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Medical Services |
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Travel Information |
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Health tips for the International Traveler
Living in the U.S. or other developed nations, you are accustomed to an environment where
government and a high standard of living ensure the safety and quality of food and water,
swimming areas, roads, and medications.
When you leave this environment you leave the "safety net" behind. You face health situations
which at home were risk free: having a glass of ice water, swimming at a public beach, purchasing
an over-the-counter medication, being bitten by an insect.
The following information is designed to provide you with information which will help you have a
safe and healthy trip. To simplify things, the information is divided into three categories:
pre-trip planning, your behavior while traveling, and the post-trip period.
Pre-trip preparation
With all the preparation involved for travel, it is easy to overlook the need for pre-trip medical
preparation. Allow at least six weeks for adequate health planning for departure. Two to three months
is preferable in many cases to ensure that all necessary vaccinations can be given in the proper
sequence.
This section provides information on things you should consider before international travel.
- If you have existing medical conditions, consult your personal physician regarding special precautions
you may need to take.
- Have your physician prepare a summary of your medical condition that you can take with you in the
event you need medical care.
- Obtain and carry a supply of all medications you ordinarily take. Be sure you have enough to last
the entire trip (including unexpected delays).
- Keep medications in the original containers and pack them in "carry-on" luggage.
- Carry a copy of the prescription orders (written using generic names) and a letter stating the need
for prescription medications.
- Bring along your own supply of needles and syringes if you have a known medical condition requiring
injections (i.e. diabetes). Make sure you will have enough for the entire trip. To prevent
confiscation at Customs, bring along a letter from your doctor which states your medical need.
- See your eye doctor. If you wear glasses or contact lens, take an extra pair and a copy of the lens
prescription with you. If you wear contacts, take an adequate supply of cleaning solution.
- Schedule an appointment for dental check-up. Have a thorough dental check-up prior to travel.
Schedule far enough in advance so that necessary work can be completed before departure.
- Get Medic Alert. If you have allergies or major medical problems, wear a "Medic Alert" necklace or
bracelet. These can be obtained through the Medic Alert Foundation, Box 1009, Turlock, CA 95381-1009;
telephone 1-800-344-3226. These emblems are recognized internationally.
- Provide medical consent forms for dependents. If you are leaving your children behind, be sure to
have a signed emergency treatment form on file with your hospital.
- Check your health insurance plan. Check your health insurance plan to determine what provisions
there are for payment of health care received while traveling. It may be helpful to take several claim
forms with you and when necessary have medical personnel fill out the insurance forms in legible
English.
- Some foreign medical providers may not accept payment through a U.S. insurance company. Therefore,
be prepared to pay cash; with the proper documentation, your insurance company may reimburse you.
Obtain immunizations (See Immunizations page). As soon as you know you will be traveling, determine your immunization status.
Vaccinations for international travel can be grouped into three basic categories:
- Those required gaining entry into a country. Contact UW-Green Bay Counseling and Health Center or
your private physician to determine if your travel itinerary includes countries requiring vaccinations.
- Those you should always have as part of good health maintenance. Check your health records to make
sure you have adequate protection from the following diseases:
- Rubeola - if born after 1956, two doses of vaccine after your first birthday.
- Rubella (German Measles) - one dose given after your first birthday.
- Poliomyelitis - a completed series of four oral or injectable doses, usually given during early
childhood.
- Tetanus - a dose every 10 years in your adult life.
-
You may want to consider the following vaccinations in order to protect yourself against specific
diseases present at your travel destination:
- Hepatitis A vaccine - given prior to travel to protect you from Hepatitis A. Hepatitis A is a
disease of the liver transmitted via contact with infected feces. This can occur by person-to-person
contact or eating or drinking contaminated food or water.
- Hepatitis B vaccine - given to protect you from Hepatitis B, a disease of the liver transmitted
through exposure to body fluids. Transmission can occur through use of contaminated syringes, needles,
dental or medical instruments, or other means such as tattooing, acupuncture, ear piercing or sharing a
razor. Transmission can also occur through contamination of open wounds, contact with blood and/or
blood products, and by sexual contact.
- Typhoid vaccine - given to protect you from Typhoid Fever, a bacteria infection transmitted by urine
and/or feces of a human case or carrier. The disease is usually acquired by ingestion of contaminated
food or water.
- Yellow Fever vaccine - given to protect you from Yellow Fever, which is characterized by yellow skin
and eyes because of liver involvement. This disease is transmitted via infected mosquitoes.
For more information about these diseases, their preventive vaccinations, and determining whether you
will be traveling to areas of risk, contact UW-Green Bay Counseling and Health Center, 465-2380, or your
private physician.
It is advised to carry a traveler's first aid kit which should contain:
- Hand disinfectant
- Disinfectant (i.e., hydrogen peroxide)
- Scissors
- Tweezers
- Band-aids/gauze with tape
- Thermometer
- Soap
- Paper and pencil
- Small flashlight
- Lotion for treatment of sunburn
- Insect repellant containing DEET
Consider taking some over-the-counter medications with you. Medications available by prescription or
over-the-counter in many countries do not meet the standards of safety, quality, and consistency
commonly found in the United States. It is best to anticipate recurring problems such as menstrual
cramps, hemorrhoids, constipation, athlete's foot, and motion sickness. Medications for allergies,
colds, fever, and traveler's diarrhea should be included when appropriate. Also, a topical antibiotic
ointment and an anti-itch cream such as Benadryl may be helpful.
Helpful Web sites:
Behavior while traveling
Staying healthy while traveling depends largely on the traveler's behavior and precautions taken.
Two major areas are taking proper protection against insects which transmit disease and taking proper
precautions with what you eat and drink.
Food and water precautions
The fact that a city or hotel boasts that its water is chlorinated is no guarantee that it is safe
to drink. Chlorine may significantly reduce the microorganism count in water but not destroy all the
germs.
In areas where sanitation and hygiene are poor, you should assume the only safe drinks are canned or
bottled carbonated drinks, beverages made with boiled water, beer or wine. Even bottled water should be
carbonated to ensure that the bottle has not been simply refilled with local water and recapped.
Avoid ice cubes. Freezing tends to preserve microorganisms rather than destroy them. Water that is
unsafe to drink is unsafe for brushing teeth, rinsing contact lens, or washing near your mouth.
Traveler's diarrhea is acquired through ingestion of fecal contaminated food and/or water. Avoid any
foods that can not be cooked or peeled by you.
-
Risky foods and beverages:
- raw meat
- raw seafood
- raw fruits and vegetables, unless peeled by the traveler
- un-pasteurized milk products
- street vendor foods/beverages
- Generally safe food and beverages:
- cooked foods that are still hot
- fruit with unbroken skin that is peeled by the traveler
- canned or bottled carbonated beverages
- wine and beer
- hot coffee and tea
- boiled water or water appropriately treated with iodine or chlorine
A good rule of thumb, "If you can't cook it, peel it, or boil it, forget it!"
Protection from insect dangers
Protection from insects which transmit disease is the principle approach to preventing vector borne
disease. Mosquitoes, ticks, mites and fleas are the most common carriers. Some vector mosquitoes are
most active dusk to dawn while others are most active during the day. Wearing long-sleeved shirts,
long pants and hats will minimize areas of exposed skin. Shirts should be tucked in.
Repellants applied to clothing, shoes, tents and mosquito nets will enhance protection.
When exposure to ticks or mites is a possibility, pants should be tucked into socks and boots should be
worn. During outdoor activity and at the end of the day, you should inspect yourself and clothing for
ticks.
When accommodations are not adequately screened or air conditioned, bed nets are essential. They should
be tucked under the mattress and sprayed with repellant. Aerosol insecticides can be used to help clear
rooms of insects.
Permethrin containing repellants are recommended for use on clothes, shoes, bed nets and camping gear.
Permethrin treated clothes repel and kill ticks, mosquitoes and other arthropods and retains this effect
after repeated laundering. There appears to be little potential risk from Permethrin treated clothing.
Repellants containing less than or equal to 30% DEET are recommended for skin or clothing; increased
concentrations of DEET are not significantly more effective and do have a potential for toxicity.
Protection from too much sun
Use sunscreen SPF 15 or greater, wear a hat to protect your face, and avoid sun when it's strongest,
usually 10 a.m. to 2 p.m.
Emergency
If an emergency arises and you require medical care, the American Embassy can provide names of hospitals
and physicians known to be reliable and speak English.
Serious emergency
In serious emergencies, you should get to the largest medical facility in the area as quickly as
possible. Hotel staff or taxi drivers can help in these situations.
HIV (Human Immune Deficiency Virus) Infection
When a person is HIV infected their immune system is destroyed. The infected person then becomes
vulnerable to a variety of diseases which are able to spread unchecked and eventually result in death.
The HIV virus can be transmitted by intimate sexual contact, body fluid exchange, blood, blood products,
contaminated needles and mother to infant. HIV knows no geographic boundaries; avoiding infection
depends on appropriate preventive behavior:
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Abstinence from any sexual activity (homosexual or heterosexual) with unknown partners is the best advice.
If you choose to be sexually active, use a condom and spermicide.
-
Avoid receiving any injections overseas. If an injection is necessary, insist all needles, syringes, and IVs,
etc., are single use and prepackaged.
-
Avoid blood or blood product transfusions unless you are in dire need of blood.
-
If you are in unfamiliar company, be cautious about leaving your drink unattended or accepting an opened beverage
from a stranger.
Post-trip period
The onset of illness picked up during travel abroad can take weeks or months after returning home. For example,
Hepatitis B symptoms may not surface for as long as 180 days after infection. Keep this in mind after you return,
particularly if you come down with an intestinal illness. Tell the doctor where you've been, what you did, how
long you stayed, what you ate and drank, and if you recall being bitten by insects.
Now that you're prepared, have a great time!
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