Travel

Planning for Healthy Travel

Whether a frequent international traveler or on the trip of a lifetime, the traveler can take steps to plan for healthy travel.

The first step is to consult with one’s health-care provider well in advance of the planned date of departure. Even healthy young adults going to developed areas should be up to date on their routine vaccinations.

Travelers’ Health Kit

The purpose of a Travel Kit is twofold: to allow the traveler to take care of minor health problems as they occur and to treat exacerbations of pre-existing medical conditions. Persons with pre-existing conditions, such as diabetes, should consider wearing an alert bracelet and making sure this information is on a card in their wallet and with their other travel documents.

A variety of health kits are available commercially and may even be purchased over the Internet; however, similar kits can be assembled at home. The specific contents of the health kit are based on destination, duration of travel, type of travel, and the traveler’s pre-existing medical conditions. Basic items that should be included are listed below.

Medications

Personal prescription medications in their original containers (copies of all prescriptions should be carried, including the generic names for medications, and a note from the prescribing physician on letterhead stationery for controlled substances and injectable medications)

• Antimalarial medications, if applicable
• Over-the-counter antidiarrheal medication (e.g., bismuth subsalicylate, loperamide)
• Antibiotic for self-treatment of moderate to severe diarrhea
• Antihistamine
• Decongestant, alone or in combination with antihistamine
• Anti-motion sickness medication
• Acetaminophen, aspirin, ibuprofen, or other medication for pain or fever
• Mild laxative
• Cough suppressant/expectorant
• Throat lozenges
• Antacid
• Antifungal and antibacterial ointments or creams
• 1% hydrocortisone cream
• Epinephrine auto-injector (e.g., EpiPen), especially if history of severe allergic reaction. Also available in smaller-dose package for children.
• Insect repellent containing DEET (up to 50%)
• Sunscreen (preferably SPF 15 or greater)
• Aloe gel for sunburns
• Digital thermometer
• Oral rehydration solution packets
• Basic first-aid items (adhesive bandages, gauze, ace wrap, antiseptic, tweez-ers, scissors, cotton-tipped applicators)
• Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol (1)
• Moleskin for blisters
• Lubricating eye drops
• Water purification tablets
• Latex condoms

A final reminder: a health kit is useful only if it is available. It should be carried with the traveler at all times, e.g., in carry-on baggage when allowable, and on excursions. All medications, especially prescription medications, should be stored in carry-on baggage, in their original containers with clear labels. With heightened airline security, sharp objects and some liquids and gels will have to remain in checked luggage.

Swimming and Recreational Water Safety

Aquatic activities are a favorite for many travelers; however, deaths due to drowning are estimated at almost 400,000 per year worldwide. Before departure, travelers should be advised of the following recommendations for water safety to reduce their risk of drowning and injury while swimming or boating.

Prevention

Water is a hazardous environment; everyone should be prepared for an emergency. Learn cardio-pulmonary resuscitation (CPR) and first aid before departing. Avoid alcohol and drug use before and during activities in or around the water or while supervising children. These substances can impair balance, coordination, and judgment. Young children, even those who have had swimming lessons, require constant supervision when in or near water; this responsibility should be delegated only to experienced, responsible swimmers who know CPR and know how to initiate help in an emergency. Ideally, choose swimming areas that are supervised by trained and certified lifeguards and obey rules, posted signs, and warning flags. Choose housing/hotel accommodations that do not permit direct access by children to any body of water without adult supervision. Swimming pools with fences that have self-closing, self-latching gates are preferable.

When planning outdoor water activities, select areas that have good water quality and safe natural conditions. Murky water, hidden underwater objects, unexpected drop-offs, and aquatic plant life are hazardous.

Marine plants and animals such as biting and stinging fish, corals, sea lice, and jellyfish can be hazardous if touched. Larger marine animals are not likely to cause injury unless deliberately or accidentally threatened. Wounds acquired in the marine environment can be contaminated with bacteria, often contain foreign bodies, and occasionally contain venom. Learn about the hazards in the area, wear protective gloves and footwear, avoid wearing shiny watches or jewelry, and avoid contact with corals and other marine animals. If traveling during winter months, avoid ice skating or ice fishing alone, and avoid unsafe ice (e.g., ice over moving water, ice less than a uniform 4 inches thick for skating, ice clouded with bubbles, and ice around partially submerged obstacles like stumps).

Scuba Diving

Scuba diving presents a variety of unique medical challenges for the traveling diver. Because diving injuries are generally rare, few health-care providers are trained in their diagnosis and treatment. Thus, the recreational diver must be able to recognize the signs of injury and ensure the availability of dive medicine help when needed.

Fitness to Dive

Planning for dive-related travel should take into account any changes in health status, recent injuries, or surgery. In general, respiratory disorders, as well as any disorders affecting higher function and consciousness (e.g., diabetes mellitus or asthma), psychological problems (e.g., anxiety), and pregnancy raise special concerns about diving fitness.

Flying After Diving

There is an increased risk of developing decompression sickness when divers are exposed to increased altitude too soon following a dive. The cabin pressure of commercial aircraft may be the equivalent of 8,000 feet (2,438.4 meters). Thus, divers should avoid flying or an altitude exposure greater than 2,000 feet (609.6 meters) for a minimum of 12 hours after surfacing from a single no-decompression dive. After repetitive dives or multiple days of diving, a diver should wait a minimum of 18 hours before ascending to altitude, to reduce the risk of decompression sickness. These recommended preflight surface intervals do not guarantee avoidance of DCS. Longer surface intervals will further reduce DCS risk.

The Divers Alert Network (DAN) can be contacted by telephone at (919) 684-2948, ext. 222, or by accessing the website www.diversalertnetwork.org. DAN maintains a 24-hour emergency consultation and evacuation service at (919) 684-8111 or (919) 684-4326 (Collect calls are accepted.) DAN will provide assistance with management of the injured diver, help in deciding if recompression is needed, the location of the closest appropriate recompression facility, and assistance in arranging patient transport.