Remember Self-Care during Travel

Nowadays, the travel destination of high-end Chinese elites has almost stretched to most hot tourist spots on the globe, even occasionally including the Polar Regions in which some adventure seekers have set foot. Aside from the delight of seeing fellow countrymen exploring exotic places, as a physician with a keen interest in travel medicine, I couldn’t help getting a little concerned about whether the enthusiastic tourists have made adequate preparations for self-protection in foreign environments.

I am happy to use this opportunity to share with everyone some commonsense about health care in global tour, hoping it would be somewhat beneficial to your preparation for the next travel.

Health risks in alien countries can generally and simply fall into two major categories: Infectious and noninfectious diseases.

There are a wide variety of sources of infectious diseases: food-borne illnesses (hepatitis A, food poisoning, gastroenteritis, etc.); insect-borne illnesses (malaria, dengue, Chikungunya, Japanese encephalitis, Lyme disease, Leptospira, schistosomiasis, etc.); air-borne illness (influenza, SARS, epidemic meningitis, etc.); animal-bite illness (rabies, for example) and illnesses transmitted by contact with body fluid (hepatitis B, C and HIV).
Noninfectious diseases, such as altitude sickness, decompressionsickness, sunburn and sunstroke, frostbite, etc. mostly result from environmental factors.

Possible precautions that can be taken against potential infectious diseases include:
1.Vaccination
2.Medication
If neither of the above options is available, then what you can do is obtain commonknowledge, and to avoid risky behaviors as much as possible to minimize the risks.

First, let’s start with vaccination.
From the perspective of travel medicine, we classify vaccines into routine vaccines and region-specific ones.
Conventional vaccines include those inoculated for citizens as specified within the national immunization program. In China at present, these vaccines encompass smallpox，hepatitis B, Japanese encephalitis，BCG, poliomyelitis, DTP, MMR, and meningococcalmeningitis,. One thing to note is that the list of vaccines, such as hepatitis B and hepatitis A. Thelist was gradually expanded over the historical course. It follows that the condition of vaccination may vary depending on the year you were born in. You are advised to refer to the records of past vaccinations or enquire of your local epidemic prevention station or center for disease control and prevention.

Region-specific vaccines are those that must be injected before entry, as regulated by the government of the travel destination, in order to prevent the locally endemic infectious diseases. Examples include the yellow fever vaccine specified in many African and South American countries as well as the vaccine of epidemic meningitis required for a pilgrimage to Mecca.

Among the internationally available vaccines at present, those that prevent food-borne illness include hepatitis A, typhoid fever, and cholera. Vaccines that prevent insect-borne illness include the Japanese encephalitis and yellow fever.

Next, let’s discuss some global travel related diseases that could be prevented by medication.
Malaria is prevalent in sub-Saharan Africa, South Asia (India and Bangladesh), Southeast Asia (Laos, Cambodia and Indonesia), Latin America (Brazil for example) and Papua New Guinea. International tourists from regions free from malaria are most susceptible to the disease due to lack of immunity.

Multiple medicines are available for therapy and prevention. Expertise is required for correct choice of drugs, because this involves the type of plasmodium and the local drug-resistance pattern, as well as with the tourist’s personal condition (e.g whether the tourist is pregnant, whether the tourist is subject to any adverse drug reaction, and the exact nature of his/her itinerary). Tourists are advised to consult medical experts in this area as early as possible when planning for the itinerary.

Finally, let’s talk aboutwhat commonsense is needed for self-protection in global travel.
The prevention of food-borne (or water-borne) illnessesis essentialin preventing diseases suchas dysentery, viral enteritis, cholera, typhoid and paratyphoid fevers, hepatitis A, and parasitic diseases.
What are counted as safe food and drink?Fully cooked food; boiled water; unopened bottled water or canned carbonated beverages; washed and peeled (by yourself) fruits; and pasteurized milk.
What are unsafe food and drink?Uncooked food, half-cooked food, and suspicious food; ice cubes that you are unsure if it’s made of clean water; street vendor foods; unwashed and unpeeled fruit; dairy products that’s you have no way to judge if it’s properly pasteurized.
A small advice: Do not assume food safety is a sure thing just because you are staying in a five-star hotel or on aboard a luxury cruise ship.I have been told a real-life story of a CEO, with whom I have since been acquainted, who ordered a glass of iced coke while having a meal at a  five-star hotel, in the capital of a South Asian country (the country name is omitted). The waiter brought a glass of coke with ice cubes floating on it. The gentleman, being a seasoned traveler,  was suspicious if the ice cubes were made of purified water, so he politelyasked the waiter for a coke without ice. Then the waiter brought a glass of icy coke without ice cubes back from the kitchen in roughly two minutes. He suspected the waiter might have simply scooped the ice cubes from that original glass of coke, but was too polite to ask again. As a consequence he suffered watery diarrhea a dozen times every day during the subsequent week and was diagnosed with cholera. Eventually, thanks to his premium medical insurance, he was airlifted to Australia for intensive treatment by anair ambulance. He finally recovered after weeks of medical treatment.

Due to space constraint, I only touched on the basics oftravel health and will be glad to answer readers’ questions if any. Wish everyone a pleasant and safe journey next time.