Time to travel, but do it safely

By DR. DAVID J. HOLCOMBE | Medical Director, LDH Region 6

With summer well behind us and school in session, it is a great time to travel. Seniors, with time and disposable income, can devote more of their life to exploring the U.S. and abroad. In fact, world travel for all ages has exploded in the last few decades, with more people traveling to more and more exotic locations, often remote and underdeveloped.

Travelers need to consider many precautions, however, prior to any long-distance, prolonged voyage in order to have a safe experience.

Precautions start in the airplane. Reduced cabin pressure, prolonged inactivity and close quarters predispose travelers to reduced oxygen, deep venous thromboses and increases in airborne or contact transmitted infections.

Once on site, exotic foods, wild animals and insect-borne illnesses all pose threats to travelers. Avoiding unfiltered water and raw or undercooked foods, especially from street vendors, can go a long way toward preventing food- and water-borne diseases. Never touch or approach any dogs, cats, or other domestic or wild animals, since rabies is common around the world.

Safe driving, safe sex and mosquito avoidance can prevent a whole host of serious health issues.

High altitude carries its own danger of altitude-related sickness, a significant risk for older travelers and those with chronic heart or lung diseases. Careful acclimatization or the use of medications such as Diamox may be required.

Remember to use caution when climbing the steps of that wonderful, ancient pyramid or magnificent cathedral.

Vaccinations

Vaccinations largely depend on the location of travel. All travelers need to consult www.cde.gov/travel for site-specific vaccination recommendations.

• Yellow fever vaccination is required for multiple areas of Africa and South America. Unfortunately, stocks of the vaccine are severely limited worldwide and there is only a single site in Louisiana — in Metairie — with consistent availability.
• Hepatitis A and B vaccines should be up to date since both diseases remain widespread in developing countries. Because both vaccines are administered in a series that takes from four to six months to complete, do not wait until the last minute. That being said, it is better to be partially vaccinated than not vaccinated at all.
• Meningitis vaccine remains necessary for most of Sub-Saharan Africa, especially in the dry winter season from December through June.
• Typhoid vaccine, as either an injection or four capsules taken over seven days, offers protection, especially for travelers in Southeast Asia.
• Japanese encephalitis vaccine is also recommended in some parts of Asia, especially rural areas.
• Cholera, transmitted by contaminated food and water, remains a danger and travelers to countries where it occurs should be vaccinated with a single oral dose of the vaccine.
• Influenza (flu) varies depending on the season, which differs in the Northern (winter) and Southern (summer) hemispheres. Annual vaccination against the flu protects in either hemisphere although variations occur in the organism due to genetic shifts in the virus.
• Measles, mumps and rubella remain worldwide threats and that particular vaccine (MMR) should be administered to those born from 1957 to 1989. Measles is highly contagious and rates are much higher outside the U.S., even in Europe.
• Poliomyelitis and TdaP (tetanus, diphtheria and pertussis or whooping cough) vaccines should be up to date prior to any travel.

Pregnant women and those with complex medical conditions should always consult a physician prior to travel. Both MMR and varicella are live vaccines and should not be given to pregnant women.

Medications and insurance

Everyone should carry enough medication for the entire trip as well as a complete list of his or her medications (with commercial and generic nomenclature) and the doses.

For older travelers, remember that Medicare does not work overseas. Some private insurances do cover clients out of the U.S. but this coverage varies significantly. Supplemental health insurance for travelers is available for a price, often hefty in senior citizens.

Travel should be a mind-expanding experience and not one ending in costly medical problems or death. See the world, have fun, but be sure to take all the necessary precautions for safe travel. Prevention is always the best medicine at any age and anywhere in the world.