Don't get bugged when you travel

Sometimes it feels like we're so bombarded with warnings about disease outbreaks around the world, you just want to stay home! Avian influenza, swine flu, malaria, cholera, ebola... the list goes on, with new bugs popping up every year and old bugs making a comeback – some of them almost impossible to pronounce!

Travelling around the globe is more commonplace today than ever. But when people travel, they often unwittingly bring along extra baggage that they didn't even know they packed. Viruses and bacteria are always on the move, as travellers carry them either by travelling while ill or by being a carrier – having the infection but not experiencing symptoms yet.

Some illnesses are transmitted by animal or insect bites, others by contaminated food or water, others by close human contact in mostly rural areas. In the past few years, Health Canada has posted travel advisories and outbreaks for the following conditions:

From contaminated food or water: cholera, gastrointestinal illness, mad cow disease (bovine spongiform encephalopathy or BSE), Salmonella, hepatitis A, listeriosis, botulism, shigellosis, ciguatera, enterovirus respiratory syndrome, gnathostomiasis, leptospirosis, and poliovirus

From insect bites: malaria, West Nile virus, dengue fever, Japanese encephalitis, plague, Rift Valley fever, Ross River virus, St. Louis encephalitis, yellow fever, and Crimean-Congo hemorrhagic fever

From person to person: measles, mumps, meningitis, rubella, hepatitis A, hepatitis B, severe acute respiratory syndrome (SARS), middle eastern respiratory syndrome (MERS), influenza, conjunctivitis, ebola, acute respiratory infection, Marburg virus, plague, poliovirus, Crimean-Congo hemorrhagic fever, tuberculosis, and hand, foot, and mouth disease

From animals (contact, bites, or dust from excrement): rabies, avian influenza, eastern equine encephalitis, hantavirus, Lassa fever, Nipah viruses, plague, and Crimean-Congo hemorrhagic fever

Airborne: legionnaires' disease

The bright side: the odds are in your favour!

The good news is that you will probably be fine if you are staying in a good hotel and are using commonsense ways of controlling your exposure to infection, such as proper handwashing and using insect repellant. And if you do come in contact with a virus or bacteria, there is an excellent chance that an antibiotic or other medication will preserve your good health.

Getting vaccinated against diseases that are common to your travel destination will give you extra peace of mind before you hop on that plane. But remember, you have a greater chance of catching a cold or the flu during your flight than in your travel destination, since you are in close proximity to other people and since the same air is continually recirculated in an airplane (although most planes usually pass the air through filters that trap the bugs that can cause illness). The Canadian flu vaccine offers protection against catching the flu on most airline routes. It needs to be injected every year, in the late autumn, to get full protection. Influenza is around during the winter in the northern and southern hemispheres and year-round at the equator. And remember: the southern hemisphere's winter happens during the northern hemisphere's summer, so think about flu vaccination if you're heading south of the equator during your summer holidays.

General advice for avoiding person-to-person infections:

  • Avoid crowds or crowded areas.
  • Use an alcohol-based hand sanitizer or wash your hands frequently. Wipe any object such a phone receiver or computer keyboard before you use it.
  • Limit physical contact (handshaking, hugging, sharing objects) in possible infected areas.

For advice on avoiding infection from insect bites or animals, or from contaminated food or water, see "What travel vaccines won't prevent."

All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Travel-Bugs

A visit to the travel clinic

Travel clinics are staffed with specialists in travel health. They have current information on which vaccines are required or recommended for people travelling to various destinations as well as information on the most up-to-date medications for travellers. Even if you've had vaccinations when you've travelled before, you will still benefit from a visit to a travel clinic, as the recommendations may have changed or you may need a "booster" for a vaccine you already have been given.

Travellers should visit their doctor or a travel clinic at least 6 to 8 weeks before departure. This will give time for the vaccines to take effect and to ensure enough time between doses, as some vaccines are given in multiple doses.

When you visit a travel clinic, be sure to bring any medical records and travel forms you have so that you can discuss:

  • your previous immunizations
  • your medical history, allergies, and current medications
  • your current health issues and infections
  • your travel plans (bring your travel itinerary) and lifestyle
  • your insurance situation

Be as honest as possible with the travel doctor so you will get the best assessment possible. To find the nearest travel clinic, visit the Public Health Agency of Canada's information on Travel Health at www.travelhealth.gc.ca. Note that visits to a travel clinic are not covered under most provincial health care plans.

Not all vaccines are 100% effective in protecting you. Also keep in mind that health problems you may encounter while travelling are not always prevented by vaccines. For example, travellers should still take proper food and water precautions.

Children and pregnant women should ask their doctors about the benefits and risks of certain vaccines. If you are on certain medications, such as corticosteroids, some vaccinations may not be recommended for you, and others may not be as effective. People who have compromised immune systems, for example people who have HIV or lupus or who are undergoing chemotherapy treatment, should also discuss the risks and benefits of vaccinations with their doctors first.

What vaccines are available?

Childhood and routine vaccinations are covered in most public health insurance plans. You will have to pay for additional vaccinations directly or through your private health insurance. Double-check with your doctor or pharmacist whether you have to pay for a vaccination.

Routine vaccines (usually as part of your immunization schedule and usually covered by public health care):

  • hepatitis B (may only be covered by private insurance)
  • Haemophilus influenzae b (meningitis)
  • HPV (human papillomavirus) (may only be covered by private insurance)
  • meningococcal
  • measles, mumps and rubella
  • pertussis (whopping cough)
  • poliomyelitis
  • tetanus and diphtheria
  • pneumococcal
  • varicella (chicken pox)

Recommended vaccines (some are required for entry into country):

  • European tick-borne encephalitis
  • cholera
  • hepatitis A
  • influenza
  • Japanese encephalitis
  • meningococcal (if you did not receive it as part of your routine immunization schedule)
  • rabies
  • typhoid fever
  • yellow fever

For a list of current travel advisories, see the Public Health Agency of Canada's information on Travel Health online at www.travelhealth.gc.ca, the World Health Organization at www.who.int, or the United States Centers for Disease Control and Prevention at www.cdc.gov/travel.

For a list of yellow fever and malaria vaccination requirements by country, visit the World Health Organization at www.who.int/ith/.

All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Travel-Bugs

What travel vaccines won't prevent

Vaccines are great for preventing many communicable diseases. But there are some problems that you can't avoid just by getting a shot.

All causes of travellers' diarrhea

The most common illness to strike Canadian tourists in developing countries is travellers' diarrhea (TD), which usually lasts 3 or 4 days but can sometimes last a week or longer. It can be caused by any of a number of bacteria, such as E. coli, and, less often, by parasites. TD is usually characterized by stomach cramping, urgency to use the bathroom, nausea, vomiting, fever, bloating, and frequent loose or watery bowel movements.

If you contract TD but it's not too severe, you may be able to treat it yourself with anti-diarrhea and fever-reducing medications, as well as oral rehydration solutions.

You can reduce your risk of getting TD or similar infections by following some basic precautions:

  • Cook it, peel it, or leave it!
  • Avoid food from street vendors.
  • Drink carbonated drinks and bottled beverages and do not add ice.
  • Avoid non-pasteurized dairy products and ice cream.
  • Avoid uncooked foods, especially shellfish, and salads. Fruit that can be peeled is usually safe.
  • Use bottled water, not tap water, even when brushing your teeth.

TD may also be prevented by taking an oral vaccine called Dukoral®. This medication can be taken by healthy individuals over 2 years of age. The vaccine is taken as 2 doses at intervals of at least a week, but not more than 6 weeks apart. Speak to your doctor or pharmacist to see if the vaccine is right for you and your family.

For more information on this and what else you can do to prevent traveller's diarrhea, check with a health care professional or travel clinic before travelling.

Bedbugs

Bedbugs live in various places, but particularly in dirty mattresses and bedding. Bedbugs leave itchy bites in neat rows – and excessive scratching can cause infections. Be careful where you sleep! If you do get bitten by bed bugs, calamine lotion or cortisone cream may help with the itching. Take an antihistamine if you have an allergic reaction to the bites. To get rid of the bugs, you will need to wash all your bedding, and possibly steam or replace your mattress.

Malaria

Malaria is an infection caused by a parasite spread by mosquito bites. It causes muscle aches, chills, and fever, and can be fatal. If you're going to an area where there is a risk of contracting malaria, you will need to take medication to prevent it. There are antimalarial pills available that are taken for a period of time before you travel, during the travel period, and for 1 to 4 weeks after returning home.

To avoid malaria and other insect-borne infections, take a few precautions:

  • Avoid mosquitoes by staying in insect-proof areas during the time of day when mosquitoes bite (evening and nighttime).
  • Use DEET-containing insect repellents. Do not use DEET-containing products on children under 6 months of age. Use 10% DEET or less on children less than 12 years old. Follow the instructions on the bottle carefully on how to use DEET-containing products. Do not spray DEET on your face or anywhere near your eyes. Instead, spray it on your hands and pat it onto your face. Ask your health care provider for more information about using DEET-containing products.
  • Sleep in screened or netted, air-conditioned accommodation or use permethrin-impregnated bed nets.
  • Wear trousers and long-sleeved shirts. Wear light-coloured clothing.
  • Take your anti-malaria medications as directed by your doctor.

There are also other infections and illnesses you can get from animals – for instance, forms of influenza that may be transmitted from birds. To avoid animal-borne infections:

  • Use alcohol-based hand sanitizer or wash your hands frequently.
  • Avoid open-air markets and farms – or avoid animals altogether.
  • Be wary of animal products.

Jet lag

It's easier on your sleep schedule to travel west than to travel east – your body can adjust as easily to going to bed 90 minutes later than normal as to waking up 60 minutes earlier. But if you have to adjust in one direction, you'll have to adjust in the other on your way back. Fortunately, there are some things you can do to beat jet lag.

Travelling east

  • For 2 or 3 days before departure, go to bed an hour earlier every night.
  • Take melatonin at bedtime for 3 to 4 nights after getting to your destination. Check with your doctor or pharmacist before taking any medication.
  • Exposure to morning light (whether or not the sun is shining) is helpful.

Travelling west

  • For 2 or 3 days before departure, go to bed an hour later every night.
  • Take melatonin at bedtime for 3 to 4 nights after getting to your destination. Check with your doctor or pharmacist before taking any medication.
  • Exposure to afternoon sunlight (whether or not the sun is shining) is helpful.

General tips

  • Adjust your routine (e.g., light exposure, activity, meals) to the new schedule as soon as your arrive in your destination.
  • Drink plenty of water to stay hydrated while travelling. Minimize alcohol and caffeine, which can cause dehydration.
  • Eat light meals during the travel time.

Note that there are studies showing that melatonin can help minimize jet lag, but none to prove it is safe to take for long periods.

All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Travel-Bugs

Insuring a healthy and safe trip

If you plan to travel outside Canada, you should get the best medical insurance you can afford – hospitalization or medical treatment can be very expensive. Canadian provincial medical insurance rarely covers the full cost and does not pay up front.

Check with your provincial health authority

For people travelling outside Canada, provincial health plans cover only emergency health services given in connection with an acute, unexpected illness or injury requiring immediate or emergency treatment. Be aware that Canadian health insurance will only cover the amount that the medical service would cost in Canada – if it costs more in the country you're visiting, you'll be responsible for paying the rest.

Buy private insurance

When you're buying private travel health insurance, be sure to ask whether your policy:

  • has an in-house worldwide, multilingual emergency hotline
  • provides for your medical evacuation (or any required medical escort) to the nearest place with proper medical care or to Canada
  • pays for the preparation and return to Canada of your remains should you die while travelling
  • covers the countries or regions you plan to visit

Carry details of your insurance with you. Also, tell your travel agent, a friend or a relative at home, and your travelling companion how to contact your insurer. If you get medical treatment when you are abroad, make sure you have all the paperwork and invoices for your reimbursement claim – most insurance companies will not accept copies or faxes. Keep copies for yourself!

Find out about the risks and where to go for help

Foreign Affairs Canada produces Country Reports that outline reported risks or concerns for Canadians visiting different countries, available at travel.gc.ca.

When you travel abroad, make sure you know the location of the nearest Canadian embassy or consulate. The Consular Affairs Bureau provides information and assistance services to Canadians living and travelling abroad. The Operations Centre of Foreign Affairs Canada operates 24 hours a day, seven days a week and is available to respond to emergency calls from anywhere in the world.

Foreign Affairs Canada offers a registration service for Canadians travelling and residing in a foreign country. This service allows the government to contact and assist you in an emergency, such as a natural disaster or family emergency at home, while you are in a foreign country. Canadians can register at travel.gc.ca.

Did you forget anything? Here is a quick checklist of things to do before you go:

  • Check travelhealth.gc.ca for any travel health advisories.
  • Get travel medical insurance – understand what it includes (your private health insurance may also cover travel).
  • Write down the emergency numbers you might need (e.g., Canadian consulate/embassy, insurance, credit card).
  • Pack any medications you need in your carry-on luggage, and bring extra in case you lose them.
  • Visit a travel clinic at least six weeks before leaving.
  • Buy alcohol-based sanitized wipes to keep wherever you go.
  • You should see your doctor if the following happens to you:
    • you were ill or felt unwell during your trip
    • become ill or feel unwell after you've returned from your trip

And remember, have a safe and enjoyable trip! Bon voyage!

All material copyright MediResource Inc. 1996 – 2019. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Travel-Bugs

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