From bed bugs to cabin pressure: The health risks of traveling outside the U.S. and how to avoid them

Thursday, February 22, 2007

By Patti Miinch

Business Today

International travel means more preparation than packing a suitcase and having your passport renewed.

There's also the risk of travel-related illness to take into account.

Local health experts say there are some simple steps to take to avoid such health problems though.

Before you leave

The Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) advises international travelers to contact their physician or local health department at least 4-6 weeks before their departure date to schedule an appointment to discuss current health information on the countries they plan to visit as well as factors that might increase possible health risks. These key factors include the length and purpose of the visit, type of accommodations, food hygiene in the area, behavior of the traveler, and any pre-existing illnesses.

Before meeting with their health care professional, the traveler might want to visit the CDC's website (, says Dr. Charles Pancoast, Emergency Room Physician at Saint Francis Medical Center. There they can learn which immunizations are recommended for the country they will be visiting, symptoms of illnesses they may be exposed to, and other useful information. When meeting with their health care professional, the traveler should obtain the recommended vaccinations and prophylactic medications as well as discuss any special needs they may have. Carol Jordan, RN, Communicable Disease Coordinator for the Cape Girardeau County Public Health Center, also recommends that travelers review their vaccination history, making sure their most recent tetanus vaccination has been within the last 10 years. She adds, "They should also consider the Hepatitis A vaccine, as Hepatitis A is transmitted by ingesting contaminated food or water."

Travelers should also prepare and pack a travel health kit. While this kit can be either commercially purchased or assembled at home, Jordan reminds travelers, "This kit should be customized for where the person is going and any specific medical conditions the person may have." The kit should be prepared in order to allow the traveler to handle minor health issues that occur and to deal with pre-existing medical conditions.

On the plane

Most international travel is done by airplane, which exposes passengers to a number of factors that can adversely affect their health. Again, careful planning and a few simple precautions can significantly reduce the risk of illness. Because cabin air pressure is lower than at sea level, the amount of oxygen carried in the blood is also lower. Patients with a history of heart and lung disease, as well as anemia and other blood disorders, are advised to notify the airline so that an additional oxygen supply is on board for their use during flight.

While many passengers experience "popping" in the ears caused by changing air pressure when the plane ascends and descends, most people can alleviate any discomfort by swallowing, chewing, or yawning. However, travelers with infections of the ear, nose, or sinuses should avoid flying; if air travel cannot be avoided, however, using decongestant nasal drops just before both take-off and descent might be helpful in avoiding pain and injury. Another common malady is motion sickness. Some passengers find sitting in the middle of the plane lessens their discomfort, but a health care professional can provide medication for more severe cases.

When you arrive

Once the destination has been reached, there are further precautions that travelers should take. Dr. Pancoast notes that while many travelers are aware of the dangers of drinking tap water, they also need to remember not to drink liquids served with ice. The CDC reminds travelers that fountain drinks should also be avoided, and Jordan notes that using tap water when brushing teeth also creates a health risk. Only bottled or boiled water, as well as carbonated drinks purchased from reliable sources, should be consumed, according to the CDC.

Care should be taken to eat only those foods which have been fully cooked and are served hot, and all fresh fruits and vegetables should be washed carefully by the traveler before being eaten. Travelers should also wash their hands frequently. In fact, frequent handwashing with soap and water or with an alcohol-based hand rub is one of the most important factors in preventing infectious illnesses while traveling.

While a dog, cat, or some other type of animal may seem clean and appealing, care should be taken not to touch animals while in foreign countries. In addition, poultry farms, bird stores, or other places where live poultry is kept should be avoided in areas afflicted with avian influenza (bird flu).

Travelers from Southeast Missouri are used to applying mosquito repellent during the summer months, and they need to do the same if they are traveling to an area where they are at risk of contracting malaria. Sleeping nets should also be used at night, and travelers should take malaria prevention medication before, during, and after their trip, as directed by their physician.

While Dr. Pancoast notes that there has been only one case of bed bugs reported to Saint Francis Medical Center in the last six months, these tiny pests have become an increasing problem for international travelers. Jordan recommends that travelers check the cracks, seams, and folds of mattresses, bedding, upholstery, and the bed frame or furniture itself. While they may live in those places first, any area forming a crack, such as picture frames or peeling wallpaper, may become their hiding place as they multiply. Eventually, bedbugs move into the rest of the room, seeking refuge behind door and window frames, under the edges of carpets and rugs, and even inside walls. Signs of infestations, she notes, include blood stained fecal smears on bedding, walls, curtains, and other light-colored surfaces. She warns, "Bed bugs are accomplished hitchhikers and are usually first carried into a home, apartment, or hotel room by people, hiding in luggage, furniture, or other belongings."

Back home

Eventually, it's time to say good-bye to that exotic locale and return to Southeast Missouri. Dr. Pancoast reminds travelers that after their return home there are several symptoms that warrant a visit to a health care professional: fever, persistent vomiting and/or diarrhea, night sweats, persistent cough, and rashes. The CDC also recommends that anyone who might have been exposed to an infectious disease while traveling schedule an appointment with their physician upon their return home.

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