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Vital Signs

Summer 2010

Plan Properly to Avoid Medical Problems While Traveling


VS-Summer10-Travel ProblemsTens of millions of Americans will travel abroad this summer, but for many, the trip will be marred by illness — a fate they could avoid by planning ahead and taking simple precautions.

People booking a journey to a developing or otherwise exotic locale should plan ahead to make sure they don’t put themselves at risk for infections endemic to that region, says Zachary Rubin, M.D., director of theSanta Monica-UCLA Center for Travel and Tropical Medicine. Part of the planning involves education on the risks, what to bring and what to avoid. Prospective travelers should consult with their primary care physicians to ensure that their general health is good.

One of the most important reasons for planning ahead is to ensure there is time to obtain any necessary vaccinations, notes Lynn Stephens, a nurse practitioner with the Travel Medicine Program at the UCLA Family Health Center in Santa Monica. “We recommend getting the vaccines four to six weeks before travel to allow time for them to take effect and for patients to get over any side effects they might experience from the vaccines.”

The immunizations recommended for travel abroad can be divided into three general categories, Stephens says. The first are vaccines that people should make sure they have had regardless of whether they are traveling, including tetanus and the MMR (mumps, measles and rubella) vaccine — particularly given that these diseases are more prevalent in many parts of the world than in the United States. Flu shots are also advisable, even in the summer, Dr. Rubin notes, since flu is spread year-round rather than seasonally in many regions.

The second group includes vaccines to prevent diseases spread by food and water, including hepatitis A and typhoid. And the third includes vaccines for diseases more specific to the locale, such as yellow fever for those entering certain tropical and jungle areas. Although most doctors’ offices can provide common immunizations such as tetanus, less routine vaccines typically require a travel-medicine specialist.

Malaria spread by mosquitoes is a major risk in many parts of Africa, Asia and Latin America. “Although there is no vaccine against malaria, medications can be prescribed that are very effective in preventing the disease,” Dr. Rubin says. These, too, require planning ahead so that they have time to take effect.

VS-Summer10-Avoid Travel IllnessAlthough the risk of illnesses from food- and water-borne infections such as hepatitis A and typhoid can be reduced with vaccines, the immunizations are not foolproof, nor will they prevent the all-too-common bout with traveler’s diarrhea. “It’s important to be aware of everything you eat and drink,” Stephens says. Travelers to less-developed parts of the world should stick with bottled water and, where it isn’t available, use filtering devices and tablets or bring the water to a boil. Avoid uncooked vegetables and fresh fruits that don’t have thick rinds or peels. In case these efforts fail, patients are sometimes given a prescription for antibiotics and are advised to stay hydrated. “As long as you can keep fluid down, the risk is minimal,” Dr. Rubin says. In more serious cases, patients can be referred to local healthcare providers.

Sometimes there are special concerns for the youngest and oldest travelers. Parents are advised not to take the youngest children to certain parts of the world if they are not old enough to have had all of their immunizations, Stephens notes. For toddlers and young school-age children, watching what they eat and drink is paramount. Children are at greater risk from diarrheal diseases and malaria, so taking protective measures, including ensuring proper hydration, is particularly important. For the elderly, Dr. Rubin recommends traveler’s insurance that guarantees they can be flown to a developed country if they require treatment while abroad.

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