CLINICAL MATTERS
As tourism continues to recover from the pandemic, more and more people are going locally and abroad on holiday. The yearly exodus from the cities that occurs every Holy Week is expected to be busier than ever this year. The crush of travelers means that there are a multitude of health hazards that can easily ruin one’s vacation. Here are some tips on what to do in order to stay healthy and safe this summer.
1. Don’t forget your medicines and a first aid kit
If you are traveling to destinations that may not have all the conveniences from the city, it is a good idea to bring a stash of over-the-counter medicines for common ailments along with a first aid kit. My own medical kit has over-the-counter paracetamol, allergy medication like antihistamines, oral rehydration solution and antidiarrhea medication. Bring enough maintenance medications for any comorbid conditions. Ask your doctor for guidance if you are unsure whether you are fit to travel and if you need to restrict yourself from certain activities.
2. Check the weather and dress appropriately
In the tropics, one of the biggest health risks is getting heat exhaustion or heat stroke from dressing too warmly or not hydrating well enough. A long plane ride can dehydrate people quickly so make sure you drink enough water. Bring plenty of fluids if you are going on long hikes or participating in strenuous activities. If you are swimming in the ocean, salt water is very dehydrating so make sure you drink enough fresh water periodically. Use sunblock to prevent sunburn and reapply every few hours.
If you are going to a temperate country in winter, make sure you check the highs and the lows of the temperatures daily. I remember when we went to the desert in Morocco, it was hot during the day but freezing at night. When there are wide fluctuations from hot to cold, layering clothes helps. Walking around in frozen conditions can lead to frostbite. Gloves, wool socks, scarves and properly insulated clothing are essential to prevent discomfort and cold injury.
3. Watch what you eat and drink
Drinking contaminated water especially in areas where there is inadequate hygiene can turn your vacation into a nightmare. Very bad diarrhea can occur, in some cases with gastrointestinal bleeding. Bottled water, portable filters, iodine tablets and other decontamination solutions are available. In some countries, even if the water is free of pathogens, the dissolved components may be substantially different compared to what you are used to and can still upset your stomach. Try to drink only distilled, purified, or bottled water as much as possible. Avoid ice in your drink since it may be made from unpurified water.
Stay away from raw food if you are uncertain of its provenance. Even fancy restaurants can have some nasty parasites hiding in raw and undercooked dishes. This is especially true with fish and crustaceans sourced from fresh water. For sushi and sashimi, make sure these are not prepared directly from live fish since there is a particularly nasty worm called anisakiasis which burrows through the stomach lining and causes severe pain. Most raw fish in reputable restaurants is flash frozen to kill this worm in case it is present before the food is served. Never ever eat raw or undercooked pork. It may contain pork tapeworm larva which can be quite alarming when its wriggling segments come out in your stool a few weeks later. Make sure fresh fruit and vegetables are properly washed since these may have some parasites on the surface. When in doubt, peel all your fruit before eating it.
4. Be aware of the local wildlife and plan accordingly
Some vacation spots have hazardous plants and animals. Mosquitoes transmit many diseases including dengue and malaria. Insect repellant can help. In malaria-endemic countries, malaria prophylaxis may be needed. Talk to your doctor about what is appropriate, including any vaccines that may be needed. Some areas in South America and Africa require yellow fever vaccination and they will not admit you without a yellow card from the Bureau of Quarantine. When camping out, always check your sleeping bag and blankets for scorpions, snakes and other bugs before settling down for the night. Store your shoes upside down so you don’t get a nasty surprise when you put them on.
Colorful clothes and fruity scents tend to attract insects and so you may want to avoid wearing these when hiking through wooded areas. Be aware of poisonous plants like poison ivy which can cause a very bad rash. Wear long-sleeved clothing when hiking in dense foliage to avoid scrapes, thorns and the ever-present “higad” (hairy caterpillars). Check for attached ticks after hiking through grass. Bring calamine lotion or other topical remedies in case you develop a bad skin reaction. When swimming in the sea, beware of jellyfish, sea urchins, and fire coral which can sting and cause envenomation. Most guides will have some vinegar or other first-aid remedies. Always be aware of the nearest hospital or emergency room in case a life-threatening complication occurs. For people with a history of anaphylactic reactions, don’t forget your epi pen.
In forested or jungle areas, be aware of the rules when it comes to interactions with animals. Some national parks in the United States require hikers to bring bear spray in case they are attacked. Give large animals a wide berth and do not approach young animals as their parents may attack you. Store food properly so as not to attract scavenging animals. Always be aware of your surroundings and make sure someone knows where you are and when you will be back if you are going off-grid and won’t be able to communicate electronically.
5. Wear masks in crowded places and wash your hands
Masks proved their worth during the Covid-19 pandemic and they can still be useful in enclosed crowded areas with inadequate ventilation. Airports and airplanes are teeming with respiratory pathogens and even if these may not be deadly, a bad cold can ruin your holiday. If you are on a boat cruise, viral gastroenteritis from norovirus is a constant risk. Wash or sanitize your hands before and after each meal and whenever you use the toilet. Bring a supply of hand sanitizer in case there aren’t enough places with soap and water.
6. Buy travel insurance
If you are going out of the country, travel insurance is especially important. Some countries may check for it prior to processing you papers at immigration. Travel insurance covers medical emergencies and cancelled flights and hotels. Some plans cover emergency evacuation and repatriation. Travel insurance is surprisingly affordable but make sure you get it from a reputable source. Your travel agent can help.
Travel is a lot of fun but there are health hazards out there that can ruin your vacation. Proper planning can mitigate many of these risks and ensure a worry-free travel experience.