Planning a little international travel this summer? Before you renew your passport and figure out how many rolls of film to buy, there are a few health precautions you should take to avoid a side trip to the hospital. Anywhere from 20% to 70% of international travelers develop health problems, according to an article in last week's New England Journal of Medicine. The risks depend on where you go and whether you take a standard weeklong package tour or trek off the beaten path for weeks of backpacking or biking. But a lot also depends on how well prepared you are and how strictly you follow a few simple rules once you get to your destination.
As you might expect, diarrhea is the traveler's No. 1 health complaint. Most people are usually back to normal after a couple of days. You should consult a doctor, however, even while still abroad, if you develop a fever or your stools become bloody. Many physicians prescribe an antibiotic for their traveling patients to use en route in just such a case. Your best bet is to avoid uncooked food (other than fruits and vegetables you peel yourself), use bottled water even for brushing your teeth, and keep your hands scrupulously clean by washing them with either soap or a liquid sanitizer like Purell.
And if you get the runs anyway? Gatorade, which you can tote along in powdered form, might help you feel less drained. But there's an even better solution--particularly if the afflicted traveler is a child, whose smaller body mass can make the loss of fluids caused by diarrhea especially dangerous. "Oral-rehydration salts are specifically designed to replenish what you've lost," says Dr. Edward Ryan, a tropical-disease expert at Massachusetts General Hospital who co-wrote the article in last week's Journal. "They've saved countless lives." The two main U.S. suppliers are Cera Products (888-237-2598) and Jianas Bros. (816-421-2880).
Find out what vaccinations you need, and follow the preventive measures listed by the Centers for Disease Control and Prevention on its website at www.cdc.gov/travel (Allow at least a month before departure for some shots to "take.") In April, the health agency reported that a 48-year-old California man died of yellow fever--a mosquito-borne infection that is often accompanied by a yellowing of the skin--eight days after returning from an adventure trip to South America. Although he had been vaccinated against tetanus, typhoid and hepatitis A, he hadn't been inoculated against yellow fever.
There are no vaccines for some tropical diseases--like malaria and dengue fever. And even the drugs used to prevent malaria don't always work. So it's important when traveling to areas where these diseases are endemic (you can learn them from the CDC website) to avoid being bitten by mosquitoes. Wear long-sleeved shirts and long pants, go inside at dusk and spray insect repellent on exposed skin.
Frightening as tropical diseases are, you're more likely to be killed in a traffic accident than by illness. Learn the local traffic rules, don't jaywalk and avoid driving after dark in rural areas. And don't assume that all's well because your trip has ended well. If you develop an unexplained fever or flulike illness within a year of your return, tell your doctor where you've been. Chances are you'll come home with nothing worse than a few tacky souvenirs, but it never hurts to be prepared.