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1) Vaccinations – get them up to date with a visit to the Public Health Department at 2650 Breslauer Way (off HWY 273 South) at 225-5073. Some series take months to complete, so don’t wait. The Hepatitis A (2 shot series) and Hepatitis B (3 shot series) last a lifetime. The clinic nurse will provide details of which vaccines are appropriate for the travel in question. These may include Tetanus/Diphtheria, Polio, Measles, Hepatitis A & B, Japanese encephalitis, meningitis, Rabies, Typhoid, Yellow fever or others.
2) Malaria Prevention – prevention should be both passive and active. Passive measures include (a) wearing DEET-containing insect repellent on the skin; (b) spraying outer clothing (shirts, pants, jackets) and bed nets with Permethrin, which lasts despite many washings; and (c) sleeping under a mosquito net (without letting any part of your skin touch the net, so that the little beasties cannot reach you). Active measures means preventive medications. Chloroquine’s the choice for areas where malaria is still sensitive to it (Mexico, N. Argentina and parts of SouthWest Asia). For resistant areas (most of South America, Africa, Southern Asia and Western Pacific), the choices include Doxycycline (taken daily; very cheap; prevents some other diseases; not for children under 8 or pregnant women), Mefloquine/Lariam (once a week, costly) and Malarone (daily, spendy). The medication needs to be taken one week prior to travel, during travel, and then for four full weeks after returning (Malarone stops one week after returning).
3) Water. If traveling to areas of questionable water supply, precautions are in order. Consider use of filtered sports bottles, filter pumps, or iodine or similar pellets. Otherwise drink beverages made with boiled water or canned/bottled beverages. Consider ice to always be contaminated.
4) Traveler’s Diarrhea. Avoid fresh produce/vegetables which are not served hot and fruit that you or your group haven’t peeled themselves. Avoid ice. Keep your fingers out of your mouth. Two Pepto-Bismol tablets taken four times a day is an excellent preventive medication (not for aspirin-allergic people) if started the day of and continued during travel. It turns tongues black (so brush) and stools too (so what?). If you get diarrhea anyway, antibiotics should be taken (Cipro, Levaquin, etc.) for three days if fever or bloody stools are present. If you plan to be overseas in one place a long time, consider just toughing out the diarrhea to get your immune system “used to it.”
5) Bugs, Scorpions, Snakes and Things. Rule #1, leave them alone. Rule #2, see rule #1. Shake out shoes before putting them on. Check your sleeping bag before climbing in, look under your pillow, use a flashlight at night, don’t go barefoot (wear sandals/thongs for bathroom runs), look where you’re stepping. Thongs/Flip-flops are a must in group showers to prevent athlete’s foot.
6) Sun Protection. Hats, sunglasses, sunscreen, and lip balm for sunny areas. Long sleeve shirts and long pants are better protection for exposed skin than sunscreen. Stay well hydrated, and that means frequent intake, not playing catch-up hours later.
7) Personal Medical Kit. Bring any prescription medications you take. Also consider bringing Tylenol, Motrin or other favorite anti-inflammatory, Benadryl for allergic reactions, anti-acid pills (Zantac, Tums, etc.), antibiotic ointment, Decongestant (Sudafed or other) for colds, steroid cream (hydrocortisone or prescription), anti-fungal cream, Band-Aids, nail clippers, etc. Keeping a good stock of personal hygiene items is a must — tooth paste and brush (don’t use tap water to brush), floss, toilet paper, pre-moistened towelettes, soap, shampoo, female items, cotton swabs, deodorant (think of your colleagues), etc. If you want it, bring it.
Andre Van Mol, MD and Julie Winter, NP
3580 Santa Rosa Way
Redding, CA 96003