Protecting your health abroad

With more and more Northwest Florida companies establishing international contacts and setting up export or import businesses, it’s important that travelers prepare for healthy travel abroad.

Have Health, Will Travel Business taking you abroad? Forget about the solar PDA charger — your most important accessory may be an updated health record By Triston V. Sanders

In today’s fast-paced international business world, you never know when you wake up in the morning whether you will need to fly out that afternoon. That’s why Tallahassee resident Ben Barrick says you can’t be too careful when it comes to your health.

"If you don’t want to be surprised, be smart," advises Barrick, a frequent international traveler who works for DVS Group, which specializes in commercial janitorial waste management. His advice: Never conduct last-minute preparations.

"If you travel abroad often, stay current on all immunizations and information that may be necessary," Barrick says. "If your health is affected while traveling, your business suffers. The health of employees is vital to the success of the company or firm."

With more and more Northwest Florida companies establishing international contacts and setting up export or import businesses, it’s important that travelers prepare for healthy travel abroad. Barrick is a good role model for other business travelers. In the past three years, he has traveled about once a month to a long list of countries: Mexico, Canada, Bahamas, the United Kingdom, France, Spain, Saudi Arabia, China, Australia, Sweden, Germany, Luxembourg, India, Pakistan, Russia, the U.S. Virgin Islands and Belize.

"When I began extensive international travel, I received several immunizations and health screenings," he says. (Some of those were company-imposed, while others were by choice.) "And I stay current on immunizations for regions that I expect to travel to in the next year. It is always the best business practice to stay current so as not to delay your travel."

A business traveler’s first stop should be to the doctor. It’s best to find one whose area of expertise is travel medicine. In Tallahassee, Dr. Philbert J. Ford specializes in travel and tropical medicine and infectious diseases. At his practice, The Southeastern Center for Infectious Diseases, he makes sure his patients are ready for their trip.

"We pay very close attention to prevention, education and safety for our travelers," says Ford, who uses a database that updates information daily on illnesses and diseases of concern around the world. "Some of the vaccinations we provide are yellow fever, typhoid fever, Japanese encephalitis, flu, tetanus, pneumonia, and hepatitis A and B. We also provide malaria prevention through education and anti-malarial medications, as well as information and preventive medication to combat traveler’s diarrhea and high-altitude sickness, among other services."

Healthy travel has become the life’s work of another doctor, Stuart Rose. Rose, a physician in Northampton, Mass., was a medical student in Tanzania when he became fascinated with travel medicine.

"I saw many exotic diseases rarely encountered in the U.S.," Rose recalls. "So in the 1980s, when I started a travel clinic, I wrote the first edition of the ‘International Travel Health Guide.’ I wrote it out of frustration. At that time, there was no single source of annually updated travel health information."

Today, Rose practices emergency medicine, but he also manages a company with a Web site, travmed.com, that provides travelers with the very latest information on how to plan a safe trip, even to the farthest corners of the Earth.

Rose says business travelers should properly plan for their trips.

"You start with a review of your itinerary," he says. "Are you going to a country where there is the risk of malaria? You may need to take pills to prevent this disease. Travelers should also be prepared to prevent insect (mosquito and tick) bites — the cause not only of malaria, but dengue fever, typhus, encephalitis and a host of other illnesses.

"‘What shots do I need? Will I be exposed to yellow fever, rabies, meningitis, etc.?’ You need to go to a travel clinic to get these special vaccines. All your routine shots (tetanus, etc.) should also be kept updated."

While immunizations are important, there are a number of other health concerns to keep in mind.

"The most common travel-related illness is traveler’s diarrhea," Rose says. "Over 60 percent of travelers may be affected during a one-month trip to a lesser-developed country. Your doctor should provide you with stand-by antibiotics (for example, Cipro) to treat symptoms."

He also cautions that the most common cause of fatalities overseas is injuries, so travelers should be cautious and conscientious about road safety. Drowning is another common cause of death. Most deaths of travelers over the age of 55 are cardiovascular, Rose says, but these deaths are not necessarily increased by travel.

It’s also important for a traveler to bring along his or her health information.

"My most current health records always accompany me — I usually leave these in the flap of my suitcase until they are updated so I never forget them at home," says Tallahassee’s Barrick, who carries a small reference card in his wallet with his blood type, allergies and other health information in case of emergencies. "Also, I do suffer from a few minor conditions that may need access to medicine. Luckily for me, these conditions are usually treatable over the counter in other countries and do not cause long-term harm if they persist for several days. Thus, if I do not have a specific medicine, I usually can find some elsewhere."

Leon County Commissioner and architect Akin Akinyemi grew up in Nigeria and is used to packing up and flying globally. He says his experience abroad allows him to travel with comfort and ease.

"Knowing someone personally in that country helps," Akinyemi says. "If not, have contact information for American embassies and consulates handy in case you need their help. Check weather and health advisories, and try to separate the fact from the myth."

Adds Barrick, who stays current with Centers for Disease Control and State Department warnings: "Warnings are easily found. Thus, I always have an idea of what to expect and prepare myself for it."

What if a business traveler is sent to a country that is known for natural disasters? Rose says people tend to panic when some sort of natural disaster occurs and thus avoid all travel to that area (for example, the Indonesian tsunami of December 2004).

"In fact, their risk of getting caught up in a disaster is extremely low," he says. "One exception: I did not travel to (the Caribbean island) Montserrat when the volcano was active a few years ago. Remember, if there is an outbreak of a disease, say meningitis in India, which occurs not infrequently, travelers can protect themselves through vaccination and/or avoiding crowded venues. Being well-informed is usually all that is necessary."

Travelers often lose sight of the fact that travel is extremely safe, but that certain common-sense precautions are mandatory. This is especially true when it comes to road safety.

"I would tend to avoid travel to certain regions more because of the threat of violence or kidnapping, especially if I were an oil executive visiting Colombia," Rose says with a smile.

While most business travelers aren’t oil execs, they certainly have their fair share of stress. Rose’s book has an extensive chapter on business travel. He says business travelers often are under a lot of stress due to the frequency with which they travel and the disruption that it causes to their family life.

"Being posted overseas may mean more prolonged exposure to diseases," Rose says. "Access to quality medical care may be limited."

With that in mind, as you set out to conquer the world, just remember to make your next and every business trip a healthy one. Don’t just pack your bag; troubleshoot your travel by taking a few extra steps when it comes to your health.

Travel Tips for Jet-Setters

When traveling overseas, you should:

• Consider visiting a travel clinic prior to departure. Travel clinics can provide specialized immunizations and prescriptions for medications, as well as essential advice about how to prevent or treat illness abroad.
• Learn about the availability and quality of health care available at your destination.
• Know how to obtain the names of qualified, English-speaking doctors and which facilities provide the best care at their destination.
• Purchase a travel health policy that directly pays doctors and hospitals abroad and that also coordinates and pays for emergency medical evacuation.
• Carry standby antibiotics to treat travelers’ diarrhea, and bring at least a basic first aid kit.
• Have available copies of key portions of your medical records (for example, a recent electrocardiogram) and a list of medications, if health problems are a concern.
• See a physician immediately if a fever develops during a trip to the tropics or soon after your return. Malaria is a medical emergency you may need to consider.

Source: "Travel Medicine: Products & Information for Safe Travel" (travmed.com)

Web Sites:

• travmed.com
• mdtravelhealth.com
• cdc.gov/travel/content/vaccinations.aspx

Travel Medicine Publications:

International Travel Health Guide, 13th Edition by Stuart R. Rose, M.D., FACEP, and Jay Keystone, M.D.

Travel Medicine 2nd Edition: Expert Consult edited by Jay Keystone, M.D., et al

The Travel and Tropical Medicine Manual, 4th Edition edited by Elaine C. Jong, M.D., and Christopher A. Sanford, M.D., MPH

Travellers’ Health: How to Stay Healthy Abroad edited by Dr. Richard Dawood

Health Information for International Travel (the Centers for Disease Control’s "Yellow Book"); chapters may be downloaded free from cdc.gov