The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.
Guest post by Charles E. Davis, M.D.
With a nod (and an apology) to our old friend, Charles Dickens, I’m going to ask you a question: When you look back on your spring break, are you going to say that it was the “best of times,” or the “worst of times?” Incidentally, if you don’t know the source of those quotes, perhaps you should stay home and read A Tale of Two Cities. Well, at least take it along with you.
Travelers’ infections are among the most common causes of ruined vacations, so I’m going to give you some tips to help you avoid illnesses that could turn this potentially wonderful spring break into the worst of times. There are far more travelers’ infections than I can discuss in this post, but here are some general guidelines—a sort of CliffsNotes approach—that will help you avoid illness, interruptions to your trip, and even evacuation back home.
- Be sure your routine immunizations are up to date and consider some additional travel-associated vaccines. You will need a tetanus and diphtheria booster if you haven’t had one in the last 10 years, and get your seasonal influenza shot! Remember the H1N1 flu pandemic began in Mexico about the time of the 2009 spring break. How about hepatitis? Hepatitis A (transmitted through contaminated food and water) and hepatitis B (transmitted through contaminated needles and sexual contact) can be reliably prevented by immunization. Check on your immune status against meningococcal meningitis, especially if you’re staying in a hostel, where susceptible young people congregate. Talk to your doctor about vaccination against typhoid fever and, if you’re traveling to South America, yellow fever vaccination.
- Minimize your chances of getting dengue fever and malaria. On hikes and other forays into rural areas and rainforests, wear permethrin-impregnated clothes and use insect repellents containing DEET. Spray insecticides into the dark places in your rooms and use mosquito nets unless you are staying in a first-class, air-conditioned hotel. If you are visiting any country in a malaria zone—and many of you will—go to a travel clinic and get a prescription for the appropriate antimalarial drug.
- Boil it, peel it, or forget it! Following this old adage really helps prevent travelers’ diarrhea (TD). Drink only sealed bottled water, carbonated beverages, and beer or wine directly out of the can or bottle. Boil tap water (iodine tablets and filters are OK) even for brushing your teeth unless you are staying in a luxury hotel or resort. Ice is made from the same tap water. Raw fruit is safe only if you peel it yourself, and all kinds of salads are risky. Piping hot food is safe, but smorgasbords and buffets are notorious sources of contamination because food is held over low flames for hours. Plan ahead and talk to your doctor about self-treatment of TD.
- Don’t expose yourself to HIV or another sexually transmitted infection (STI). Other than for genital warts, there are no vaccines against STIs, but travelers younger than 26 years old—both sexes—are eligible for this effective vaccine. Condoms are the only other protection. Used properly, they are quite effective against all STIs except genital herpes and genital warts. Women who may have a new sexual partner should carry male condoms and strongly consider using a female condom.
These tips won’t guarantee you a trip free of traveler’s infections, but they will greatly increase the chance that your spring break will be “the best of times.” Why not choose Dickens’s “age of wisdom,” rather than his “age of foolishness”?
Charles E. Davis, M.D., a specialist in microbiology and infectious diseases, is professor emeritus of pathology and medicine at the University of California, San Diego, and director emeritus of microbiology at the UCSD medical center. His book, The International Traveler’s Guide to Avoiding Infections, will be available this spring from JHU Press.
The information provided in this blog post is not meant to substitute for medical advice or care provided by a physician, and testing and treatment should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the individual and his or her physician. This post has been written to help with that dialogue. The services of a competent medical professional should be obtained whenever medical advice is needed.