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Family Health Magazine
GROWING OLDER

Have Health, Will Travel
Healthy travel from the resort to the outback

Whether you put on your backpack to travel in the ’60s or head overseas in your sixties, travelling can take many forms throughout life. Travel offers a wonderful way to experience different cultures, gain a new perspective, or simply relax. Healthy choices before and during travel help ensure a safe trip now and more in the future.

Older adults are traveling more than ever, whether a quick trip to a resort or a three-month backpacking adventure. Planning for your travel health needs is just as important as heading to the passport office.

It is easy to take our Canadian health care system for granted. Trans­lating names of medications, calling an ambulance, and finding an English-speaking doctor can be surprisingly challenging in a foreign country. Even stopping at a pharmacy for diarrhea medication can end in an embarrassing game of charades!

Pre-trip health planning can simplify travel, prevent medical complications, and make problems easier to manage while away.

Sound advice

There is no substitute for travel health counselling specified to you and your destination. Your health care provider or a travel clinic can provide this to you. A review of your vaccination status, prescription medications, and personal health needs are important steps before beginning your adventure.

The longer you travel, the more exotic your destination, and the more complex your health needs, the more you will benefit from a consultation at a travel clinic. Book your appointment well in advance, at least six weeks before you depart. Staff at the travel clinic will review your plans and provide any vaccinations you may require. They can identify your risk for other diseases such as malaria, and suggest medications and alternatives to keep you healthy.

These clinics provide up-to-date information on health risks and disease outbreaks around the world. As well, staff can guide you through the vaccination and health certificate requirements of other countries.

A list of travel clinics can be found at www.phac-aspc.gc.ca/tmp-pmv/travel/clinic_e.html.

Peace of mind

Provincial health care plans cover only a small portion of the costs of health care services received in another country. An ambulance ride, a trip to the hospital, or a flight home can mean a big bill. If an illness or accident occurs, financial hardship should be the least of your worries. Additional health insurance can offer peace of mind.

Unfortunately, travel health insurance can be confusing. Do your homework. Some plans will cover medical conditions that you already have, while others will not. For travellers over age 55, medical questionnaires are often required.

If you have complex medical con­cerns, clarify what is covered if you fall ill overseas. Get it in writing. Some plans require that medical fees be paid up front before you are paid back. Others will pay only for services received at select hospitals or clinics in your destination country.

Do not assume that your existing health insurance will cover you while you are outside of Canada. Research your options well ahead of your depar­ture date. Take copies of your plan with you, including emergency phone numbers. Leave copies at home with a friend or family member.

What to pack

If you take prescription medication, take enough to cover the length of your trip, plus some extra. Keep your medications in your carry-on luggage. All medications should remain in their original, labelled containers. Customs officials may not take kindly to unidentified pills! As well, bring along a written prescription from your health care provider, making sure medication names are written clearly using the generic name.

Carrying an extra pair of glasses (or a prescription) and replacement hearing aid batteries may also save precious holiday time.

Do you use needles and syringes for insulin injections or other medical reasons? In this case, you absolutely must bring a signed letter from your health care provider. It must state what supplies you carry and why you need them. Customs officials are bound to question a bag full of syringes.

Bring information about your health conditions written in the language of your destination country. This can help if you are dealing with a new health care system. As well, a note explaining food restrictions or allergies can bring peace of mind when you order your supper!

Some travellers take along an antibiotic, such as ciprofloxacin. This can treat a number of illnesses that may arise while you are away, such as a gastrointestinal or bladder infection. Ask your health care provider if this is a reasonable option for you.

Vaccinations

As you plan your trip, make time to review your vaccination status and get those booster shots! Adults often require updates to standard vaccinations such as tetanus or measles. You will need these whether or not you are traveling. A yearly influenza vaccination is also helpful, since it is always flu season some­where in the world.

Your destination and travel activities may also put you at risk for other infectious diseases. Typhoid and hepatitis A vaccinations may be recommended if you travel to areas with poor sanitation. Staying at the most luxurious resort does not protect you. Often staff have a lower standard of living and so can pass illnesses on to tourists.

Hepatitis B, Japanese encephalitis, and rabies vaccinations may also be recommended. Though most of these are suggested for travel, some countries require a Yellow Fever vaccination certificate before you can cross the border.

Checking your vaccination needs several weeks before departure allows enough time to receive injections. It also gives your immune (defence) system enough time to develop the necessary antibodies.

Resources

The following trustworthy websites on the Internet can provide up-to-date information specific to your destination. Inform yourself. Health Canada is a good source of valuable information. When applying for your passport at a government office, you can also pick up print copies of some of these documents.

Government of Canada Consular Affairs

Health Canada

Public Health Agency of Canada

World Health Organization

U.S. Centres for Disease Control

Eat, drink and be healthy

Vaccines do not provide 100 per cent protection from disease, nor are all diseases covered by vaccinations. Choices you make while traveling can greatly reduce your exposure to possible health problems.

When it comes to food the rule is: cook it, boil it, peel it, or forget it. If you would not drink the tap water, you do not want your ice made out of it, nor salad washed in it. Find out about local water quality before leaving home. Remember that resort water and what the locals drink may differ. Water quality in different parts of the same country can also differ. To play it safe, drink bottled water.

Although ‘turista’ diarrhea often does not last long, you must waste time holed up in a hotel room. If you have other medical issues or are on certain medications, the effect on your health can be more severe. Replace lost fluids with plenty of water (bottled, of course). Consider carrying medication prescribed by your doctor to treat diarrhea and antibiotics to manage last­ing symptoms. If symptoms get worse, you have a fever or bloody diarrhea, get medical help.

Bug out

Canadians often joke about the size of the mosquitoes in Winnipeg. However, in many places around the world these pesky creatures carry disease. The arrival of West Nile virus in Canada has created a greater awareness of the need for precautions against insects.

Malaria exists in Africa, Asia, Central and South America, and parts of the Caribbean, South Pacific and Eastern Europe. The pattern of malaria outbreaks changes on a regular basis. This depends on many factors, including the weather, season, and location. Two days in a five-star, air-conditioned downtown hotel carries a different risk than a trip to a hostel in a remote jungle village.

Consult a travel clinic to help determine your risk and learn about precautions. Several preventive medications are available. These differ based on your destination, health status, and other medications you take. It is important to take the malaria medication as prescribed.

Vaccines or medications do not exist for other diseases caused by insects, such as dengue fever. Preventive measures are your first and only line of defence. Above all, use an insect repellent that contains DEET. Some bugs bite at the beach, some at dusk and dawn, and still others will find you in the middle of the day. Whether you are camping in Alberta or rafting the Amazon River, make a habit of using insect repellent. Remember to re-apply it regularly.

Depending on your destination, you may need to place mosquito nets containing permethrin over your bed. Wear pants and shirts with long sleeves when hiking. In tropical areas of Asia, South America, the Caribbean and Africa, avoid swimming in fresh water, as there is a risk of being infected with a parasite.

Healthy activities

The choices you make and the actions you take while traveling can help keep you healthier. On the airplane, drink plenty of water, walk around, and do leg stretches to reduce the risk of forming blood clots in your legs. Certain medical conditions put you at greater risk for blood clots. Discuss this with your health care provider.

If you have a chronic medical condition, such as diabetes, pre-trip planning is essential. Passing through many time zones affects your eating and sleeping routine, as well as when you take medication. Visit your health care provider to plan how to manage your health concerns, make adjustments, and handle emergencies when away.

The same health advice often heard at home also applies when traveling. Remember to wash your hands or use an alcohol-based hand sanitizer frequently. This reduces the spread of diseases and lessens your exposure to germs. Use condoms to reduce exposure to sexually transmitted diseases. Wear your seat belt and be wary of unsafe road conditions. Prepare for the weather. Know the type of climate you are heading to and what clothing will keep you comfortable. Whether you are hitting the beach or the ski hill, wear sunscreen with at least SPF 15 and re-apply it regularly.

If you develop a fever or are ill within two months of returning from your vacation, be sure to inform your health care provider of your travel history.

Have fun!

Though there is much to consider when it comes to healthy travel, the goal is to have fun and enjoy the experience. Inform yourself and take steps to protect your health before heading out on your great adventure!

FAMILY HEALTH is written
with the assistance of
College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [GO_FHd07]
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