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Daily Dose

Three ways to prepare for overseas travel


If you’re traveling to an exotic destination this summer you’ll likely need to take certain precautions to avoid getting an exotic infection.

More than half of all travelers to developing countries get sick while abroad, usually diarrhea or other gastrointestinal symptoms, and 8 percent have symptoms severe enough to warrant medical attention, according to the World Tourism Organization.

A new analysis of 42,000 tourists from America, Europe, and elsewhere who sought medical care for travel-related infections during 2000 to 2010 found that there was more than a 50 percent increase in such illnesses over the course of a decade.

Some of the most common problems were due to mosquito-borne illnesses like malaria, dengue fever, and chikungunya. While malaria infections decreased due to improved mosquito control in certain African countries, dengue fever is on the rise.


Gastrointestinal infections from bacteria and other microbes in food and water are among the most common cause of infections, according to the study, which was published online last Wednesday in the Centers for Disease Control and Prevention journal Emerging Infectious Diseases.

“Often there’s an incubation period, and people may not become ill until they return,” said study co-author John Brownstein, an epidemiologist at Boston Children’s Hospital. Doctors need to be informed about recent overseas travel if you’re getting treated for a stomach bug or flu-like illness.

“Fever is the most concerning symptom,” said Dr. Regina LaRocque, an infectious disease specialist at the Massachusetts General Hospital’s traveler’s advice and immunization center. “It’s always a good idea to touch base with your doctor if you return from traveling abroad with a fever since some can be signs of life-threatening conditions.”

Those at highest risk of coming back with such infections include folks visiting friends or family members in developing countries because they tend to eat foods from local markets, drink from the local water supply, and spend more time outdoors in mosquito-ridden areas.


“Immigrants returning home to visit loved ones are the most common patients we treat for infections acquired during travel,” LaRocque said. “They’re also the least likely to seek medical advice and immunizations before their trip.”

On the less severe end of the illness spectrum, travelers to Southern Hemisphere countries like Australia could pick up the latest flu strain that circulates there during these countries’ winter months — six months ahead of ours and well before the latest vaccine is available in the United States.

Australia is also experiencing a new strain of norovirus this season called Sydney2012. Unfortunately, the nasty gastrointestinal illness marked by vomiting and diarrhea remains a problem for cruise ship travelers everywhere, and there’s little they can do to prevent it besides washing their hands frequently.

Whether you’re planning a trip to Thailand, Peru, or Kenya, getting those medical preparations in order before you go is just as important as getting your passport renewed or your hotel booked. Here’s what LaRocque recommends.

1. Get necessary vaccines four to six weeks before you depart. You’ll likely need an immunization or two if you’re heading to a developing country. My teenage daughter needed a hepatitis and typhoid vaccine, for example, before she traveled to Fiji on a teen community service trip. She was able to get these shots from her pediatrician. Since it takes several weeks for the vaccine to reach its full effectiveness, LaRocque said, see your doctor at least a month ahead of time.


2. Consider prescriptions to prevent or treat certain illnesses. You might need to take anti-malarial medications if you’re traveling to a country where the parasite is prevalent in the mosquito population. (Most medications need to be started one to two days before traveling and taken for up to several weeks afterward.) LaRocque said she sometimes prescribes an antibiotic just in case a patient develops a gastrointestinal illness while abroad and also recommends packing over-the-counter anti-diarrheal medications. If your primary care physician isn’t comfortable providing treatment, get a referral to see a travel physician or someone who has a speciality in infectious diseases.

3. Research government health websites. Check out the CDC’s travel section (wwwnc.cdc.gov/travel) for updates on immunizations, precautions to take, and new outbreaks. The site allows you to put in your destination and whether you’re traveling on a cruise; you can also fill in whether you’re traveling with children, pregnant women, or those with special health conditions. Deborah Kotz

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.