Maintaining your health on the road

With the deep freeze well underway, traveling abroad is a sure fire way to escape the hardships of winter, if only briefly.

Your trip, however, is only going to be as good as you feel, so take some advice from a medical professional who knows how to make your travel experience a healthy one.

According to Dr. Kianoush Dehghani, Public Health and Preventive Medicine Specialist Physician from the Cree Board of Health and Social Services of James Bay (CBHSSJB), healthy travel begins with careful planning, sometimes months in advance.

Her advice is that if you are traveling abroad, particularly to developing countries in Latin America, Africa and Asia, start your planning at least two months in advance.

“Depending on the destination, it is important to see your family doctor at least 4-6 weeks before you leave to discuss the management of your known health problems away from home, and to get a prescription for your usual medications for the travel period. Your family doctor should also make sure that your basic vaccinations are up-to-date,” said Dehghani.

As required vaccinations can vary from location to location and individual to individual, depending on your health needs, this is an important conversation to have with your doctor.

According to Dehghani, the most common travel-related health problems are infectious diseases and accident-related injuries. While you might not be able to avoid getting into a car accident or cutting your foot on the coral, certain kinds of infectious diseases, like Hepatitis A, can be prevented with a vaccination. Other issues can also be averted by simple healthy behaviour.

“For example, traveler’s diarrhea is a common infection in most tropical destinations outside North America. This can be prevented by regular hand-washing (with soap and water, or a liquid hand sanitizer) and by avoiding street food, and instead eating well-cooked meals in well-established places, like hotel restaurants,” said Dehghani.

As it is sometimes easy to throw caution to the wind on holiday, Dehghani said that being abroad is actually where it is most important to practice healthy behaviour, as the risks can be high. For example, motor-vehicle accidents and drowning are the most common causes of death among North American travelers, so being cautious in the water or on the road is never more important than while away. She added that often avoiding injuries is all about common sense and avoiding drunk driving, speeding or walking alone at dark in more deserted areas. 

Dehghani also said that healthy sexual behaviour is important during international travel.

“Many individuals are infected with more serious sexually transmitted infections (STIs), like gonorrhea, syphilis or HIV, during their travels. It is very important to avoid anonymous sexual encounters, like Internet dates, and commercial sex workers at all times, but especially when travelling. If you choose to have consensual sex, it is important to use condoms at all times and bring some from Canada,” said Dehghani.

People taking medication for ailments such as diabetes should see a doctor at least six weeks before leaving, especially if they are travelling to another time zone. How much medication to bring is another issue that needs to be discussed with a physician as is procuring a letter from the doctor explaining the medical condition and the need to carry medications as well as needles and syringes in the airplane (for example, for an insulin injection). Safe storage of that medication needs to be discussed with a doctor or pharmacist as some medications can lose effectiveness in hot weather. Those with diabetes should check the Canadian Diabetes Association’s website for travel advice: www.diabetes.ca/diabetes-and-you/healthy-living-resources/general-tips/travel-tips-for-people-with-diabetes

For those planning a getaway with the very young or the very old, Dehghani recommended first and foremost to choose a travel destination that is family friendly meaning that it has access to clean water and is practical for everyone in the family.

Just like at home, she said that breastfeeding is the safest food and drink for infants while abroad and that this is a great tip to remember.

As for everyone beyond that stage of life, Dehghani said that when travelling in tropical countries it is important to eat well-cooked meals from an established hotel or resort restaurant, and drink boiled or bottled water.

“Infants, small children and the elderly are more prone to health problems such as infection diseases. So if they develop signs and symptoms of infections, it is important to contact a designated medical professional as soon as possible as their medical condition can deteriorate rapidly. You may want to ask your family doctor for oral rehydration salts for your infants, toddlers or the elderly prior to your departure. Infants, small children and the elderly can become dehydrated quickly with diarrhea, so it is important to keep them hydrated and contact a health professional as soon as possible when they develop symptoms,” said Dehghani.

She recommended that if your trip is to somewhere tropical, like the Dominican Republic, during the winter that it is necessary to pack along with your usual medications, some preventative ones. This would include things like alcohol-based hand sanitizers, sunscreen (with SPF of at least 15), sunglasses, insect-repellent spray, comfortable and cool clothing, boxes of condoms (just in case), your prescription glasses and other medical devices like a walker that you would usually use.

As for vaccinations, in addition to basic ones, like measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis, polio, varicella (chicken pox) and your annual flu shot, there are other vaccines that could be helpful, if not necessary depending on where you are going. She suggested a hepatitis A vaccination for those who are traveling to tropical countries. But if your trip is to South America, Africa or Asia, a visit to a designated travel clinic at least six weeks prior to travelling would be necessary as this is not a service offered on Cree territory.

As this is a specialized field of medicine, a travel clinic is the best way to ensure that someone going abroad would have the appropriate vaccines and/or preventive medications for that specific region. They would also be able to provide tips for that region, such as appropriate clothing, insect repellants and bed nets to prevent malaria in areas where this is needed.

Dehghani’s recommendation was to inquire with McGill’s Tropical Medicine Clinic at the Montreal General Hospital (www.medicine.mcgill.ca/tropmed/txt/pretravel.htm). 

Happy trails!