Mark Fischer, MD
Mark Fischer, MD, Regional Medical Director for International SOS, a leading risk mitigation company that provides health and safety services to clients across the world.
No one wants to get sick while on a long-awaited vacation. Fortunately, pre-planning can help you stay well and enjoy every minute of your trip. Here’s a look at how to prepare for some popular destinations.
Some of the most common health risks on a cruise include gastrointestinal illnesses caused by norovirus, salmonella, E. coli, and shigella, as well as respiratory illnesses, such as influenza.
Before you go, make sure all of your immunizations are up to date and any medical conditions are well controlled. Research what risk mitigation practices the cruise line implements to create a safe environment.
Whenever traveling, make sure you have enough of any prescription medications and, if possible, extra in the event of an unforeseen delay. Talk to your doctor about any medications you should pack, such as anti-diarrheal and anti-nausea drugs. (See the sidebar on sea and motion sickness on page 28.)
While you’re there, always practice good hygiene by washing your hands thoroughly and frequently, including before eating, after going to the bathroom, and after coming into contact with high-touch surfaces, like doorknobs and stair railings. Soap and water are best: Hand sanitizers don’t work well against norovirus.
Whether you’re going to the beach, the Caribbean, or the desert, you need to prepare for sun exposure and heat.
Sun exposure. Pack sunscreen that has an SPF of 30 or higher, is water resistant, provides broad-spectrum coverage, and is not expired. Apply sunscreen before going outdoors. It takes approximately 15 minutes for your skin to absorb the sunscreen and protect you. The American Academy of Dermatology notes that most adults don’t use enough sunscreen. You need about 1 ounce (think a shot glass) to fully cover your body. Make sure you get all bare skin, including your ears, the tops of your feet, and your scalp if your hair is thinning. Reapply every two hours, or immediately after swimming or sweating. Wearing a hat can provide added protection.
Heat. Prolonged exposure to high temperatures can lead to heat stroke. To help prevent it, stay hydrated; wear lightweight, loose-fitting clothing, and a hat; schedule outdoor activities for early morning or evening, when temperatures are cooler; and if you begin to feel unwell, use fans, cooling towels, or air conditioning to lower your body temperature. Don’t try to push through it.
When traveling outside of the United States, research your destination to understand the required and recommended vaccinations and potential non-vaccine-preventable diseases. The Centers for Disease Control and Prevention website is an excellent resource. It’s important to be up to date on all your vaccinations at least a month prior to your departure. You may need to see a travel medicine physician for some of the required vaccinations.
When traveling out of the country, drinking water is one of the most common causes of illness. Drinking water that is contaminated with bacteria (like E. coli, salmonella, and cholera), protozoa, or viruses (like hepatitis, rotavirus, and polio) can lead to everything from inconvenience to a hospital visit and even significant medical complications. You can visit the CDC website for specific information for your destination.
When traveling anywhere with questionable tap water, use only commercially bottled water from an unopened, factory-sealed container for drinking, preparing food and beverages, making ice, cooking, and brushing your teeth. Avoid fountain drinks and ice, which might be made from contaminated water.
Avoid raw food when traveling. Instead, choose foods that are fully cooked and served hot. If you’re in an area where you’re unsure about the sanitation of the food supply, avoid uncooked vegetables, salads, raw fruit, and unpasteurized fruit juice. Be careful about buying food from street vendors.
To reduce the risk of drowning, practice safety around water. If you’re on the beach, be aware of water conditions, such as riptides, waves, and other hazards. Never swim alone: Always swim with a buddy or in designated swimming areas with lifeguards.
When boating, kayaking, or participating in any water sports or activities, wear a properly fitting life jacket. Don’t drink alcohol before or during swimming or water activities.
Don’t swim in lakes or rivers after a heavy rainfall. Runoff can contaminate water with sewage, insecticides, and other chemicals.
If you have any open wounds, don’t swim in freshwater or seawater without a waterproof bandage.
A little bug repellent can go a long way. “Mosquitoes and the diseases they spread have been responsible for killing more people than all the wars in history,” according to the Illinois Department of Health. Mosquitos can sicken people with viruses like Zika, malaria, West Nile and many more in almost every country in the world. The only places without them are Iceland and Antarctica.
Ticks can also spread a range of illness, like Babesiosis, Ehrlichiosis and Rocky Mountain Spotted Fever, to name a few. Some simple steps can reduce your risk at home and abroad.
Planes, trains, automobiles (and boats and amusement park rides) can cause motion sickness in some people. Here are some strategies to try:
Medication. Over-the-counter remedies like diphenhydramine (Benadryl), dimenhydrinate (Dramamine), and meclizine (Bonine) can help reduce the nausea of motion sickness—but they can also cause sedation. Some medications that are intended to prevent seasickness can interfere with other medications, so talk to your doctor or pharmacist about their use. Furthermore, people with certain medical conditions will need further guidance from a health-care provider before using the above medications.
Non-medication strategies
