In Travel, A Little Prevention Goes A Long Way

After more than 20 years of globe-trotting, I recently had my first consultation with a travel medicine specialist.

I don’t know what took me so long. Hubris, I suppose — the fantasy that my own common sense and good luck would spare me the maladies that afflict so many fellow travelers. I’ve spent my share of time in overseas emergency rooms, but overall I have indeed been lucky.

With a child in tow, however, it’s time to become more responsible. That thought hit me one day when I took my daughter Zelda for a hepatitis A shot — and the doctor inquired as to whether I, bound for a family vacation in the Balkans, had been similarly inoculated.

I had not. The next day, I was at a Minute Clinic, lining up for the hep A shot recommended by the Centers for Disease Control for travelers to Eastern Europe.

As the experts made clear, a little prevention — certain key vaccines, a well-stocked prophylactic medicine kit and a good travel health policy — goes a long way toward ensuring your vacation won’t be deep-sixed by, for example, a weeklong bout of traveler’s diarrhea.

So just in time for the summer travel season, I thought I’d share what I learned.

It’s a good idea to visit a travel medicine clinic if you’re planning a trip outside the United States, particularly if you might visit developing countries or remote areas where healthcare may not be up to U.S. standards. Travel medicine practices are found at hospitals, stand-alone clinics and urgent care centers.

An hour-long consultation will run you about $100 and is not generally covered by insurance. Any recommended vaccines run extra, including my $140 hepatitis shot (Zelda’s was covered by insurance, since it’s now part of the regular childhood vaccination schedule.

I calculated the cost of losing up to six months of my life to fever, fatigue, jaundice and abdominal pain – not to mention ruining a four-figure vacation — and decided $140 was a good lifetime investment. Many of the vaccines recommended for other popular destinations — a polio booster for Israel, yellow fever for the Andes — prevent far more serious, life-threatening diseases.

Ideally, you visit a clinic six to eight weeks before your adventure, leaving ample time to let vaccines become effective and to fill prescriptions. But even a last-minute appointment can yield valuable prophylaxis; Zelda and I had our shots the day before we left, and they are good for life. (If you're wondering about the safety of getting a bunch of serious-sounding vaccines all at once, I already asked; the answer is yes.)

A travel medicine expert not only advises you on what shots you might need for a given itinerary (information you can also find on wwwnc.cdc.gov/travel, the CDC’s country-specific travel health site). You also get prophylactic prescriptions, such as antibiotics for traveler’s diarrhea or an anti-malaria regimen; a heads-up on the specific health risks in the region you are visiting, from rabid dogs and altitude sickness to mosquito-borne diseases; and information on reliable healthcare facilities in your target region.

This last bit of advice is critical, because most U.S. insurance plans do not cover overseas care. Many foreign hospitals refuse to even evaluate uninsured patients without a substantial upfront payment. But a travel insurance policy is cheap: $5-15 a day buys you comprehensive coverage that includes emergency evacuation if necessary, along with a verified list of local providers that meet Western standards.

If your vacation takes place closer to home, there are still health risks to consider — chief among them the myriad ailments spread by mosquitoes and ticks.

Let’s start with mosquitoes. The same species is responsible for carrying the Dengue and Chikungunya viruses, tropical diseases that have recently expanded throughout the Caribbean and Florida and which can make you very sick. Reliable protection comes from insect repellent containing DEET.

DEET is also your best ally against ticks, whose numbers have exploded in recent years, along with the diseases they transmit: Lyme, tularemia and Rocky Mountain Spotted Fever.

Finally, eliminate standing water that breeds mosquitoes; kiddie pools are a frequently overlooked culprit. And speaking of pools, drownings are a top cause of death for children under five — so whether in your backyard pool or at a beach in Thailand, keep kids within arm’s reach until they are sound swimmers.

Then slather on your sunscreen, throw on a hat — and enjoy summer.

editor@jewishweek.org