Stay Healthy While Traveling Abroad

Are you planning a trip to other countries? Remember: healthy travel
requires planning, preparation, self-discipline, and vigilance.

The Food and Drug Administration (FDA) sends inspectors and other
employees all over the world to check that products it regulates,
which are made in other countries, are legal and safe for use by U.S.
consumers.

In the Guide to International Inspections, FDA advises employees on
safe and healthy travel basics. Here are a few pointers that can help
you stay healthy, too.

Before You Go

Do some research. Learn about access to reliable medical care at your
destination. Also read up on current events there. Good resources
include

* The Centers for Disease Control and Prevention (CDC) Travelers'
Health (wwwn.cdc.gov/travel/default.aspx)
* The CIA World Fact Book (https://www.cia.gov/library/
publications/the-world-factbook/index.html)
* U.S. Department of State Travel Information (http://
travel.state.gov/travel/cis_pa_tw/cis/cis_1765.html)

Don't buy medicines abroad. Many drugs sold in developing countries
contain impure or toxic ingredients. Don't buy any medical product
without consulting a competent health care professional. United States
embassies can often recommend physicians, although the amount of help
they are able to provide may vary.

Take an ample supply of medications. Keep prescription and over-the-
counter medications in their original packaging to avoid problems with
border guards. Carry one or two days' worth of prescription medicine
to cover unexpected delays. Consider carrying sunscreen and protection
against insects, as well as treatments for the common cold;
constipation; cuts, scratches, and burns; diarrhea; heartburn or
indigestion; insomnia; motion sickness; allergies; nasal congestion;
pain or fever; sore throat; and malaria prevention.

Don't use Entero-Vioform. This drug, widely distributed abroad for
treating diarrhea, has been linked to nervous system complications.

Think about immunizations. Consult your health care professional weeks
in advance, since some immunizations are administered over weeks or
months. Also, check CDC's Web site for information on immunizations
for travelers (wwwn.cdc.gov/travel/contentVaccinations.aspx)

Consider altitude. Even healthy, athletic people can become ill at
altitudes above 10,000 feet. Young children are especially at risk. If
you're going to high altitudes, plan to rest during the first 12 to 24
hours there to adjust to breathing in less oxygen. People with chronic
heart and lung disorders should consult a physician before traveling
to altitudes above 3,000 feet.

Tips for the Trip

Exercise. During long trips, help avoid circulatory problems in your
legs by standing up and walking for several minutes every hour or so.

Eat and drink wisely. Drink plenty of liquids. Avoid overindulgence.
Too much alcohol and/or food can result in gastrointestinal problems,
poor sleep, and altered moods.

Fight off jet lag. Minimize fatigue associated with time-zone hopping
by eating normally. Try to get a good initial night's sleep at your
destination.

While in Developing Countries

Avoid tap water in all forms. This includes ice, water by the glass or
in mixed drinks, and water used when brushing your teeth. In
developing countries, water may be contaminated by such unpleasantries
as amoebas and other parasites, and the virus that causes hepatitis.
Even a small amount of infected water can make you ill.

Drink safe beverages. These include

* Boiled water – one minute of boiling is adequate.
* Hot beverages – these are relatively safe even if full boiling
is not assured.
* Bottled water – carbonated water is the best assurance that the
container was just opened and not filled at the tap.
* Bottled or canned beverages
* Treated water – commercial iodine or chlorine tablets provide
substantial protection if added to tap water and allowed to stand
according to the directions.

Avoid raw fruits and vegetables. This includes salads and uncooked
vegetables. Eat only food that has been cooked and is still hot, or
fruit that has been washed in clean water and that you have peeled.
Fruits and vegetables that grow near to the ground are likely to be
contaminated by the same organisms as the tap water.

Avoid other foods. These include

* Raw or undercooked meat, poultry, fish and eggs
* Dairy products from small independent vendors
* Food that has been left unrefrigerated, especially food
containing meat, poultry, eggs and dairy products

Eat safe foods. These include

* Thoroughly cooked fruits and vegetables
* Fruits with a thick covering (citrus fruits, bananas, and
melons), which you peel yourself
* Thoroughly cooked meat, poultry, eggs and fish. (Pork and lamb
should be well done; beef can be medium)
* Dairy products from large commercial dairies

Illnesses to Avoid

Diarrhea. The most common cause of tourists' diarrhea can be treated
with over-the-counter, "upset-stomach" products. (Buy these before you
leave.) Effective drugs that control the frequency of diarrhea include
Lomotil (diphenoxylate), lmodium (loperamide), and Kaopectate.
Remember that adequate fluid intake is essential to preventing
dehydration. Find reliable medical help if you have severe abdominal
cramps, severe abdominal pain, high fever, blood or mucus in your
stool, and/or severe dehydration.

Respiratory diseases. Many diseases—including influenza, tuberculosis,
and diphtheria—are spread through sneezing, coughing, or talking.
Consult your physician about testing and immunization.

Mosquito-borne diseases. These include malaria, yellow fever, dengue,
and Japanese B encephalitis. To avoid mosquitoes

* Bring plenty of liquid mosquito repellent with at least 30% of
the active ingredient Diethyltoluamide (DEET).
* Wear long sleeves and long pants.
* Sleep in a bed protected by mosquito netting, if needed.

Schistosomiasis. Swimmers need to know that many freshwater ponds in
South America, Africa, and Asia are infested with a parasite that
causes a chronic disease called schistosomiasis. Chlorinated pools and
salt water are generally safe from infectious diseases.

When You Return

Some travelers should have a physical examination including blood
tests and stool analysis upon returning home. The need for specific
tests will depend on where you went, how long you stayed, and what you
did. Consult with your physician before you go and schedule an
appointment for your return if advisable.

This article appears on FDA's Consumer Health Information Web page
(www.fda.gov/consumer), which features the latest on all FDA-regulated
products. Sign up for free e-mail subscriptions at www.fda.gov/consumer/consumerenews.html.
For More Information

FDA: Guide to International Inspections and Travel
www.fda.gov/ora/inspect_ref/giit/default.htm

Date Posted: June 23, 2008

http://www.fda.gov/consumer/updates/...lth062308.html