Healthy returns

Christy Brown has been planning a safari in Tanzania for the last year and a half.

She’ll take a balloon ride over the Serengeti to see migrating wildebeest. She’ll hike Mount Kilimanjaro and will visit one of the world’s largest craters.

And Brown, a 32-year-old Spokane resident, is doing everything she can to make sure the only things she brings back from safari this October are memories and a few souvenirs.

She’s already started getting immunizations against hepatitis, as well as booster shots for tetanus and polio. She’ll be vaccinated against yellow fever and says she’ll take her anti-malarial pills religiously.

The threat of tropical disease would never keep her from traveling, Brown says, but that doesn’t mean she won’t take precautions.

“I do what I can to prevent it,” she says.

Some 80 million people travel from industrialized nations to developing ones each year, according to the World Tourism Organization.

The bad news: Each of those trips carries health risks.

The good news: With the proper planning, many of those risks can be minimized.

Too often, though, travelers don’t consider their health before getting on the plane.

“The biggest mistake they make is not thinking about it,” says Dr. Richard Gower, an internal medicine specialist at the Rockwood Clinic. “The big mistake is they wait too long to come in.”

Hepatitis shots need to be repeated over a span of several months to build immunity. Pills to prevent malaria must be started a week before traveling.

Travelers to exotic locales should start thinking about health concerns six months before they leave, says Dr. Susan Ashley of Spokane Valley Family Medicine.

“A lot of times people will show up a week before they’re going to be leaving,” Ashley says. “All those things can take time.”

There are no one-size-fits-all guidelines for medical precautions when traveling. Advice depends on your destination and your medical history.

Will you be staying in a five-star hotel or in a tent in the desert? Do you have heart disease or asthma or another chronic condition?

“It really just depends on lots of variables,” says Gower, who is also board-certified in allergy, asthma and immunology.

But here is some advice that applies to many travelers, especially those headed to developing countries:

“ Look online, and you can get plenty worried about exotic diseases with scary-sounding names. But the biggest risk while traveling is the least exotic.

“In terms of the health risk, what’s the most common thing that’s likely to occur?” says Dr. Paul Arguin, branch chief for geographic medicine with the Centers for Disease Control and Prevention.

“It’s diarrhea. That’s absolutely by for the No. 1 thing that occurs to people while traveling.”

In fact, travelers’ diarrhea will strike between 20 percent and 50 percent of all international travelers, according to the CDC. The nastiness is generally caused by food or water that has been contaminated by fecal material.

Almost all cases go away by themselves in a week, but that can make for one long week – especially when you’re supposed to be on vacation.

“That can be pretty miserable,” Ashley says.

Ashley often gives patients antibiotics to take if they develop travelers’ diarrhea on their trip. And she recommends that they pack an over-the-counter diarrhea medicine as well.

Brown says her doctor, Dr. Gower, advised her to take several Pepto-Bismol tablets each day she’s in Africa to ward off stomach bugs.

And, of course, people should be smart about the food and water they ingest.

Choose beverages from sealed containers. Pick freshly prepared foods rather than those languishing on the buffet table.

Opt for fruits and vegetables still in their peels as opposed to those that have been handled.

Wash your hands often, and carry hand sanitizer.

“ The leading cause of death while traveling abroad is not disease. It’s actually injury, Arguin says.

“You tend to let your guard down a little bit when you’re traveling,” he says. “Certainly continue to have fun, but be safe when you’re doing it.”

Vacation doesn’t mean a vacation from wearing seat belts or bike helmets, he says.

“ Hepatitis A is the most common vaccine-preventable infection that’s picked up while traveling, Arguin says. The virus spreads through the feces of infected people, which then contaminates water, shellfish, fruits, vegetables and other foods.

The Hepatitis A virus attacks the liver. Illness can last a couple of weeks or several months.

The vaccine needs to be given a couple of weeks before traveling to build up immunity.

“ Think about your medical history while planning your vacation.

“A lot of times people don’t realize how strenuous a trip can be,” says Deborah Alexander, a travel counselor with AAA Travel in Spokane.

Will you be able to handle lots of walking in the hot sun? If not, you may want to reconsider some tour plans.

Also, be sure to pack more than enough of your medications – in your carry-on bag.

“(We) both have escorted groups and have had situations where people have lost medications or not brought enough with them,” says Lori Cox, service center manager with AAA.

“ Don’t forget about your trip once you get home. Your travels should now be part of your medical record.

Gower once saw a teen-age patient with unusual symptoms. It turns out, the boy had malaria.

The diagnosis would have been made sooner if the young man had told Gower of his travels and the fact that he didn’t take his anti-malarial pills.

“If there’s anything that happens within six months of when they come back, make sure they give that travel history to whomever they see,” Gower says.