Nearly half of all visitors to developing countries will get sick during a two-week trip, according to Dr. Phyllis Kozarsky, a travel-health consultant for the Centers for Disease Control and Prevention (CDC). But health problems aren't limited to the these regions, of course; viruses don't recognize borders, and accidents can and do happen anywhere.
"American travelers tend to think of the world as a giant amusement park—that they can have a wonderful experience with little risk," says Dr. Edward T. Ryan, director of the Travelers' Advice and Immunization Center at Boston's Massachusetts General Hospital. " The reality is that the world is a risky place. A well-informed traveler is most likely to come back healthy." Taking these 10 precautions should be as much a part of your trip preparation as buying a plane ticket or booking a hotel.
BEFORE YOU GO
1 Do your homework. Know the health risks of your destination and what immunizations are required by checking the country's Consular Information Sheet on the State Department Web site (www.travel.state.gov). Some countries, such as Uganda, require proof of yellow fever vaccination prior to entry. The CDC site also offers a travelers' health section (www.cdc.gov/travel) and the International Society of Travel Medicine site (www.istm.org) has a link to Outbreak News, a rogues' gallery of "hot zone" diseases compiled by the CDC and the World Health Organization. The list should compel any reader to make a doctor's appointment, ideally at least one month before heading overseas, to ensure routine immunizations are current and to begin specific vaccines or prophylactic drugs, such as antimalarials, if required.
2 Consider a travel-medicine consultation if you're heading to a high-risk area. Although a personal physician can advise on destinations such as Europe, Dr. Jay Keystone, a Toronto-based travel- and tropical-medicine specialist, recommends visiting a travel-health clinic for anything more complex. You can find a comprehensive list of travel clinics on both the CDC and ISTM Web sites. "Family physicians don't have the time to keep up with the risks and outbreaks, disease and drug-resistance patterns, or the newer vaccinations and drugs," says Keystone, who is also the former president of the ISTM.
3 Check your current health insurance policy. It's crucial to have medical insurance that's valid overseas, says Dr. Joan Pfinsgraff, director of health intelligence for iJET, an Annapolis, Maryland, international risk-assessment firm. Since many health care plans don't cover emergency medical evacuation or even basic medical attention overseas, you should consider buying a travel-health insurance policy. The State Department Web site lists companies such as Travelex Insurance Services (www.travelex-insurance.com; 800/228-9792) and Travel Guard International (www.travelguard.com; 800/826-4919) that provide supplemental insurance.
4 Consider purchasing evacuation insurance. Many air-ambulance companies do not repatriate patients to hospitals in their home countries but instead transport them to the nearest acceptable medical facility. However, travel-insurance providers MedjetAssist (www.medjetassist.com) and Global Rescue (www.globalrescue.com) will fly patients to the U.S. hospital of their choice; individual and family policies are available for trips lasting from seven days to one year.
5 Pack a small medical kit. The CDC has a helpful checklist: items such as tweezers, a digital thermometer, antidiarrheal medications, and hydrocortisone cream. Depending on your destination or allergies, you may want to include insect repellent, antimalarial medications, water-purification tablets, prescription pills for skin or parasite infections, and an epinephrine auto-injector. Medex Assistance sells several kits on its site (www.medexassist.com; from $18). Also: bring extra prescription drugs, and carry them in clearly labeled, original containers. It may be hard to find your medications while abroad.
6 Carry your medical history with you at all times. Travelers who suffer from a chronic or preexisting condition should bring a copy of their medical history (which can be stored on a wallet-sized disk or USB drive). Med-InfoChip (877/872-3475; www.medinfochip.com; from $70) sells USB drives that contain prepared forms for information on allergies and medications, medical history, and doctor contacts.
ONCE YOU'RE THERE
7 Don't drink the water. It may seem obvious but it bears repeating: In undeveloped countries, stick with bottled water in sealed containers, even for brushing your teeth, Pfinsgraff advises. (Refilling discarded bottles with tap water is a thriving business in many poor countries, so be sure that the bottles you buy are sealed.) Also, resist the urge to buy food from street vendors and avoid fruit that's already been peeled, salad, and leafy green vegetables. Wash your hands frequently with soap and water or use an antibacterial hand sanitizer.