Another holiday season is rapidly approaching, and most of you made flight and hotel reservations months ago — but have you spent equal efforts preparing for good health on your hard earned holiday? Each holiday season I see a massive rush of patients in my hospital just a few days before their vacations, looking for travel medicines and advice. Very often, those medicines are sold out, or they’ve run out of time for vaccinations. That’s why it’s crucial to plan early. You still have time now, so follow my tips below and you should be fine.
First, you need to know the health risks of the places you are visiting. You may think you need nothing, but what if your 5-star beach resort is in a high risk malaria zone? This is why the first step is to always check a travel website to see what you need. My favorite is from the US CDC and State Department, at www.cdc.gov/travel, but the UK also has a useful site at www.gov.uk/foreign-travel-advice. Both have fully detailed and updated summaries of every country’s health status, listing potential threats and outbreaks. Perhaps you need a Hepatitis A vaccine, or a polio booster, or malaria prevention pills — these websites will give you the answers. Bookmark these websites, and read before you go visit your doctor! This will save a lot of time for both you and the doctor.
Many people will be visiting tropical jungles and beach resorts, so let’s discuss the main problems there: diseases from mosquitoes and stomach infections. Mosquitoes are a major hassle in most of these countries, and they can infect you not just with deadly malaria parasites but a host of other bugs causing dengue fever, typhoid fever, japanese encephalitis — and many others. Your number one treatment is prevention! That means using really good anti-mosquito spray, which usually contains Picaridin or the chemical DEET. DEET is much more widely available, and you should use one with at least 20% DEET. Please don’t scrimp on wimpy mosquito repellants, especially for your children. This includes China’s very popular green bottles full of eucalyptus oil or citronella — they only work for a couple hours and barely work. Even babies and children should use DEET, as it is officially rated safe by pediatric groups for any child over 2 months of age (read here for more safety information).
Malaria is such a serious threat worldwide that many travelers should be taking preventive medicines during their entire trip. Here in China we usually prescribe doxycycline, which you have to take every day — and continue to take for 28 days after your trip. Malaria is a tricky parasite and can stay dormant inside your blood cells for months, so it’s important to finish all of the medicines!
Vaccines are also important for many countries, especially hepatitis A and B, japanese encephalitis, rabies and any needed boosters. Many of these vaccines need to be given at least a few weeks in advance in order to get the multiple shots needed, and you also need that time for the protective antibodies to develop.
The number one cause of a ruined vacation that I see is being stuck on a toilet for days with diarrhea. Everyone should prepare a small medicine bag stocked with the most useful pills, especially for these very common stomach infections. My favorite OTC medicine for this is loperamide (immodium), which is very effective to slow down most people’s watery (non-bloody) diarrhea. It doesn’t cure the infection but it does cut down the frequency of bathroom visits, which can be wonderful if you are on a long plane or bus ride. A couple of healthier OTC medicines can help you recover more quickly, including the charcoal powder Smecta as well as probiotic pills (capsule forms of the good bacteria in yogurt). Both are also available for infants and toddlers.
In southern Asia, many bouts of diarrhea are caused by bacterial infections, so you should seriously consider carrying along some antibiotics as well. For example, many travel doctors now prescribe azithromycin with instructions on how to use as soon as diarrhea symptoms start. You would need a doctor’s visit to get these antibiotics; many local pharmacies will sell these to you but this isn’t legal — and their instructions often are incorrect. Their choice of antibiotics may be dangerous for children — or useless against the infection. Your local pharmacist is not a medical doctor!