are traveling far and wide to newer and more exotic destinations.
With these adventures come the risks which we should all be aware
A variety of problems may be encountered during
travel to the destination before you even get there. Patients with
chronic heart failure and chronic lung disease may encounter
breathing difficulties in the plane due to the cabin pressure which
is equivalent to an altitude of 5000 to 8000 feet above sea level.
Motion sickness may occur. Position yourself where
the motion is the least, e.g. middle of ship or over the wings in
the planes. Avoid reading and alcohol intake. Consume small amounts
of simple foods and beverages. Avoid any oral intake for short
Those susceptible to motion sickness may take
other preventative medications like diphenhydramine (Benadryl),
scopolamine or meclizine, an hour before departure. Dermal patches
are available for some medications. Always consult your doctor prior
to use because many of these medications may cause significant side
effects especially among senior citizens.
Coach Class syndrome
occurs as a result of being boxed in a cramped coach class seat in
the plane for an extended period of time. This may cause clots in
the veins. Deaths have been reported. Domestic air carriers have
been slow to respond to this problem, whereas international carriers
frequently show videos of exercises that you could be doing while
sitting in the seat.
Except during food service, flight attendants do
not mind you walking around. Get out of your seat and walk around
every one to two hours. A glass of water may be preferable to an
alcoholic drink. A tablet of a blood thinner like aspirin prior to
embarking on travel may reduce the risk. Check with your doctor
While filtered air systems present in the plane do
minimize infections, transmission of respiratory infections from a
person coughing and sneezing close to you is possible. Serving
contaminated food in the plane is possible but rare.
Altitude or mountain sickness may occur among
mountain climbers as well as those landing at high altitude
airports. Partial pressure of oxygen decreases with increasing
altitude and as many as 20% of travelers ascending above 8000 feet
in less than a day develop symptoms. Children are at the greatest
risk. Ascending slowly helps, but the safe rate of ascent varies
among individuals. The best treatment is to descend to a lower
altitude. There are no tests to predict who may be at risk.
Prolonged air travel across time zones disturbs
biologic rhythms and may result in jet lag. It is more common among
Your doctor may prescribe a mild sedative like Ambien to minimize
the problem. Melatonin taken in the evening at your destination may
help reset your biologic clock.
Vaccination against a variety of diseases like
Hepatitis A, Yellow fever, cholera, polio, typhoid, meningitis,
rabies etc. is available and should be undertaken based on your
travel destination. Immunization requirements change frequently, so
be sure to check before embarking on travel.
Individuals traveling to tropical countries of
Asia, Africa, and Central America are at risk for developing
mosquito-borne diseases like malaria, yellow fever, and dengue
fever. Use of protective clothing, insect repellants, insect sprays
in the living surroundings, as well as mosquito nets during the
sleep help reduce the risk.
Apply insect repellant to the exposed skin, but
away from eyes and mouth. Do not allow kids to apply it themselves.
Do not use it on the hands of small kids. Although not proven to be
absolutely safe, DEET is perhaps one of the better insect
repellants. Use products containing less than 10% DEET and follow
label directions carefully. Products containing soyabean oil and PMD
are perhaps the best among botanical repellants.
Use of chloroquine pills can reduce the risk for
malaria. In countries with chloroquine resistant malaria, mefloquine
and Doxycycline are reasonable alternatives. Chloroquine and
mefloquine are administered weekly whereas Doxycycline needs to be
taken daily. Start Chloroquine or mefloquine 1-2 weeks before travel
and continue for 4 weeks after returning. Doxycycline can be started
1-2 days before travel to destination.
Traveler's diarrhea is a concern when traveling to
any area with new and different kinds of foods. The more
adventuresome your culinary tastes, the greater the risk.
Contaminated foods are bigger source of traveler's diarrhea than the
Drink boiled water or fluids that are reliably
bottled. Bottled or canned carbonated beverages are usually safe. Do
not ingest ice cubes or tap water. Portable filters are not
recommended. Eat hot cooked foods. Avoid salads, uncooked vegetables
and un-pasteurized milk.
Prophylaxis for traveler's diarrhea although
effective, is not routinely recommended. The diarrhea is usually
self-limiting. Treatment involves drinking plenty of fluids and an
antidiarrheal medication, e.g. loperamide (Imodium). Addition of
Peptobismol may help. Antibiotics like Cipro may be needed.
Frequently only one dose of Cipro may be sufficient, although it may
be needed for 3-5 days. Talk to your doctor first. Many doctors
give their patients such medications to take with them for use
Seek medical help immediately if you develop
bloody diarrhea or fever, or if diarrhea does not resolve with
Do not forget the problems related to sun exposure
when you are enjoying the beautiful weather. Open water and snow
skiing exacerbate the risks of sun exposure. Wear hats and other
protective clothing. Use sunscreens with a sun-protective factor of
30 or higher. Apply it 30 minutes before exposure to sun. Don't be
miserly on the lotion. An average bikini-clad woman requires as much
as a full ounce of lotion to cover her body.
Air travel up to 36 weeks of uncomplicated
pregnancy is no problem. Be sure to check with the doctor first.
Wear the seat belt below the abdomen.
Metallic component of pacemakers and orthopedic
devices may activate security systems. Be sure to take a letter from
your physician. Patients with chronic illnesses should wear medical
identification bracelet or necklace.
While people tend to focus on preventing
infections, they may not realize that traffic accidents and drowning
are a major cause of fatalities amongst travelers to foreign
countries. In many developing countries, people drive like crazy and
rules of the road are seldom followed.
insurance plans may not be valid in foreign
lands. Travel insurance plans are an option and are available
through travel agents. Check the U.S. State department for any
traveler advisory for your destination prior to departure. A
consultation with the local travel health clinic is a wise
investment. Contact your state health department or nearby medical
school for information about such clinics.