Healthy Travels: A Q&A with Joseph Vinetz, MD
Traveling to distant and perhaps exotic locales is about having fun and making memories; the latter presumably not intended to include horrific tales of getting sick or hurt. Good planning and good sense are good ways to avoid medical mishaps while abroad. So too is advice from Joseph M. Vinetz, MD, a professor of medicine certified by the American Society of Tropical Medicine and Hygiene in tropical medicine and traveler’s health.
Vinetz oversees a travel medicine clinic at the Perlman Medical Offices in La Jolla, which provides a full range of services for travelers going anywhere in the world. We asked Vinetz for help packing our bags, medically speaking.
Question: Are there any vaccinations that you recommend every traveler have before going abroad?
Answer: There are two questions to be answered here.
First, what vaccines does the traveler need to get caught up on?
Second, are there any required vaccines specific to where the traveler is going?
Obviously, it’s important to be up-to-date on boosters for things like tetanus, measles, mumps and pertussis. These are conditions that may be problematic in some parts of the world. Polio is making a comeback in a few countries, which recommend that travelers get a vaccine booster for it before going to such places.
Often, though, travelers come into the clinic needing specific vaccines for specific countries. Places where yellow fever is endemic require a yellow fever vaccination and you need official proof of vaccination. Typhoid is another example.
As a rule of thumb, it’s best to get vaccinated at least two weeks before travel so that your body has time to develop an immune response. That requires planning in advance.
It should also be noted there is no vaccine to prevent malaria. There are pills and some strategies to help repel mosquitoes (which carry the infectious virus), but no vaccine to prevent the disease itself.
Q: How should you pack prescription medicines?
A: Some basics: Keep your medications in their original containers, which serve as legal documents when you’re passing through security and customs. You can divide them into daily pill separators after you’re in-country. Bring a doctor’s note for drugs like narcotics or psychoactives. Some countries look very closely at these kinds of drugs and you may be required to show official justification.
You don’t need to keep insulin refrigerated. It will be OK without refrigeration for a couple of days. But read and keep the packaging insert with the medication, especially if you’re also carrying hypodermics for injecting it. You might want to bring a doctor’s note, too if you’re going to be carrying needles.
Bring along a list of all of your prescriptions and the conditions they’re used for in case you need replacements. The drug list should be generic names because these don’t change from country to country.
Pack more than what you expect to use during a trip, just in case you run into delays.
Q: What’s the best preventive, take-along remedy for gastrointestinal problems?
A: Pepto-Bismol and Immodium or similar products are useful. It’s also good to bring along a prescribed antibiotic. Simple diarrhea will get better in a few hours if you take an antibiotic as soon as you feel ill. You don’t need to take the antibiotic for days either, a couple should suffice.
Q: If a traveler finds himself in need of medical care during a trip, what should he know beforehand? What should he have with him? What should he be looking for in terms of assessing the quality of the care being provided?
A: Make sure to bring along a copy of your insurance card. Sign up for international evacuation insurance. There are a lot of companies that do this. It’s relatively inexpensive. And if you have a serious illness or get into a car accident, you want to be medically evacuated to the United States or the closest excellent medical center as soon as possible. With modern transportation, nowhere in the world is more than 12 hours away.
Q: What travel advice would you give about staying healthy while away from home?
A: People need to practice good common sense. Drink bottled water. Make sure it’s not counterfeit. Eat hot foods. Avoid street vendors. Don’t go jogging in slums or places where you really shouldn’t be. Be careful crossing the street.
It’s prudent to consult with doctors before any trip if you have any underlying medical conditions or uncertainties about safety risks. We do these kinds of consultations frequently, both before travel and post-travel.
Q: Should travelers have concerns about bringing home an unwanted souvenir, such as a parasite?
A: For the usual business trip, it’s probably not necessary unless something particular has happened. If the traveler has been in a rural place or had a prolonged stay in an exotic locale, it might be wise to have a post-trip check-up.
The most common reasons for a post-travel exam are severe fever and headache, especially if the traveler has come back from someplace like the sub-Saharan Africa. They should see a doctor immediately to rule out any chance of malaria.
Other reasons to see a physician are diarrhea that lasts more than a couple of days or new skin rashes.
Watch a video of Dr. Vinetz discussing travel medicine on UCSD-TV.