What is travel medicine?

Travel medicine is all about taking care of your health and preventing sickness when you visit another country. In 2022, about 917 million people traveled around the world, and traveling has increased over the past few years. What some may not realize is that going to different places can bring new illnesses or make existing health issues worse. When you travel, there is a chance you might experience infections, serious injuries, blood clots, allergic reactions, and the worsening of long-term health conditions.

 

What are some general safety measures everyone should take before traveling?

If you have health issues, it’s important to bring a list of your health problems, a list of your medications with dosages, and enough medicine for your entire trip. Be cautious about buying medications in poorly-regulated places, as they could be fake, expired, or contaminated.

  • Air travel: Some travelers may need extra oxygen during flights, and this should be arranged with the airline beforehand. Sitting on flights longer than 4 hours can increase the risk of blood clots, especially for those with cancer, recent surgery, pregnant individuals, or those who’ve had blood clots before. Some ways to prevent this are: using compression stockings, drinking lots of fluids, and standing up frequently while on the plane.
  • Cruise travel: If you’re going on a cruise, make sure you’ve had COVID-19 and flu vaccines. It is important to learn about maintaining hygiene, like washing your hands or coughing and sneezing in your elbow, as well as managing other common issues like diarrhea. If you’re prone to motion sickness, consider bringing medication along for the journey.
  • Food and drink: When it comes to what you eat and drink, it’s safest to choose bottled water or water that has been boiled or purified. If you can’t find safe drinking water, make sure to boil it for at least one minute.
  • Insects: Many diseases, such as yellow fever, malaria, or dengue fever, are spread through mosquito bites. To stay safe from insects, use insect repellents and wear long sleeves and pants. When sleeping, choose somewhere with screened windows and doors, and use bed netting to avoid insect bites.
  • Animals: Many diseases spread from animals to humans through bites, scratches, or eating food that has been contaminated by animals. It’s important to avoid contact with roaming dogs, monkeys, and bats to lower the risk of getting sick.

 

Pretravel vaccine recommendations:

Make sure to get a pre-travel check at least 1 month before you leave, especially because some vaccines need more than one dose. If your immune system is weakened, it’s advised to have the check as early as 6 months before your trip due to a slower immune response. Some vaccines, like yellow fever and measles-mumps-rubella, are live vaccines and should be given on the same day or at least 4 weeks apart.

  • Yellow fever: A disease spread by mosquitoes, found in part of Africa and South America. 1 dose of this vaccine should be taken at least 10 days before travel and should not be given to anyone under 6 months old.
  • Typhoid fever: Occurs when water and food are contaminated, mainly found in parts of South Asia. 1 dose of this vaccine should be given at least 2 weeks before travel and should not be given to anyone under 2 years old. 
  • Rabies: A deadly disease if not treated; vaccination is recommended for those working with animals or traveling to Africa, Asia, and Central/South America. 2 doses of this vaccine should be given 1 week apart and depending on your risk category, a booster can be given.
  • Japanese encephalitis: A viral infection spread by mosquitoes in Asia. 2 doses of this vaccine should be given 28 days apart and completed at least 1 week before traveling. This vaccine is recommended for trips longer than one month duration to certain countries.
  • Tick related encephalitis: A virus found in Europe and eastern Asia, usually spreading through tick bites that are active from April to November. 3 doses of this vaccine are needed to complete the series and are recommended for those engaging in extensive outdoor activities.
  • Cholera: Causes a severe, water diarrhea though fecal contamination; rare and preventable with safe food, water, and hand hygiene. 1 dose of this vaccine should be given at least 10 days before traveling and should not be given to anyone younger than 2 years old.
  • Dengue: A common mosquito infection in Southeast Asia, Central/South America, and the Pacific Islands. 3 doses of this vaccine is available for children ages 6-16 years old.
  • Polio: A virus that can cause paralysis and is present in Pakistan and Afghanistan. 3 doses of this vaccine should be given at least 4 weeks before travel and should not be given in children less than 6 weeks old.
  • Other recommended vaccines: As a part of childhood series as well as current CDC guidelines, everyone should have vaccines for COVID19, Tdap/Td, MMR, Hepatitis A, Hepatitis B, Meningococcal, and yearly flu vaccines

 

Preventative medicine recommendations:

  • Malaria: This is a disease spread through mosquito bites and is a risk in Haiti, the Caribbean, Central America, and Southeast Asia. Some drugs used for prevention include chloroquine, hydroxychloroquine, and mefloquine.
  • Altitude sickness: Altitude sickness may happen if you’ve had it before or if you’re going to a place higher than 3000 meters. Acetazolamide is the most common medication to prevent this. 
  • Traveler’s diarrhea: This is the most common travel-related issue, and symptoms are usually mild. Bismuth Subsalicylate can be used to prevent it.
  • Jet lag: Jet lag can occur when you travel across many time zones. Things like exposure to light, caffeine, and exercise can be helpful.
  • Motion sickness: Motion sickness can happen in moving vehicles. Commonly used medications to prevent this are diphenhydramine, scopolamine (patch or oral), and meclizine.

 

What are some signs to look out for if you are traveling and not feeling well? 

While you’re traveling, pay attention for any serious injuries, bloody diarrhea, or unexplained fever. Usually, signs show up a few days after you return from your trip. Watch out for signs like fever, chills, heavy sweating, severe headaches, diarrhea, rashes, or any other illnesses that you can’t explain. If you experience any of these symptoms, talk to your doctor.

 

Check this CDC link for specific information about each country:

https://wwwnc.cdc.gov/travel

Use this link to access the CDC pre-travel checklist:

https://wwwnc.cdc.gov/travel/yellowbook/2024/preparing/travel-health-kits

 

 

Apoorva Jagadeesh

Doctor of Pharmacy Candidate 2024

Philadelphia College of Pharmacy