Summer may be winding down, but travel isn't! Getting ready for a big trip abroad can be a lot of work — especially for people with health concerns. This travel tips checklist can pave the way for a smooth journey.
Before your trip
☑ Check for travel advisories
You should be aware of health or political circumstances relevant to your destination(s). The US Department of State has a number of resources for the traveler, including postings on health and security alerts for specific countries.
☑ Check the CDC's traveler health information
There is a wealth of information here, including general advice for travelers, suggestions for travel health kits, recommendations for specific vaccinations for your selected destination, and guidance for groups such as pregnant women and children.
☑ Make a doctor's appointment
Ideally, visit your doctor about four to six weeks prior to travel. Confirm that your routine vaccinations are up to date (influenza, tetanus, hepatitis A), and check if additional vaccines are recommended for your destination (e.g., typhoid, Japanese encephalitis). It may take several weeks after receiving the shots before they offer protection.
For some areas, pills for malaria prevention are recommended. There are several options here. Talk to your doctor about which choice is best for you, based on your preferences as well as the malaria strains present at your destination. Some medications for malaria prevention need to be started one or two weeks before you leave.
Depending on where you are going, "traveler's diarrhea" can be a common ailment. The risk is greater in countries with limited access to plumbing and safe water. Traveler's diarrhea usually goes away on its own in three to seven days. Discuss with your doctor the option of bringing antibiotics to have on hand for moderate to severe diarrhea. The benefits of using antibiotics (shortening duration of bacterial illness by about a day) should be weighed against the risks (side effects, breeding resistant strains of bacteria). Keep reading below for some tips on reducing your risk for traveler's diarrhea while on your trip.
If you have chronic medical conditions, ask your doctor for copies of your latest medication and "problem" lists. If you have a heart condition, ask for a copy of your recent electrocardiogram (ECG) to bring on your trip. If you suffer from chronic lung conditions such as severe emphysema, check with your doctor if you might need supplemental oxygen while in flight, since the amount of oxygen in the pressurized passenger cabin is lower than on the ground. If you use oxygen, contact the airline in advance to make arrangements as personal oxygen tanks are not allowed on aircrafts.
☑ Contact your pharmacy for a "vacation override"
Usually, the pharmacy can work with your insurance company to allow an early medication refill if needed for your trip. Pack your medications in the pharmacy-labeled containers, and also in your carry-on in case of lost luggage.
☑ Look into traveler's insurance
If you're not sure about your health coverage, call your insurance company to confirm if medical expenses abroad are covered. For some families, it makes sense to purchase specific travel insurance in advance of the trip, especially if circumstances are such that there is a chance the trip will be canceled or interrupted, if family members have serious health conditions that might require medical evacuation if acutely ill, or if there are plans to participate in risky activities and there is limited access to appropriate healthcare at your destination.
On the plane or in the car (any time you're sitting for a long time)
☑ Prevent blood clots
Sitting for prolonged periods, such as on a long flight or car ride, increases the risk of blood clots. Take walking breaks or do exercises such as calf-raises and ankle circles as much as possible. Wear compression stockings to help prevent blood clots as well as decrease swelling in your feet.
While you are away
☑ Prevent mosquito bites
Mosquitoes (and other insects) carry many diseases, depending on the region: malaria, dengue, Zika virus, various encephalitides, etc. Some infections can be serious or treatment may not be easily available, which makes preventing mosquito bites all the more important. Wear long-sleeved shirts and pants tucked into socks, use mosquito repellents (products with 20% DEET or permethrin-treated clothing work best for adults; the EPA website can help you find the best product for your family). Avoid going outside at dusk when mosquitos are most active, and use bed nets if sleeping without adequate screens or air conditioning.
☑ Avoid uncooked food and non-purified water
If traveling to less developed areas, follow precautions with food and water. If you are not sure if this applies to your destination, check the CDC travel site for your destination and refer to the section "Eat and drink safely." Use only boiled or sealed bottled water for drinking and brushing your teeth. Ice should also be made from purified water. Choose only cooked vegetables and fruits you peel yourself, and avoid the temptation of street food. Handwash with soap before eating, and carry hand sanitizer just in case.
☑ Buckle up
Always use seatbelts and helmets, especially with foreign roads, rules, and vehicles.
When you return
☑ Finish those malaria pills
Even if you did not get sick while you were on your trip (yay!), you should complete any malaria prevention medications as prescribed. That is, continue for one to four weeks after return, depending on the medication. Symptoms of malaria usually appear within 30 days, but sometimes can take a year.
There is a lot to think about before an international trip, but the extra work of planning in advance is well worth it to help ensure that you get to enjoy the scenery and experience, and to avoid last-minute chaos and any unfortunate illnesses.