As we approach our departure to Southeast Asia, Mr. Chuckles and I are doing some final preparations for our first big trip of 2020. Unfortunately, some of the excitement about our impending international adventure has been dampened by anxiety over this Wuhan coronavirus outbreak. We were supposed to be travelling in a group of three including my mom, but she has made the difficult decision to cancel her trip due to this health concern.
Mr. Chuckles and I have still decided to go ahead with the trip ourselves, as long as our flights aren’t cancelled. Things still look promising for now as we are not even transiting through mainland China. I have been following the news about the coronavirus with great interest in my capacity as a frontline healthcare worker, and have assessed our overall risk of getting sick to be low enough to go ahead with our travel plan. I figure that if I stay at home and reschedule myself for work, I am at considerably higher risk of contracting some weird and wonderful illness from my workplace exposure alone!
In any case, virus outbreak or not, I have established a pretty extensive routine of preparation to stay healthy while travelling and it has served me well so far. Here are my top 5 travel health tips.
1. Get vaccinated.
Making sure that our vaccinations are up to date is a mandatory part of our pre-travel checklist. Primary care physicians are usually not equipped to provide formal travel medicine consultations (in fact, most family physicians in Canada do not get paid for travel consults via the public system) so we make a point to visit dedicated travel clinics for this. These are staffed by physicians or nurse practitioners with travel medicine training, who can give you very useful information about the exact vaccinations you need for your destination. There are many immunizations recommended in sources such as the CDC Yellow Book, but you realistically do not need all of them. That is where the travel medicine specialist comes in. If they are doing their job properly, they will give you accurate advice about what you truly need. They will tailor it to your itinerary, taking into consideration factors such as whether you are staying in urban or rural regions, or participating in high risk activities.
2. Purchase travel medical insurance.
Having taken care of many visitors and returning travellers who rack up huge bills when hospitalized out of country, I can tell you that medical insurance is probably the most valuable pre-travel purchase you can make. Hopefully you will never have to use it, but it really is very important to have in place. Mr. Chuckles and I both have good coverage through our extended health plans, which includes emergency medical evacuation. Many credit cards also include travel medical insurance if you book your trip on the card (I use the World Elite Mastercard). Otherwise, I have heard good things about Allianz and many of my patients have been adequately covered through them. World Nomads is another company that is endorsed by the likes of Lonely Planet and Intrepid Travel, but I have come across some pretty nasty reviews about them, so take that for what you will. 🤷🏻♀️ If you are planning to participate in higher risk activities (e.g. high altitude climbing, scuba diving, motorcycling), you may want to make sure that this is reported on your insurance application in case it affects your coverage.
3. Be cautious about food and drink.
Forget about Wuhan coronavirus; I think the bigger risk during our upcoming travels is catching a stomach bug, especially since we are planning to fully explore the street food scene. The general mantra with food in less developed regions such as Southeast Asia is “cook it, wash it, peel it, or forget it”. I would also personally advise against drinking tap water, even when brushing teeth, and to avoid ice cubes (based on a bad experience when I was in Tanzania). It’s helpful to bring along some anti-diarrheal medications, Pepto-Bismol, and a course of ‘rescue antibiotics’ that can be taken if the condition gets more severe. Some travel medicine specialists may recommend vaccination with Dukoral, which has some limited evidence for prevention of traveller’s diarrhea.
4. Protect against mosquito bites.
If you followed my daily blogs during our trip to Thailand and Laos, you may remember that I am very prone to mosquito bites. I am diligent about taking my anti-malaria prophylaxis, but it is also important to take general measures to prevent mosquito bites as there are other insect-borne illnesses such as Dengue Fever, Chikungunya, and Zika virus that are not vaccine preventable. I always pack an ample supply of insect repellent containing at least 25% DEET and as much as possible, try to wear light colours and long sleeved clothing.
5. Prepare a medical kit.
Mr. Chuckles laughs at me every time I put together my big bag of medications, but it has actually come into use on a few trips! I dread the idea of having to run around local pharmacies in a foreign country, so I like to bring a supply of standard over the counter medications and supplies on all our travels.
- Cold and sinus medications (DayQuil, Neocitron)
- Anti-diarrheals (loperamide)
- Anti-nausea medications (dimenhydrinate)
- Indigestion/heartburn medications (Pepto-Bismol, Tums)
- Polysporin or other antibacterial skin ointment
- Antihistamines (Claritin, Reactine)
- Eye drops (artificial tears, Polysporin)
- Analgesics (acetaminophen, ibuprofen)
- Sleep aides (melatonin, ZzzQuil)
- Alcohol based hand sanitizer and wet wipes
As for those face masks that people are hoarding – although they are effective when used by healthcare workers, there is really very limited evidence supporting their use by laypeople in everyday life. Universal precautions, as in routine hand washing and covering your mouth when you cough or sneeze, are much more important for preventing exposure and spread of infections.
Most important of all, relax and enjoy your vacation.
There is a great deal of hysteria surrounding this coronavirus outbreak, some of which is founded and some of which is not. I certainly would not travel to China at this time, but the risk outside of China remains very low. However, the decision to travel is a personal one based on your own risk tolerance, and I would say that those who feel that they are going to be stressed and worried throughout their trip should reconsider their plans. After all, your mental health is important too. In the meantime, Mr. Chuckles and I are going to wash our hands religiously and focus on enjoying our long awaited holiday.
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