Travel Advice from Dr. Zach

BT Montreal | posted Wednesday, Feb 8th, 2017

• Facebook
• Twitter
• E-mail
• Print

Plan ahead

• Make sure you have medical insurance
• Hopefully you won’t need it but if you don’t have it you’ll probably need it
• Affordable, shop around
• Make a timely Pre travel appointment with your doctor (less than 50% of ppl do)
• You could need vaccinations – routine or otherwise – may need 4-6 weeks for this
• Vaccines are individualized and depend on where you’re going.  Available:  yellow fever, meningococcal, typhoid, hep A, hep B, rabies, cholera, japanese encephalitis
• Routine vaccinations — influenza, tetanus, diphtheria, pertussis, mmr, polio, varicella

Consider safety while away

• Hand hygiene
• Sun protection for eyes and skin — sunglasses, sunblock, sun shirts, hats, mosquito protection
• Driving — intl license, be careful
• STI’s – bring protection

Top things think of if you’re travelling to Mexico, Caribbean, or southern US this spring break:

1. a) Traveller’s Diarrhea

• Most common illness in travelers
• Develops within 10 days of return
• Variety of bacterial (etec most common), viral, parasitic (tend to persist longer) organisms
• Prevention is key — eat only throoughly cooked hot foods, fruits you peel, pasteurized dairy.  Bottled drinks without ice, use straw
• Freezing does not kill the diarrhea-causing organisms.  Alcohol does not sterilize them.  Fruit salads, lettuce, chicken salads unwise
• Water purification — boiling for 3 min then cooling to room temp.  Adding 2 drops of 5% bleach to a quart of water will kill most bacteria in 30 min.  Adding 5 drops of tincture of iodine to a quart of water will kill bacteria within 30 min.compact water filters can be used
• Chemoprophylaxis not recommended

1. b) Chikungunya, Zika viruses – mosquito avoidance

• Avoid feeding time (malaria Japanese encephalitis, west Nile virus between dusk and dawn; for dengue, chikungunya, zika, yellow fever during daytime)
• Wear clothing that covers skin
• Insect repellant.  DEET (there are others that work)  don’t saturate the skin.  Not under clothing.  Avoid eyes mouth genitals, wounds
• Treat fabrics with insecticides’
• Screens, tents

1. c) Malaria (DR, Haiti) – chemoprophylaxis, mosquito bite avoidance

• Depending on what else you do — diving barotrauma, STIs

2.     Staying well en route and coming home:

Air travel

1. risk of VTE (blood clots) on flights of 4+ hours. Consider asa, compression stockings.  Get up and walk.
2. Decreased paO2 in planes – may cause fatigue, “foggy brain”, headache.  Most ppl are fine but if sig heart lung dz, anemia, talk to your doctor
3. It’s dry up there — drink
4. Air pressure changes can cause ear pain in people with resp tract infections with blocked eustachian tubes — chew, yawn, suck sweets, valsalva, decongestant/antihistamine
5. Jet lag — Curtail coffee, stay hydrated, Avoid or limit alcohol inflight, Try to sleep on the plane, Use sleeping pills wisely, Get outside, light, Adjust your clock, exercise
6. Sharing germs — wash your hands!