Posted on: Sunday, February 18, 2007
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Mosquitoes carry malaria and several other serious diseases. Talk to your doctor before your trip if you're planning to visit affected areas.
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My favorite oddball medical malady that affects travelers is Stendhal syndrome — being physically overcome by the beauty or grandeur or spiritual emotion of your surroundings. This genuine affliction, which manifests in blurred vision, weak knees, rapid heartbeat and dizzy or fainting spells, has been documented around the globe, occurring particularly in museums and churches with powerful works of art, at memorials for wars and catastrophes and in landscapes of unearthly scenic beauty. Vulnerable people succumb, albeit briefly, to an overwhelming rapture, to a swooning ecstasy.
But Stendhal syndrome, though physiologically and psychologically intriguing, is not primary among a traveler's health concerns. The U.S. Centers for Disease Control and Prevention maintains a 24-hour service dispensing international travel health information, including notice of any mandatory inoculations. Call toll-free (877) 394-8747 or (800) 311-3435 or see www.cdc.gov/travel. This taxpayer-funded institution will tell you more than you ever wanted to know about each disease (and prevention treatment) that may be lurking at your overseas destination.
All treatments mentioned in this article should be discussed in advance with a physician for evaluating appropriateness, efficacy and possible negative side effects. Any immunizations received should be entered into a yellow International Certificates of Vaccination for a portable and permanent record. If your doctor or public-health office does not have booklet PHS-731, which contains the certificate, it may be purchased for $1.25 from the U.S. Superintendent of Documents — call toll-free (866) 512-1800 — or at the Government Printing Office Web site, www.bookstore.gpo.gov. Keep this document with your passport when entering countries that require inoculations.
Jet lag. We all have suffered the effects of jet lag, but what, exactly, is it? This malady results from a dysfunction of the normal body clock when hurdling time zones. Severe symptoms include disorientation, loss of appetite and concentration, weariness and stomach upset.
Frequent fliers swear that light therapy, special diets and meal schedules play a large role in resetting their circadian rhythms. Check out the plans described at www.antijetlagdiet.com and www.stopjetlag.com. Melatonin, a natural hormone that aids your body's quick resynchronization, has been a popular anti-jet lag remedy for years. A more recent candidate, ENADAlert, a biochemical energizer, promises to boost your energy and alertness if taken one hour before landing. Ingesting light foods, avoiding caffeine and alcohol and drinking lots of water to prevent dehydration are recommended precautions against jet lag while in the air.
Intestinal upset. "Montezuma's revenge," "Delhi belly," and "the trots" are popular names for travel's most common and most unpopular affliction: diarrhea. I've only had it once in 45 years of world travel, but that was more than enough. Contaminated food and water are the culprits behind this gastro-intestinal distress. Updated medical research indicates that taking an antidiarrheal containing loperamide (prescription antibiotic ciprofloxacin or nonprescription Imodium A-D or Pepto Diarrhea Control) may now cure this malady in as few as three days. Newer to the market is prescription Rifaximin, a site-specific antibiotic that, unlike broad-spectrum Cipro, remains in the gut to battle the microbes that cause diarrhea.
Malaria. Travelers are at risk for malaria in many parts of the world. Just before dusk is when the malaria-transmitting anopheles mosquito will appear. Confer with your doctor about the proper preventive for the kind of mosquito you're likely to encounter. Many strains have become resistant to the traditional chloroquine tablets and are becoming immune to mefloquine (prescription Lariam.) FDAapproved Malarone is reputedly a powerful malaria drug that causes minimal negative side-effects. Skin repellents with concentrations of 25 percent to 35 percent DEET are recommended for adults. Insect sprays with permethrin are highly effective against mosquitoes, chiggers, ticks, fleas and other biting insects when sprayed on clothing, netting and in enclosed areas. To avoid attracting insects, don't wear jewelry and brightly-colored clothing or use perfume, scented deodorants, soaps and lotions.
Altitude sickness. People under the age of 60, surprisingly, are twice as likely as older travelers to develop the ill effects of Acute Mountain Sickness, aka altitude sickness. Sufferers report symptoms of headaches, fatigue, shortness of breath, insomnia and dizziness, commonly occurring at altitudes above 8,000 feet. Physicians recommend sufficient time for acclimation, high-carbohydrate meals, rest and plenty of water. The most frequently prescribed chemical remedy for AMS is acetazolamide, sold under the name Diamox.
Hepatitis. Immunity against the highly contagious viral disease of hepatitis A is gained for five years through an initial injection, followed by a six-month booster, of the Havrix vaccine. Spread by contaminated food or water or intimate personal contact, hepatitis affects more than 10 million people each year. The virus attacks the liver and can result in jaundice, fever, diarrhea, stomach pain and vomiting. If you're traveling to countries where overcrowding and poor sanitary conditions reign, consider this preventative. And Typhium Vi is the most recent FDA-approved vaccine for typhoid that requires only one dose, eliminating the multiple injections or oral doses of previous treatments.
Emergency assistance. If you have a medical condition or are at risk for one that could require emergency attention abroad, investigate the services of the International Association for Medical Assistance to Travelers, (716) 754-4883 or www .iamat.org. This highly regarded nonprofit organization offers its members a worldwide directory of English-speaking physicians who have agreed to treat members for a modest, set-fee schedule. Other free services include updated, detailed publications and charts on health, climatic and sanitary conditions around the globe. A small donation is welcomed and earns you membership and full access to the offerings of this venerable 47-year-old organization.
Irene Croft Jr. of Kailua, Kona, is a travel writer and 40-year veteran globetrotter. Her column is published in this section every other week.
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