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Staying Healthy on the Road

Before You Go

Healthy travel begins long before your departure date. A few simple things addressed during the planning stages can prevent a health issue from impacting your trip of a lifetime.
  • Shape up. If your upcoming trip will include several walking tours and your normal routine consists of the house-to-car and car-to-office routes, it's time to begin a moderate exercise program. (Discuss this with your doctor in your pre-trip visit mentioned below.) Start several weeks before travel, gradually increasing the intensity as the day of departure approaches, and continue exercising while traveling.
  • Research your destination to find out what vaccinations are required and which are recommended. Be sure to consider whether you'll be traveling through another country or directly from the United States. While some vaccinations may not be required on flights directly from North America; they may be mandatory if arriving from some third country.
  • Schedule a physical with your doctor a few weeks prior to your departure. Be sure you let him or her know your reason for the checkup and your destinations. If traveling to an exotic locale, consider contacting a travel medicine clinic. You can find a listing of travel medicine specialists at Travel Health Online (www.tripprep.com). Be sure to allow enough time for any immunizations to take effect.
  • While you are at it, set up an appointment with your dentist. You don't want some dental problem to take a bite out of your vacation.
  • Decide whether you need travel insurance. Travel insurance can compensate you if a last-minute illness or family emergency causes you to cancel your trip or assist if something should occur en route.
  • Pack a first-aid kit. You can build your own or buy a pre-made kit. If buying pre-made, you may wish to supplement it with any over-the-counter medicines you normally use such as antacids, pain relievers, laxatives, etc. The longer your trip and the more off-the-beaten path, the more deluxe your first-aid kit should be.
  • Refill your prescriptions a couple of weeks prior to departure. The day before you leave is no time to realize you're down to your last few pills and have to scramble for a refill. Be sure to pack all medicines in your carry-on bag in their original containers.


Contaminated Food & Water

According to the Centers for Disease Control, contaminated food and drink are the most common sources of infection for travelers. The common infections are e-coli, shigellosis or bacillary dysentery, giardiasis, cryptosporidiosis, Norwalk-like viruses, and Hepatitis A. Other less common maladies include typhoid fever, salmonella, cholera, rotavirus infections, and a variety of protozoan and helminthic.

Tips to Avoid Contaminated Drinking Water

  • Don't drink beverages with ice.
  • Do drink beverages such as tea and coffee, made with boiled water.
  • Drink canned or bottled carbonated beverages, including carbonated bottled water and soft drinks.
  • Drink beer and wine. (When was the last time someone told you to drink more of this to stay healthy?)
  • Drink reliable brands of bottled water such as Evian. However, be wary of street vendors that may simply be reselling infected water in recycled water bottles. Check the seals!
  • Don't rinse your toothbrush under tap water. Throw away your toothbrush and get a new one if you forget!
  • If reliable sources of bottled drinking water are not available, bring along your own means of water purification. See our related article, Water Purification Overseas.
  • Be aware that glasses washed in contaminated water may be contaminated themselves. Drink directly from the bottle or can after a quick cleaning with an anti-bacterial wipe.

Tips to Avoid Contaminated Food

  • Don't eat food purchased from street vendors.
  • Avoid salads and uncooked vegetables.
  • Don't eat dairy products unless you know they have been pasteurized. This includes unpasteurized cheeses.
  • Eat only food that has been cooked and is still hot.
  • Be wary of seafood, especially shellfish.
  • Avoid foods that have been stored for long periods at room temperature such as pre-made sandwiches.
  • Remember the adage "If you can't boil it, cook it or peel it - don't eat it!"

Insect-Borne Diseases

Mosquitoes, ticks and biting flies transmit many diseases. These diseases can range from mild flu-like symptoms that subside in a week or two, to serious, often lifelong recurring, and debilitating illnesses. Insect-borne diseases include malaria, dengue fever, yellow fever, viral encephalitis, and filariasis. These are certainly more common in the less developed world, but you don't have to fly off to the Amazon to encounter disease-carrying insects. As evidenced by the growth of West Nile Virus in North America, all travelers, regardless of their destination, should take precautions.

Tips To Minimize Infection from Insect-Borne Diseases

  • Research your destination to find out the prevalence of diseases, and begin any required immunizations 4-6 weeks before your trip to allow time for shots to take effect. For more information, see our related article, Why Travel Medicine
  • Use insect repellent containing DEET on all exposed skin.
  • Wear long-sleeved shirts, long pants and hats to avoid exposed skin when traveling in risky areas.
  • After returning indoors, wash treated skin with soap and water.
  • Window screens are less common outside the USA, so bring along a bed net to use at night.
  • Treat clothing, bedding and other materials with Permethrin.
  • Use a mosquito head net in heavily infested areas.
  • Stay inside during dusk and dawn.
  • Tuck pants into socks, shirts into pants, cinch collars and cuffs tight and wear shoes or boots in place of sandals.
  • In high risk areas or for extended outdoor activities, wear insect repellent clothing. This special clothing has a highly effective insect repellent tightly bonded to the fabric.


Sun Safety

By now, most of us know the long-term dangers of overdoing sun exposure; melanomas and other cancers are a direct result of sun exposure. News programs and health magazines have been warning us to cover up and use sun block for years now. Unfortunately, many vacations are still spoiled by the short-term danger of a nasty sunburn the first day out. So, to avoid ruining your vacation (and to protect your long-term health), it won't hurt to reinforce some key points. For a more detailed discussion on safety, see our related article, Sun Safety for Everyone.

Sun Safety Tips

  • Use sunscreen with an SPF factor of 15 or greater.
  • Reapply sunscreen every two hours or after swimming.
  • Avoid sun exposure when possible by staying in the shade.
  • Avoid sun exposure during the middle of the day. (Use the old adage, if your shadow is shorter than you, the sun can hurt you.)
  • Cover up exposed skin.
  • Wear a wide brimmed hat.
  • Wear sunglasses.


Automobile Accidents

Automobile accidents are the greatest cause of death for healthy Americans traveling abroad. Driving in an unfamiliar area, in an unfamiliar car, when tired, pre-occupied or while looking at a map is the perfect setup for an accident. Be aware of the dangers as both a driver and a pedestrian.

Safe Driving Tips

  • If possible, rent a car with which you are familiar. Even if the car you normally drive is not available, cars of the same brand have many similar characteristics.
  • Familiarize yourself with all the controls, especially lights, turn signals, wipers, radio and ventilation BEFORE you head out of the rental lot.
  • Pull over to read the map; do not attempt to read a map while driving.
  • Pull over when using your cell phone, too!
  • Avoid driving at night, especially if you have never driven to your destination in the day time.
  • Safety features such as airbags, anti-lock brakes, child seats and even working seat belts may not be as common in less developed countries. Be sure to consider this when choosing a rental car company.
  • Keep in mind that, while in developed countries rental cars are serviced regularly and sold while still having relatively low mileage, other countries may keep cars in service for much longer. So be sure to check tire wear, tire pressure, oil level, headlights, wipers, and brakes, and whether the gas gauge is working in your rental car.
  • Consider carefully if you have the skills to rent a moped or scooter, and insist on a helmet if you do.
  • Log on to the web site of the Association for Safe International Road Travel (www.asirt.org), to learn about steps you can take to help avoid a fatal accident (especially in developing countries). Their Road Travel Reports are available for over fifty countries around the world.
  • Do not drink and drive, ever! Appoint a designated driver.


Safe Pedestrian Tips

  • Pay attention. It is easy to step off the curb when marveling at a great cathedral.
  • Be especially alert when crossing the street in countries that drive on the opposite side of the road vs. North America. You may be in the habit of looking inthe opposite direction for traffic.
  • Wear bright colored clothing.
  • Avoid jogging at night; local drivers may not be accustomed to runners on their narrow roads.
  • Practice what you learned in kindergarten: cross only at crosswalks (don't jaywalk), wait for the light, look both ways, and follow all pedestrian signs.

Expect the Unexpected

While none of us intends to become ill or injured on a trip, it is wise to at least consider the possibility. The longer your journey and the more exotic your destination, the more you should consider what you will do if afflicted. Use some common sense when determining your risk. Backpackers traveling to the farthest reaches of a country, drinking from streams and buying local produce are at greater risk than someone staying at the five-star hotel in the capital city and eating in the finest restaurants. Factors that affect your illness risk are related to your destination and length of stay. According to the International Travel Health Guide by Stuart R. Rose, M.D., there is a 60-70 percent chance you will develop an illness if you spend time in less-developed countries around the world. Thankfully, the risk of contracting most travel maladies can be drastically reduced or avoided altogether with a bit of planning and prevention.

Some questions to ask are: What are the likely problems that could occur? Where would I get medical assistance if I need it? Will my insurance pay for my care if traveling outside my home country? See our related article, Medical Assistance on a Trip Abroad.

With just a little planning and a few precautions, you can assure that your trip will be more comfortable, safe and rewarding.

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