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How to travel healthy

Consult a travel doctor for preventive medicine

By Marnie Hunter
CNN

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(CNN) -- Getting organized for a trip overseas can be a stressful experience. There are passports, visas and tickets to arrange, accommodations to book, prescriptions to fill and pet sitters to hire -- and, if you're headed to a developing country, doctors to see.

You may have come across a daunting list of diseases your destination has to offer while reading up for your trip. Don't panic. A growing number of doctors specializing in travel medicine can help tailor preventive measures specifically suited to you.

"What the travel medicine doctor does essentially is go through who you are, what your health history is, what medications you're on, what vaccines you might have received previously, where you're traveling specifically -- where in the country, what time of year, the season -- and tailors a plan ... to help keep your trip healthy and safe," said Dr. Bradley Connor, president of the International Society of Travel Medicine.

Guidebooks can be misleading when it comes to health information, Connor said. Information gathered well in advance of publication and sometimes carried over from edition to edition may be incomplete, inaccurate and sometimes downright wrong, he said.

Connor, who is also the director for the New York Center for Travel and Tropical Medicine, recommends the Internet as a good first resource. The Centers for Disease Control and Prevention's Web siteexternal link provides broad destination overviews and directories for travel medicine providers, which will help travelers assess health care options.

But Web sites don't take into account the variables unique to each traveler.

"If you're a VIP executive from some company and staying in a five-star hotel in Bangkok and just going to meetings there or at your company office there, then your risk is very, very different from a student backpacker in college," said Dr. Phyllis Kozarsky, the CDC's chief of travelers' health.

The itinerary -- urban versus rural locations, camping versus first-class accommodations -- and the length of a traveler's stay in the region, as well as the underlying medical history, determine the need for preventive measures.

A consultation at Emory Healthcare's travel clinic in Atlanta, Georgia, where Kozarsky sees patients, involves a series of questions to pinpoint the exact nature of the trip, followed by advice to the traveler on a range of issues, from food and water safety and the use of sunscreen and insect repellents to the risks of sexually transmitted diseases.

The clinic administers vaccinations and prescribes anti-malarial drugs and antibiotics as warranted.

Personalized consultations cut down on unnecessary treatments administered because of generalized information about a destination's risks.

"[Some health care providers] say, 'Oh my gosh, exotic place, developing world, we'll give them everything,' when they don't really need it," Kozarsky said.

Cost and timing

Insurance coverage of travel clinic visits varies. Some companies offer coverage, others will cover certain vaccinations and consultations if a patient is referred by their primary care physician. Some plans won't cover it at all.

"Insurance companies don't look at preventive medicine sometimes the way they look at treatment, and travel medicine is preventive medicine," Connor said.

Connor estimated a typical visit with vaccinations runs between $150 and $200. The cost can go up to several hundred dollars for a particularly long or exotic trip.

"Sometimes it's penny wise, pound foolish," he said. "To contract hepatitis A and be out of work for a month and a half when you come back, the economic consequences of that to the individual are a lot greater than paying the $75 or $80 for the hepatitis A vaccine."

The CDC's Web site urges all travelers to take simple precautions to avoid traveler's diarrhea, a common ailment on the road. Drink boiled or bottled water from sources you trust and avoid tap water, ice cubes and fountain drinks.

Eat only food that is fully cooked and fruits and vegetables that have been washed and peeled. The CDC's Web site offers the caution, "Boil it, cook it, peel it or forget it."

Washing your hands thoroughly and frequently and using insect repellent containing the chemical DEET are also top CDC travel tips.

Kozarsky and Connor advise travelers headed to developing countries to start thinking about health issues four to six weeks prior to travel.

While planning ahead is ideal, most vaccinations received any time before a trip can be helpful. For example, the optimal time to receive a hepatitis A vaccination is two weeks before exposure, but getting it late in the game is OK, too, Connor said.

"We know that even if you got the vaccine on the way to the airport it would provide protection because the incubation period for the virus is two weeks," he said.

Don't let health preparations scare you away from traveling.

"Our aim really is to educate people so that if you go and you remain healthy, you'll want to go again," Kozarsky said.


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