Originally created 01/08/01

Staying healthy on a foreign vacation



With the holidays behind us, the great migration south has started. Thousands of Americans are gearing up for vacations that replace snow and ice with sun and fun.

Many head to increasingly popular vacation spots in Mexico and the Caribbean.

Last year, more than 4.8 million U.S. residents flew to Mexico, making it the most popular international air destination for American travelers, according to the U.S. Department of Commerce. Jamaica also is among the top international destinations for Americans, the department reported.

But tropical getaways are not all paradisiacal. Travelers to Mexico and the Caribbean can encounter passport requirements, language barriers and unfamiliar currencies. And there are health risks - some of them serious - that come with venturing outside the United States.

To help vacationers stay healthy while out of the country, we asked a few experts for some words to the wise: Dr. Hal Martin, medical director of Park Nicollet's International Travel Clinic in Minneapolis, Dr. Abinash Virk of Mayo Clinic, and Dr. Patricia Walker, medical director of the International Travel Clinic at Regions Hospital in St. Paul, Minn.

Here are their top recommendations:

Get a checkup before you go. Infectious diseases that are rare in the United States - such as traveler's diarrhea, hepatitis A, malaria, dengue, polio, typhoid, yellow fever and some parasitic illnesses - may be a regular part of life where you're going.

Travelers who stay in resorts generally don't need to worry as much as those heading into the jungles or rural areas for adventurous treks, Virk said. But no one should dismiss the risk of these diseases entirely, she added.

Specialists in travel medicine can help people learn more about the health issues at their destinations, Virk said, as well as the specific kinds of vaccinations they need. "We get into the nitty-gritty of where they are going and what their risks are going to be," she said.

Check out health-insurance coverage ahead of time. Don't wait until there's a problem to find out that your plan doesn't cover medical care at your vacation destination or transportation from it, Virk said. If necessary, purchase traveler's medical insurance.

Plan ahead for traveler's diarrhea. Visitors to Mexico and the Caribbean will be exposed to many exotic organisms - usually in water and food - that can make them sick. Up to 50 percent of visitors to these areas may be affected, said Walker.

To avoid limiting your itinerary to your hotel's bathroom, all three physicians recommend drinking only bottled water or carbonated beverages, not putting ice in drinks, and eating only cooked vegetables and fruits that you peeled yourself. Don't use tap water even to brush your teeth.

Travelers should bring Imodium, an over-the-counter anti-diarrheal medication with them, Walker said, and talk to their physician ahead of time about getting antibiotics to handle a severe case.

In addition, Walker said, parents should be especially alert for signs of dehydration if children get traveler's diarrhea; it can happen very quickly in youngsters and become life-threatening. Parents may wish to consider packing Pedialyte or other products designed to prevent dehydration in children.

Stock up on prescription drugs ahead of time, as they may not be readily available at your destination. Bring enough to last you not only for the planned duration of the trip but also for possible travel delays, Virk said. Store enough medication for the trip in both your suitcase and carry-on bag. If one gets lost or stolen, you won't be left in the lurch.

Bring insect repellent and use it. Mosquitoes in some parts of Mexico and the Caribbean carry malaria and other diseases. The best advice is to prevent bites in the first place, said Martin. Use products that contain DEET, and wear the repellent at all times. It's a good idea to stay in screened-in areas when mosquitoes are out. If you'll be in a region where malaria is a major problem, ask your physician about a medication called chloroquin that can help prevent malaria.

Slather on the sunscreen to avoid a vacation-wrecking sunburn. People tend to burn faster in areas closer to the equator. Plus, sun rays are reflected off the water. "You can be sitting under an umbrella all day and still get a sunburn," Martin said. Use a product with a sun-protection factor of at least 15.

Don't pet the animals. Rabies is much more common outside the United States, said Walker, who estimated that up to a third of dogs in some developing countries may be carriers of the disease. If you are bitten, seek emergency care immediately. If the rabies vaccine and another type of medication called rabies immune globulin aren't available, "It's time to fly back. This is a medical emergency," Virk said.

Heed "No swimming" signs, and know how to handle ocean hazards. Martin learned this personally on a trip years ago, when he jumped in the water and wound up in a vicious rip tide. If you're caught in one of these and are heading out to sea, try to swim across it, not against it, he said.

The ocean also has its share of unfriendly creatures, Martin noted. If you're stung by a jellyfish, wash off the affected area with vinegar, rubbing alcohol or sea water. Rinsing with fresh water causes stingers remaining in skin to snap and release more venom. For sting-ray stings, soaking the area in hot water for 30 minutes or more can help relieve pain.

Watch out when eating fresh fish, especially those caught near coral reefs. Snapper and grouper, for example, may be contaminated by a microorganism that produces a toxin. Eating such contaminated fish can cause a condition called ciguatera poisoning. Symptoms include numbness and tingling, diarrhea, nausea, general malaise and the reversal of hotcold sensations - meaning that hot things feel cold and vice versa. Travelers concerned about ciguatera poisoning can purchase a product called Cigua-Check that tests fresh fish for this microorganism. The product sells for about $30 on the Internet at http:/www.cigua.com.

Don't throw caution to the wind. Advice that's good at home is doubly good away from it, all three physicians said. Practice safer sex. Avoid being out alone after dark. Use alcohol in moderation. Wear seat belts. Wait to get that tattoo or body piercing until you're back home. "The best advice is to use common sense," Walker said.