What if I am Pregnant

Pregnant women should consult with their obstetrician before travel. If available, a consultation with a travel-medicine specialist is also recommended. Live vaccines are usually avoided in pregnancy. Some medications must also be avoided. This may put pregnant women at higher risk for getting sick in a foreign country.

Pregnant women should also be aware that the quality of obstetrical care in foreign countries varies considerably. It is best to have the name of a reputable clinic or hospital on hand. Women in the third trimester should consider delaying travel until after delivery. Check with your health-insurance provider in advance to determine what is covered in the destination country.

Diarrhea, some types of hepatitis, and malaria can be especially severe in pregnant women. Follow food, water, and insect precautions. Avoid areas with malaria if at all possible, and take medications as directed.

What about traveling with children

Some vaccinations and medications are not recommended for children. This means that the risk or severity of certain diseases is increased in children.

Diarrhea is more common in children because so much ends up in their mouths. Children can quickly become dehydrated. Make sure that your child keeps up with his or her fluids. Consider adding an oral re-hydration solution to your medical kit.

Children are attracted to animals and are more likely to get bitten. Bite wounds may become infected or transmit rabies. Keep children away from animals. Newborns and infants are at special risk. Breastfeeding will help reduce the risk of diarrhea. There are limited options for malaria prevention in infants. Around the world, malaria remains one of the major causes of death in children.

Why should travelers see a physician before they leave abroad

Travelers should see a physician before leaving for a trip if they are going to developing countries, going off the usual tourist routes, or if they have chronic diseases that could be affected by travel.

Travelers should protect themselves against common diseases that may be mild but that will disrupt their trip as well as protecting themselves against less common diseases that may be serious or even fatal. Some foreign countries require certain vaccinations before they will allow the traveler to enter the country.

All travelers need to be up to date on routine vaccines they would normally get if they were not traveling (for example, an annual influenza vaccination if indicated). No vaccinations are required for re-entry into the United States for foreign travelers.

What if I have a medical condition or a chronic disease

Careful preparation will allow travelers have a safe and enjoyable trip. See your physician before traveling to be sure your understand how to manage your condition while traveling. In some cases, an exercise regimen may be recommended to get in shape before the trip. It is important to check with your health-insurance provider to determine what is covered in the destination country.

Travelers with diabetes may need to adjust their insulin-dosing schedule if they cross several time zones. Frequent monitoring of blood sugar (glucose) by finger stick is usually recommended. Remember to carry insulin in your carry-on baggage (otherwise it will freeze in the cargo hold). An identification bracelet showing that you have diabetes is also recommended. Carry a source of sugar in case your blood glucose drops. Remember that exercise may cause blood sugar to dip, so always carry your supplies on hikes, etc. Finally, keep up with your fluids. Hydration can help avoid complications if your blood sugar jumps.

Travelers with heart disease should carry a recent electrocardiogram and a list of all current medications. Medications should be kept in carry-on luggage. If you have a pacemaker, you should know the name of the company that made it and how to contact someone if it stops working. Travelers with unstable heart disease (unstable angina, severe heart failure, recent heart attack, or unstable heart rhythm) should delay travel until their condition is stable.

Travelers who have problems with their immune system due to active cancer, chemotherapy, or AIDS may encounter special problems. In general, vaccines made from live organisms are usually avoided in people with significantly impaired immune systems. Even non-live travel-appropriate vaccines may not work as well as usual, but they are still beneficial and should be given. Consider delaying travel until the immune system is back to normal, if this is possible. Consultation with a disease specialist and a travel-medicine specialist before departure is strongly recommended.

Travelers with disabilities should know that accommodations will vary widely between and within countries. The Department of Transportation can assist with getting accommodations on airplanes (1-800-778-4838). Service animals such as guide dogs are subject to quarantine regulations and may not be allowed to enter some countries.

What are the medical concerns with jet lag

Jet lag happens when travelers cross several time zones and disrupt their normal sleep-wake cycle.

To reduce the duration and the symptoms, try to be outside when the sun is up. It may make for a very long (or short) first day, but it will help you adjust more quickly. Some travelers also try to change their sleep-wake habits before they leave.

Medicines are available that can promote sleep, but there are few studies on how well they work with jet lag.

What about diseases for which there is no vaccine or preventive medication

There are several diseases of concern for travelers for which there is no vaccine or medicine to prevent infection. Among these are some viral infections, sexually transmitted diseases, and parasitic infections.

Many viral infections can be spread by biting insects such as ticks or mosquitoes. These include serious infections like hemorrhagic fever, a viral infection that causes high fever and bleeding. Another virus causes Chikungunya fever, which is common in Africa and Asia. Spread by mosquitoes, Chikungunya fever causes high fever and severe joint pain and usually lasts for days or weeks. Another viral illness is dengue fever, which occurs throughout the world in tropical areas. Symptoms of dengue fever are high fever, headache, and occasionally bleeding (hemorrhage). The key to reducing the risk of getting these infections is to follow insect precautions (see section on insect precautions).

Sexually transmitted diseases can be acquired anywhere in the world. The only sure way to prevent disease is to abstain from sexual intercourse. Use of condoms will reduce risk.

Parasites occur in most areas of the world, but are especially common in tropical and subtropical regions. Some are spread by eating contaminated food (see food and water precautions), while others are spread by direct contact with infected water or soil. Most travelers do not get parasitic infections, but those who are going into rural areas of developing countries should ask their doctors about parasites they might encounter.

What should be in my first aid kit

  • Prescription medications that you take at home
  • Medications that your doctor recommended prevent travel-related illness
  • Over the counter medicines to treat minor illnesses (heartburn, headache, head cold, mild diarrhea, motion sickness)
  • Sunscreen, lotion to use to treat sunburn
  • Insect repellents
  • Bandages, tape, thermometer, and tweezers
  • Adventure travelers who are far from medical help will need to consider additional items
  • Women who get vaginal yeast infections should consider carrying along a treatment course (pills or vaginal products)
  • Other items according to your itinerary

What can I do to avoid insect bites

  • Wear light, protective clothing.
  • Use insect repellents that contain DEET (most popular brand-name insect repellents in the United States contain DEET). Reapply according to directions. When using sunscreen, apply sunscreen first and then repellent.
  • If you are hiking, tuck your pant leg into your sock. Check yourself over for ticks at the end of the hike.
  • Use mosquito netting or window screens if they are available.
  • Products that contain permethrin (an insect repellent) are available to spray on your clothes or tent for added protection.

What is safe to eat and drink while traveling

  • In general, it is best not to drink tap water in a developing country.
  • Ice is not safe. Freezing water does not destroy most infections.
  • Boiled water and drinks made from boiled water (tea) are usually safe.
  • Alcohol (beer, wine) is usually safe.
  • Carbonated bottled water or sodas are usually safe. Uncarbonated water may be safe, but even bottled water may be filled up from the local tap water source.
  • Iodine tablets or commercially available water filters may be used to purify water when camping.
  • In general, foods that you peel yourself (bananas) are safe.
  • Hot, well-cooked foods are usually safe.
  • Spices do not kill bacteria. Food can be so spicy that it burns your mouth and still cause traveler’s diarrhea or more serious diseases.
  • Foods that put the traveler at high risk for infection include undercooked meat and seafood.
  • Foods washed in contaminated water may have a residue of bacteria.