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Start with up-to-date vaccinations–for chicken pox, MMR, tetanus, and hepatitis A, B, and C–then tear out this cheat sheet to preventing six common adventure-travel risks.
mosquito 445x260Mosquito (iStockphoto.com)




  Disease Description Risk Treatment Prevention
Mosquitoes Malaria A parasitic disease involving fevers and flu like symptoms including chills and head/muscle aches. Incubation period: one week to one month. Common across tropical latitudes, the highest relative risk for infection is in west Africa, but India and Central America are also hotbeds. Check for country-specific warn-ings at cdc.gov/malaria. If you have visited a malaria-
endemic country and develop a fever, seek medical help ASAP. Early treatment is most effective and reduces the risk of complications. Treatment varies based on parasite species.
> Avoid traveling to areas with active epidemics (check cdc.gov/travel).
> For malaria prevention, take prophylaxis before, during, and after travel.
> Be aware of mosquito-biting activity in the area and modify your behavior to avoid exposure. Dengue -transmitting mosquitoes are most active during the day; malaria-transmitters, during twilight.
> Cover exposed skin and use a permethrin repellent on clothing and gear.
> Use insect repellent (apply after sunscreen).
Dengue Fever (and Dengue Hemorrhagic Fever) An acute fever-causing virus (1% develops into hemorrhagic fever) accompanied by symptoms like head/muscle aches, joint pain, nausea, and flushed skin. Three to 8% of travelers returning from dengue-endemic areas, especially South America, the Caribbean, and South Asia will become infected. Unlike malaria, dengue is common in urban areas. There is no treatment, but most cases resolve within a month. Rest, stay hydrated, and control fever and pain with doctor-prescribed meds. Avoid drugs with anticoagulant properties, and be alert for signs of internal bleeding.
Water/Food Amebiasis This intestinal disease is caused by a protozoan parasite. Symptoms (cramps, watery or bloody diarrhea, and weight loss) develop one to four weeks after exposure. About 14 of every 1,000 U.S. travelers return—mostly from South Asia, South America, and the Middle East—with this parasite. As many as 40% of travelers are incapacitated for two to three days by diarrhea. Eighty to 90% of infections resolve without treatment. Seek medical care and an antibiotic prescription for symptomatic infections lasting longer than six weeks; complications like liver abscesses and bowel perforations can be fatal. > Avoid raw foods.
> Frequently wash hands or use an alcohol sanitizer.
> Drink (and brush teeth with) only purified or bottled water. Avoid ice.
> Stay out of water that may be contaminated with human or animal feces.
Giardiasis This diarrhea-inducing illness has a one- to two-week incubation. It’s characterized by foul-smelling and/or greasy stools (two to five per day), cramps, bloating, flatulence, fatigue, and nausea. More common among long-term travelers. Approximately 31 of every 1,000 returning U.S. travelers get this parasite. It mostly affects travelers in South Asia, the Middle East, and South America. Most infections self-resolve within two to six weeks. Treatment with antimicrobial drugs including tinidazole and metronidazole may cure as many as 80% of infections, shorten the presence of symptoms, and reduce symptom severity.
Environmental Motion Sickness Dangerous? No, but this movement-induced imbalance between the inner ear and eyes—and the fatigue, dizziness, and nausea that follow—can sure ruin a trip. Motion sickness can happen anywhere, but many travelers may experience symptoms for the first time in developing countries, where driving is more chaotic, or on long
boat transits.
The symptoms often stop when movement does, but may improve or disappear as a traveler builds a tolerance to the motion, or with medications like antihistamines or Dramamine, or exposure to fresh air. > Optimize your position (sit in the front seat of a car or bus, and the center of airplanes and boats). > Reduce sensory input (close your eyes, or look
at the horizon).
> Use mint aromatherapy, eat ginger or ginger candy.
Venous Thrombo-embolism
(DVT – Deep Vein Thrombosis and PE – Pulmonary Embolism)
Related conditions in which blood clots block veins. Many leg DVTs don’t show early warning symptoms and become dangerous PEs, which resemble a heart attack or stroke. Traveling triples the risk of developing DVT or PE, and traveling longer than four hours further doubles it, especially in people over age 40 or who are obese. For a complete list of risk factors see cdc.gov/travel. DVT symptoms include redness, swelling, pain, and warmth of the skin. PE symptoms may be acute or mild, but often include shortness of breath, chest pain, or dizziness. PEs are urgent and life threatening. All clots need doctor care and may require meds. > A prophylactic dose of heparin may reduce risk.
> Avoid constrictive clothing, but consider wearing compression stockings to increase leg circulation (opposite).
> Hydrate.
> Do circulation-boosting exercises.


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