop blood clots in their legs during lengthy plane or car rides.

    • Travel medicine clinics also treat and advise travelers with altitude issues, motion problems and even disabled travelers who are blind or deaf.

    • If you bring home an illness as a souvenir, contact a travel medicine specialist post-travel for immediate treatment.

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