Tourism

Health Tips For Travelers

Tips for Making Travel More Comfortable

Catch up with jet lag

Almost every airplane trip involves crossing time zones. International travel can even include crossing the dateline. The out-of-sorts feeling you get upon arrival at your destination is commonly called jet lag. Symptoms of jet lag include a feeling of extreme tiredness during the day, loss of appetite, irritability, insomnia, restless sleep, stomach and bowel distress, sensitivity to light and sound, and reduced problem-solving ability and attention span. These symptoms can worsen because of sleep lost during the flight and the first few days following arrival. Adults generally have a harder time getting their body clocks back on track, making it difficult to focus on the business at hand. Children generally recover from jet lag easily by adjusting their nap and bedtimes. For vacationing kids ready to explore, it’s hard when Mom and Dad want to sleep.

Although there is no single effective cure for jet lag, several things that might help can be recommended by your physician, including medications and diet. Environmental treatments – setting your watch to the destination time zone when you depart, eating and sleeping at the local times right away, adjusting your body clock before you go by altering bedtime – may also help. Several high-tech solutions are also available, including computer programs to help you alter your diet and light exposure, and sound generators. Your travel clinic specialist or physician can discuss which method may be best for you.

As you can see, safe travel is no accident; it takes planning ahead. But a little forethought and preparation can help ensure that all your trips, business or pleasure, are a success and that all you bring home are happy memories.

Children and motion sickness

Children and motion sickness

Motion sickness is a normal reaction to certain types of motion. It usually affects people who have difficulty adapting to motion while they are traveling as passengers. The various types of motion sickness include car sickness, seasickness, and airsickness. Since travel by car, boat, and airplane is a daily occurrence, motion sickness can make any trip a difficult one. This is especially true for children.

Toddlers/preschoolers at greatest risk

Motion sickness occurs more often in cars and buses than on trains, planes, and large boats. Children are most prone to motion sickness, which is usually a combination of nausea, vomiting, paleness, and a cold sweat. Toddlers and preschoolers are most frequently affected, while infants are rarely troubled by motion sickness. Motion sickness is usually outgrown after age 5. Some children, however, may reach their teenage years and still have a weak stomach when traveling.

Before the motors start

Symptoms of motion sickness cannot be effectively treated once they appear. For this reason, it is smart to always travel with a leak-proof container. Resealable food storage bags are good for this purpose. Although not foolproof, the best medicine is to prevent motion sickness before it starts.

In a car or bus, sit where you can see out the windshield to anticipate the vehicle’s motion and open a window for fresh air. On a large boat, choose a room in the middle of the ship at the waterline where the motion is less noticeable and, when on deck, stay where you can see an earth-stable reference such as the horizon. On an airplane, sitting next to a bulkhead in the middle of the plane makes turbulence less noticeable.

Other practical measures

Additional ways to help prevent motion sickness include avoiding heavy meals up to two hours before traveling and avoiding eating while traveling. If you must, eat only light snacks such as clear juice, soda, crackers, a roll, or canned fruit. Reading materials should be avoided.

For children, action figures, travel games, and looking out the window make good diversions. Motion sickness preventatives are available from your family physician or travel clinic.

An ounce of prevention is worth a pound of cure.
Provided as a service by the Merck Vaccine Division

Don’t let travel spoil the trip

Getting there isn’t always half the fun
When travel to your destination involves spending long times in transit, crossing several time zones, or just enduring the sheer physical stress of travel, the fun and anticipation of the trip can be replaced by fatigue and discomfort. Fortunately, there are things you can do to help reduce travel-related discomforts such as jet lag, motion sickness, and headaches, and arrive at your destination in relative comfort.

Flying

  • Keep busy. Boredom makes time pass slowly and gives you the opportunity to dwell on even minor discomforts. Watch a movie, read a book, write a letter, stroll up and down the aisle, or listen to music to help pass the time.
  • Drink plenty of water or juice. The longer the flight, the drier the cabin air gets. Drinking about one glass per hour can counteract this dryness. Avoid alcohol and caffeine, which can dehydrate you even further.
  • Sit comfortably. Proper sitting helps minimize aches, pains, back soreness, and swollen feet. Keep legs uncrossed and remove any bulky items from your back pockets.
  • Open air vents. Choose a center seat over the wing or the wheels. This is the steadiest part of the craft, where you will feel the least amount of motion. An aisle seat will offer you easier walking and bathroom access, more leg room, and a speedier exit.
  • Avoid ear pain. Chew gum or suck on hard candy to encourage swallowing and ease inner-ear pressure during take-off and landing.
  • Eat lightly and wear loose-fitting clothes.
  • Sleep. Try to sleep during night flights, but limit yourself to only short naps on day flights.

Cruises

  • Avoid shipboard accidents. Get plenty of rest, be careful when taking any medication that may affect coordination, and watch out for slippery steps and gangways. Excessive alcohol consumption can increase risk of accidents, too.
  • Take precautions against seasickness. Ask your physician or travel medicine specialist about remedies for seasickness, which often occurs during the first few days of an ocean cruise.
  • Avoid too much sun or wind. Because water and sun can wreak havoc on your skin while you are on board, use waterproof, high SPF (over 18) sunscreens. Also, be aware that some medications, including those to prevent traveler’s diarrhea or treat infections, sugar substitutes, and even lemons may sensitize you to the sun and can lead to severe sunburn.
  • Check the medical crew’s qualifications before you leave. To confirm that there will be a high standard of medical care in the event of an emergency, call the medical director or medical department of the cruise line or ask your travel agent to check for you.
  • Following these simple guidelines will help you stay comfortable during transit, so that you’ll be more likely to feel “ready to go” upon your arrival.

Malaria: A serious health risk for travelers

Each year, an estimated 7 million Americans travel to countries where malaria is a common occurrence, placing themselves at risk of acquiring this serious, and potentially fatal, infectious disease. Malaria is transmitted by the bite of an infected mosquito. Malaria parasites invade a person’s red blood cells, causing a disease characterized by headache, fever, chills, and sweating. These symptoms alternately subside and then recur over periods of 2-3 days. Left untreated, the disease may progress to anemia, jaundice, kidney failure, coma, and even death.

Keys to prevention

When travel takes you to tropical or subtropical areas where malaria occurs, follow these preventive steps:

  1. Become informed about the risk of acquiring malaria in the region of the world that you plan to visit. Malaria exists throughout the tropics, but the risk of acquiring it is greatest in Africa. It occurs, but is less of a risk in India, the Far East, South America, Central America, and Mexico. However, the malaria situation changes constantly, so check with your physician, travel medicine specialist, or the CDC for any new developments before you travel.
  2. Take measures to prevent mosquito bites.
    1. Sleep in well-screened rooms and under a mosquito net
    2. Wear long pants and long-sleeved shirts in the evening
    3. Use an insect repellent that contains DEET (DEET, or N,N-diethylmethyltoluamide, is an ingredient found in many commercially available insect repellents)*
  3. If necessary, your physician will prescribe medication to help prevent malaria.** Be sure to take your malaria pills as prescribed by your physician.

* If a reaction to insect repellent is suspected, wash treated skin and seek medical attention.
** Be sure to ask about possible side effects of your antimalarial medication before you begin a preventive regimen.

If you become ill

Even if you take antimalarial pills, it is still possible to get the disease. Seek medical treatment immediately if symptoms of malaria occur, especially if you are in, or have been in, an area where there is malaria. Symptoms of malaria can be delayed for weeks to months after exposure, even if you took your antimalarial medication as prescribed.

If children, pregnant women, or breast-feeding women must go to areas where there is malaria, they should consult with their physician, since there are risks associated with antimalarial drugs.

To learn more about malaria

Detailed recommendations for the prevention of malaria are available 24 hours a day by contacting the Centers for Disease Control and Prevention (CDC) Malaria Hotline by phone: (404) 332-4555 or by fax: (404) 332-4565.

The Pregnant Traveler

Although pregnancy does not mean a woman cannot travel, certain precautions may be appropriate; this is especially true for women with high-risk pregnancies, women carrying more than one child, and women with a history of miscarriage.

Be sure to check with your travel medicine specialist or physician for help in planning.

Traveling internationally while pregnant presents unique problems. One of the most important is the limitation on the vaccines that can be given and the medications that can be taken to prevent traveler’s diseases. Live virus vaccines must be avoided due to the potential risk to the fetus. Polio vaccine should be given by injection rather than orally. Getting vaccines in the second and third trimester is safest. These same precautions go for women who are breast-feeding as well.

Although there are no restrictions on air travel for pregnant women, the second trimester is considered the safest because it avoids immunization problems and potential bleeding problems during the first trimester, and the potential for inducing premature labor in the last trimester. If you are traveling during your ninth month, the Federal Aviation Authority (FAA) requires you to carry a letter in triplicate from your obstetrician, stating that you have been examined within 72 hours (24 hours is preferred) of departure and that you are fit to travel. Your due date should also be noted. While flying, pregnant women should avoid cramped positions and sitting for long periods. Moving your legs and toes helps to improve circulation on long trips. The most important things for the pregnant traveler to know are:

  • How to prevent and treat malaria
  • How to prevent and treat traveler’s diarrhea and other food- and water-borne diseases
  • Where to get the best quality medical care at your destination
  • Your medical coverage
  • The warning signs of a problem or pregnancy-related illness
  • Specific hospital names with English-speaking doctors

Join the fun: Chronic conditions need not prevent travel abroad

Long gone are the days when a chronic medical condition would automatically keep you from traveling abroad. Today, with the help of physicians, families, and a surprising number of special associations, many people with heart disease, cancer, diabetes, or disabilities such as hearing or sight impairment are traveling abroad by the thousands. And they’re getting their fair share of all the pleasures travel has to offer. All it takes is your doctor’s support plus a little extra planning, and you’re ready to get set and go!

Planning is the key to a successful trip

Although different chronic conditions may require specific preparation, all conditions share certain essential requirements. To satisfy them, you should meet with your doctor or a travel medicine specialist to discuss your trip 4-6 weeks before your planned departure. Your review should include:

  1. The need for a physical (and perhaps a few extra tests) Your physician will want to confirm that your chronic condition is well under control. If your blood pressure is still too high, for example, or your diabetes or ulcerative colitis is giving you trouble, your doctor may suggest that you delay travel until these problems can be resolved. For some patients, the prospect of a trip abroad is the incentive they need to carefully follow their physician’s suggestions. Then once their condition is under control, the trip abroad is a fitting reward!
  2. Immunization status Your basic immunizations such as diphtheria and tetanus (DT); measles, mumps, and rubella; or polio may need updating. Depending on your itinerary, your physician may recommend vaccination against other diseases such as hepatitis A, hepatitis B, typhoid, yellow fever, Japanese encephalitis, meningococcus, rabies, influenza, and pneumococcal pneumonia. The Centers for Disease Control and Prevention (CDC) provide detailed information on infection risks and vaccination recommendations by phone: (404) 332-4555; or by fax: (404) 332-4565.
  3. Current medications Ask your physician to give you a prescription for all the medications you will need (with enough for one extra week) and two additional prescriptions using generic names (brand names vary by country and can cause confusion).
  4. Special travel arrangements If you have a physical challenge or need constant oxygen, your doctor will need to make arrangements with your airline or tour operator.
  5. If you need a travel “escort,” there are at least two associations that provide medical escort services worldwide: MedEscort International (call collect 610-791-3111) and Traveling Nurses’ Network (360-694-2462).
  6. Handling emergencies No matter how unlikely, possible emergencies should be discussed with your physician and a plan of action developed before you leave.
  7. Health Insurance Check with your health insurance carrier to make sure you are covered when you travel outside the U.S. If you are not covered, get a referral to other medical insurance firms that offer short-term coverage for the duration of your trip.

Your own pocket medical minder

One of the most effective ways to protect your health is to create and carry a Pocket Medical Minder. This is a brief medical profile that all travelers (including healthy young people) should keep accessible at all times. The basic Pocket Medical Minder could include:

  • A brief medical history
  • A list of all current medications (with generic names) and dosing schedules
  • A list of drug allergies
  • For patients with heart disease: A copy of your latest electrocardiogram (ECG)
  • For travelers with an artificial joint or pacemaker: A note from your doctor stating that you have an implanted cardiac pacemaker or artificial joint, and giving the model and lot number. (You’ll be glad to have this note if one of these devices sets off the metal detector at the airport, as often happens.) You’ll need to have this note translated into the languages of the countries you plan to visit.
  • Your physician’s name and phone number, complete with U.S. country code*
  • A note from your physician giving you “clearance” to travel by all modes of transportation
  • Your medical insurance policy number and phone number with U.S. country code*
    *(1-XXX-XXX-XXXX)

Avoiding potential medication problems

Ideally, you should carry all your medications in your carry-on luggage when you travel by air, in case your checked baggage is lost or delayed. If the number of medications is considerable, carry a week’s supply of each and leave the rest in your suitcase. In addition, carry at least one set of signed prescription forms for every prescription drug with you (consider placing one set in your Pocket Medical Minder and another set in your suitcase).

One last warning on medications: Even though it may be more convenient, don’t put drugs in special plastic carrying packets; keep them in the original pharmacy-labeled containers to avoid problems with Customs. This is especially important for inhaler canisters. They may look like bombs on airport x-ray machines, and you may be required to open your luggage and try to explain your needs in a foreign language.

Timing your medications

If it’s 8:00 a.m. when you land in London, but your body feels as though it’s 1:00 a.m. in Boston and not ready for your morning medication, when should you take it? A good question, because your health may be affected. The answer? Only your physician knows for sure, so be sure to ask before you leave.

Still reluctant to travel? Consider a cruise

If you’re especially cautious about traveling abroad, consider one of the least stressful and safest ways to travel to exotic locations – by cruise ship. Although there are occasional reports concerning disease outbreaks, all ships arriving at ports under control of the United States are aggressively inspected for sanitation and cleanliness. (You can get the most recent report on a specific vessel by writing to: Chief, Vessel Sanitation Activity, Center for Environmental Health and Injury Control, 1015 North America Way, Room 107, Miami, FL 33132.)

The beauty of cruise travel for persons with chronic disorders is that not only is someone else “doing the driving,” but also you can restrict your eating and drinking to shipboard if you have any concern about contaminated food and water in port. This should reduce the possibility of developing travelers’ diarrhea or any other travelers’ illness.

Special equipment a problem? Plan ahead

Before you decide that you really can’t travel because you’ll need special equipment such as a wheelchair, oxygen supplementation, a ventilator, respirator, or special diet, be assured that such needs are not all that uncommon. But you do need to plan well in advance of your trip. If you need oxygen, most airlines will arrange to carry your supply in the hold and let you use theirs. You’ll pay a fee, of course, and your physician must make the arrangements, but it’s really no big deal for the airline as long as they have advance warning.

Need a wheelchair? Some airlines have specially-built wheelchairs to navigate the narrow aisles. And a few planes will accommodate wheelchair-bound passengers with wheelchair-accessible lavatories.

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