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The World's Worst Travel Diseases
What it is: A potentially fatal disease caused by a parasite, usually transmitted by a bite from an infected mosquito. Chills and headaches are just two of its milder symptoms.
How to avoid it: Ask your doctor to prescribe the appropriate prophylaxis before traveling—usually mefloquine or chloroquine, depending where you’re going. And take measures to prevent mosquito bites, like wearing long sleeves and pants and protecting your skin with a repellent containing DEET.
It seemed like a good idea at the time. After an inspiring day at Angkor Wat in Cambodia, I returned to my guesthouse to find locals sharing stories—and homemade rice wine. My instinct told me to stick with bottled beer, but their insistence wore me down. The wine tasted good and complemented their tales of Siem Reap. Feeling in tune with local life, I went to bed happy.
Later in my trip, however, happiness turned to violent illness (I’ll spare you the details). I had contracted giardia, an intestinal parasite—probably from the wine. It took three rounds of antibiotics to get rid of it.
My situation was hardly unique. “In our efforts to have fun while traveling, we often leave our common sense at home,” says Shelly Diaz, traveler’s health spokesperson for the Centers for Disease Control (whose Yellow Book contains an updated list of risks and recommended vaccinations). But finding that balance between experience and safety isn’t always easy. Wrap yourself in a bubble and you can miss out on unforgettable events. Take risks and you can end up with unwelcome surprises like giardia—or worse.
Those surprises don’t always take the form of some exotic disease (sunburns and twisted ankles are common, too). But with a growing number of Americans looking for off-the-beaten-path experiences, the risk of a less pedestrian problem multiplies.
“Travelers are increasingly heading to areas where water isn’t always clean, or where mosquitoes can carry deadly diseases,” says Dr. Phyllis Kozarsky, professor of medicine at Emory University and an expert consultant for the CDC. “And in areas with political destabilization, mosquito control isn’t very high on a government’s to-do list.”
Such areas are definitely on the CDC’s radar, along with places where contaminated food and water can present problems for travelers. The agency is monitoring the growing problem of diseases like malaria, the increasing number of cases involving chikungunya fever, and what Kozarsky calls the “sweeping rise” in dengue fever.
And it’s not just off-the-beaten-path travelers that can be at risk. “West Nile taught us that mosquito-borne viruses can spread, even in our own country,” says Kozarsky. Of course, Americans also face the danger of Lyme disease here at home. And any cruising aficionado has heard about norovirus spreading on ships.
Nevertheless, there are specific actions travelers can take to protect themselves. Here’s what Kozarsky recommends:
- Get the proper vaccinations. Ask your doctor about what protection you’ll need for whatever part of the world you’re traveling to (like yellow fever, for example, for Sub-Saharan Africa and tropical South America. It’s also essential that your basic vaccinations—like diphtheria, tetanus, measles/mumps/rubella, and hepatitis A and B—are up-to-date.
- Bring a traveler’s health kit. Don’t count on being able to find the proper medicine in the region where you’re traveling; counterfeit medication is often rampant. Instead, bring your own pain medication, along with Imodium and an antibiotic for intestinal problems. Of course, if you’re heading to an area affected by malaria, ask your doctor to prescribe the proper prophylaxis.
- Watch what you eat and drink. Let common sense guide you. Drink bottled water or boil it, and make sure fresh vegetables are hot and steaming. (See the CDC’s recommendations on safe food and water.)
Sometimes, even following all these steps won’t be enough. But, says Kozarsky, you shouldn’t let fear stop you from exploring. “We travel because we want to enjoy certain experiences,” she says. “Just remember to take steps to protect yourself.”