Travel to Developing Countries - General Health Precautions

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General Health Precautions	Travel Precautions	References
Traveler's Diarrhea	Traveling with Health Problems

General Health Precautions

Over 50 million people from industrialized nations travel to developing countries each year. Such trips can pose significant health hazards. Travelers who plan to visit developing or tropical countries and those embarking on prolonged vacations or arduous treks should take a number of precautions.

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Medical Preparation

A visit to the doctor is very important in preparing for travel to a developing nation. Since many doctors may have trouble keeping abreast of medical trends in foreign countries, a local travel clinic may be especially helpful.

Travelers to developing countries should have a thorough check-up and prepare for any health contingency at least 8 to 10 weeks before the trip.
They should obtain a brief summary of their medical histories to take with them, including the results of abnormal tests or EKGs and a list of drug allergies.
They should also prepare a list of medications they normally use, noting all trade and generic names as well as dosages. In addition, the doctor should provide a letter authorizing any necessary medications; this precaution will facilitate customs and security checks.
Contact lens wearers should consider taking ocular antibiotics if traveling to remote countries.

Immunizations and Preventive Drugs: General Guidelines

The following are some general guidelines for vaccinations and other preventive medicine for travelers:

Travelers to developing countries should check with the U.S. Centers for Disease Control, U.S. State Department, or World Health Organization for the latest information on immunization requirements for their destinations. Studies indicate that multiple vaccines may be given at the same time to most adults without significantly increasing adverse effects.
Adults and children should make sure their recommended routine vaccinations are up to date. Booster shots may be required for travelers to developing countries even if they have completed the initial series. Vaccinations may include polio, meningitis, measles, and varicella-zoster (chicken pox), and a series for tetanus, diptheria, and pertussis (Tdap). Infants and children are generally vaccinated against these three diseases, but until recently teens and adults did not receive pertussis (whooping cough) immunizations. Due to an increasing number of pertussis cases, the CDC now recommends that adults and adolescents receive a newly licensed booster shot that protects against pertussis as well as tetanus and diptheria. Travelers who require tetanus boosters should check with their doctor about receiving the new Tdap shot.
Pregnant women should have vaccinations appropriate to the trimester. Not all vaccinations are appropriate during pregnancy.
Older adults may either not respond to a vaccination as quickly as younger people or they may have a higher risk for toxic effects. They should check with their doctors.
Upper respiratory infections are very common after foreign travel. The influenza vaccine may be recommended when traveling to any country during flu season, particularly for the elderly and people at risk for serious illness. This group may also need the pneumococcal vaccine.
Travelers to areas where there are tuberculosis (TB) outbreaks should have skin tests before traveling; those with negative tests should have a repeat test 2 to 4 months after they return.
Vaccination against hepatitis A is recommended for all travelers to developing countries. Hepatitis B vaccination is recommended for people traveling to countries that have a high prevalence of hepatitis B. The hepatitis B vaccine is especially important for people who expect to have close or sexual contact with the local population. Some doctors may recommend that travelers receive a combination hepatitis A and B vaccine.
Travelers to countries with malaria should take preventive drugs.
Some countries may require vaccinations against yellow fever, meningitis, polio, typhoid, cholera, Japanese encephalitis, and rabies under certain circumstances. Some of these are covered in this report.