Thank you for coming to The Travel Clinic. We hope we have addressed all of your concerns, and we wish you a pleasant, healthy trip.

 The following is a summary of some of the advice, inoculations and medications that have been recommended for you.

Traveller’s Diarrhea

 Traveller’s Diarrhea (Montezuma’s Revenge, Delhi Belly, etc.) is the most common affliction of travellers to the tropics.  Your chance of developing diarrhea depends upon:

• your destination
• the precautions you take
• your style of travel
• LUCK!

In general, it is a good idea to follow the words of Montezuma himself – “Boil it, bottle it, peel it, cook it…or forget it!”  Beer, carbonated drinks, bottled water, tea and coffee should be OK.  Avoid vegetables and fruits that might be washed in local water.  Ice cubes are not to be trusted! 

There are several water purifiers on the market that can provide you with clean water.  But that doesn’t necessarily protect you from the people handling your food, and the flies landing on it. 

To treat diarrhea, begin with rehydration, using purified water, carbonated drinks, tea or soups.  Rehydration formulas, e.g. Gastrolyte, are ideal.  An antiperistaltic agent (it slows you down) such as Imodium may be helpful. These should not be used alone with severe diarrhea. As most cases of diarrhea in travellers are bacterial, an antibiotic, such as Noroxin or Cipro, along with a bit of Imodium, might give the quickest relief.  Remember…Travel expands the mind…and loosens the bowels!

Malaria…And More

There are several infections passed by mosquitoes and other bugs, such as dengue fever, yellow fever, Japanese encephalitis, tick typhus…and more.  But malaria is by far the most important. 

There are four strains of malaria.  One of them, Plasmodium falciparum, may be fatal if treated improperly or not early enough.  This same strain has developed resistance to several antimalarial medications. Having said that, malaria is usually a preventable, and when necessary, a treatable infection.

Personal measures such as the following are very important.

limit outdoor exposure from dusk to dawn

use protective clothing

use an insect repellent containing DEET (e.g. Muskol)

consider an insect net at night

 Antimalarial medications are used to lower your risk of becoming ill with malaria.  They DO NOT prevent an infection…they suppress it.

 It is extremely important that prescribed antimalarial medication be taken as directed. 

They are usually started a week before your trip…taken regularly during your trip…and continued for 4 weeks after you leave the malarious area. It is important that you follow the instructions carefully.

 All drugs, including antimalarials, have side effects…in some people, some of the time.  Mefloquine (Lariam), the most commonly used antimalarial, may be associated with:

• Stomach upset (so take it with food)
• Dizziness
• Sleep disturbances, vivid dreams
• Mood changes – anxiety, depression
• Other antimalarials, which may be used in certain situations, include Chloroquine, Paludrine and Doxycycline.

 Remember even with malaria medication, and personal protective measures nothing is 100% proof.  Suspect malaria up to one year after your return.  Should you develop a fever, chills, or flu like symptoms, seek medical attention promptly and advise them of the countries you are returning from.

Pre-Travel Shots

The ‘shots’ you receive depend upon your destination(s), the duration of your trip, your ‘style of travelling’, your medical history and your age.  Personal preference (yours) also plays a role.  The shots really aren’t that bad, but you may experience a sore arm, some aching, or a fever in a few days after the shot.  Allergic reactions are rare. 

You must remain in the office for 15 minutes after your inoculations.

Inoculations are not always 100% protective. Therefore, personal measures to prevent infection remain important.

The following are the inoculations you might have received, with their duration of protection in brackets:

• Tetanus-diphtheria-polio (10 years)
• Measles-mumps-rubella (life)
• Yellow fever (10 years)
• Typhoid fever (3-5 years, depending upon the vaccine used)
• Hepatitis A (1-10 years after a booster)
• Hepatitis B (life)
• Meningococcal meningitis (3-5 years)
• Japanese encephalitis (2 years)
• Rabies (2 years)
• Cholera (6 months)
• Influenza (1 year)

 

Several inoculations may be given at the same visit. You will be given an immunization card or booklet containing a record of your inoculations. Try not to lose it.  Please bring it to any future visits.

 Some Helpful Tips

• Be sun smart! Use a sunscreen with an SPF of at least 15, and cover up. Wear a hat. 
• Avoid walking barefoot in places that might be contaminated with human or animal feces. It helps to keep those worms out of your system. 
• Motor vehicle accidents are an important cause of injury and death abroad. Motorbikes are not a great idea. Try not to drive at night, and avoid crowded buses. 
• Don’t leave home without adequate out-of-province medical insurance. Be sure to read the fine print. 
• Beware of your personal safety. Don’t walk or jog where you shouldn’t be! 
• If you are travelling to a high altitude (more than 6,000 feet), take it easy, in order to avoid altitude sickness. Drink lots of fluids, and avoid alcohol. It may take a few days to acclimatize. If you are climbing, it should be with experienced guides, and done safely. 
• Jet lag is one of the joys of travel. There are a few ways to try and beat it. One of them is to get off of the plane in good shape! Try not to overeat or over drink alcohol during your flight. Do drink plenty of  water. Get up to stretch from time to time. Upon arrival try to adapt to the local time schedule. 
• If you are carrying any medications, make sure that you have more than adequate supplies. They must be kept in their original labelled containers. Carry them in your hand luggage. 
• Should you have any medical problems, it might be wise to carry an explanatory note from your doctor. 
• IAMAT is an organization which will provide you with names of English speaking doctors around the world. Phone 1-519-836-0102. 
• If you are travelling by boat, take along something for motion sickness. This might include Gravol, ginger root, or one of the commercially available ‘wristbands’. 
• Do not return with a sexually transmitted disease. Abstain or use a latex condom. Avoid foreign needles if at all possible. Have your acupuncture, tattoos and body piercing done at home.  
• Avoid swimming in freshwater in the tropics, due to an infection called schistosomiasis.
• Some More Tips…
• Enjoy your adventure.
• Take lots of pictures, but remember, not everyone wants to be your subject.
• Learn some of the cultures, do’s and don’ts.
• Learn a few important phrases including, but not limited to “where is the bathroom” before you go!
• Bargaining is a way of life in many countries. Enjoy it…but don’t get too competitive!
• Keep a  diary. It’s great to read 25 years later.
• SEND US A POSTCARD!