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Tripping Out:
Tips for Traveling Abroad

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Just when you have your trip to that warm spot booked and bags packed, along comes a direct to consumer TV ad that suggests that anyone contemplating having a cool drink on beach should get stabbed with nothing more than this product. When traveling to a foreign destination, you need to assess your risks by more than a commercial on television. There are at least twenty different types of needles and numerous medicinal regimens available to travelers. I think of Yellow Fever, Malaria, Dengue, Encephalitis and Typhoid before I assess Hepatitis B and AIDS as risk factors. What you require depends largely on where you are going and what you are going to be up to. For example, imagine visitors arriving at Pearson for a short tour of Toronto in mid-January, wearing mosquito nets and rubbing arms still sore from rabies shots, because someone back home told them Ontario is full of Rabies and West Nile Viruses. Caribbean cruise ship personnel get the same chuckle when Canucks order drinks by the pool rubbing arms still sore from Hepatitis shots. When a friend informed me that our travel agent suggested Hepatitis shots for a Caribbean trip, I caused a bit of a stir by phoning the agent and insisting on being switched to a cleaner ship. I had no intention of traveling aboard a ship that required Hepatitis shots. Cruise ships are inspected regularly and the scores posted on the Internet. Prevention is still better than prophylaxed submission. Many tropical and third world diseases do not have immunizing shots. A shot in the arm is no reason to let your guard down. Most people traveling to a Cuban resort, a Mexican Riviera hotel, a Florida or Caribbean cruise need only a little knowledge and common sense to enjoy their holiday. As a general rule, travel companies and cruise-lines tend to avoid destinations with mandatory immunization requirements, no matter how beautiful they are.

So how does one prepare for a trip abroad? The first thing I usually ask people is how much traveling they are planning to do in the next few years. It is sometimes more economical to consider a long-term plan. Ensure that your own immunizations are up to date. We should all have some immunity or immunization for Tetanus, Diphtheria, Polio, Measles, Mumps, Rubella and Influenza. Many of us should also be up to date with Hepatitis B, Tuberculosis, Meningococcal and Pneumococcal immunity. For a specific upcoming trip, I would suggest that you sit down and list all the major ports, airports, cities and islands that you plan to visit by name. Determine if you are simply going to relax in the sun, or perhaps you plan to build schools, dig latrines and so forth in highly rural areas. The more time you spend directly in contact with sewage, garbage and accompanying bugs, the higher your risk. In our example of the couple arriving at Pearson, it would make perfect sense if they were planning to spend a May weekend wandering around Algonquin forest. My favorite web sites for travel are maintained by the Americans who post up-dates daily. Visit CDC, which is run by the Centers for Disease Control and Prevention in Atlanta Georgia. It is just a tad more reliable than television commercials. On the main page is a link to Travelers Health, which allows you to check all destinations on your itinerary for recommended preventative measures. The information is complete but can be confusing. For example, Malaria medication is only suggested for some parts of the Dominican Republic. Some immunizations are mandatory while others are only recommended for certain activities. This information can be downloaded and taken with you. See also A Virtual Library of Useful URLs for more travelers tips including a link to The Travel Doctor.

Some general tips for travel. Take more than enough medication that you regularly use to account for delays. Always split your supply in half. Carry half of it with you. That way you can only lose half your supply at any given time. Carry a written one-page summary of your health, medications, numbers and doctor contacts. I also recommend a small first aid kit that includes over the counter medications such as acetaminophen, Imodium, allergy pills, stomach upset pills and perhaps an antibiotic suggested by your doctor. In some places you just cannot get items that we take for granted. The other great web site that I often refer to is Travel.State.Gov. It provides travel advisories based on political upheaval from a purely American point of view. I don't really mind this since the funny thing about traveling around the world is that most of the people on this planet still have trouble telling us North Americans apart from each other.

On another note, our Canadian Olympic athletes are preparing to leave for Italy to compete in the Winter Olympics. I wish them the best of luck and want them to know that they make us all proud. God speed, especially on time clocks and score boards. The time commitment and sacrifice that these athletes put forth is truly wondrous. There will be also be a contingent of ex-Olympians and accomplished athletes accompanying them as well, to lend support and provide color commentary. To our own Kylie Richardson, Barb Underhill and Stan Haba, I wish you much success. And finally a word to Pat and Wayne: if you happen to find yourself injury plagued and are in need of a mature but patriotic pinching defense-man, just send the word. Have flag, will travel. Remember, that torch is heading to Canada next.

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