5 Flu Season Travel Essentials

flu shotWe all know that airplanes double as mobile petri dishes. But with a particularly nasty flu epidemic upon us, the Gadling team thought we’d mother you by reminding you to get your flu shot, already. That, and bring along these proven deterrents to the flu and other airborne nastiness. Look at it this way: it can’t hurt.

1. Airborne or Emergen-C: If nothing else, these will shorten the duration and symptoms of an oncoming bout of cold or flu, if taken regularly at onset of symptoms. You can also talk to your travel doctor or primary care provider about prophylactic immune supplements (be wary of homeopathic or naturopathic preparations, which may not be FDA-approved, or could interact with prescription drugs you may be taking. Always talk to your pharmacist, first.).

2. Travel pillow: Need another reason? Because sharing leftover drool from an airline pillow is gross. While you’re at it, pack a lightweight blanket or shawl; if you are coming down with something, it will ward off the chills. And god knows your airline won’t supply you with one.

3. Ibuprofen: Being crammed into a seat is uncomfortable enough without adding fever aches to the mix.

3. Packet of antibacterial wipes: This time of year, it’s a good idea to wipe down airline bathroom faucets, your tray table, and possibly that runny-nosed, coughing toddler seated next to you.

4. Hand Sanitizer: Travelers should always be in the habit of carrying this, in lieu of soap and water. Use it after touching ATM’s, airline check-in screens, elevator buttons and money.

[Photo credit: Flickr user @alviseni]

MRSA, MRSA Me: How To Avoid A Community-Acquired Staph Infection

mrsaIf you’re at all squeamish, just skip the below paragraph. Look away. Look away!

Last Thursday, while a surgeon was lancing my second ginormous skin abscess in six weeks, I found myself thinking, “WTF?” I’d never had an abscess in my life until moving back to Colorado three months ago. In September, I required an emergency room visit, and this time I ran a fever and suffered muscle and joint pain.

I wasn’t truly concerned, however, until my doctor informed me that I have MRSA (Methicillin-Resistant Staphylococcus aureus; pronounced “mur-sah“). “I hope it’s not MRSA,” my mother had fretted back in September, when I told her about my first abscess. “How on earth would I get that?” I scoffed. I think I actually snorted before I said it. Payback is a bitch.

Much has been made of MRSA in recent years, with good reason. The over- and improper use of antibiotics has created a super-strain of Staphylococcus aureus that’s the bane of hospitals, in particular. Also at higher risk are the elderly and immunocompromised, although healthy people (presumably, me) can get MRSA, as well. And unfortunately, once you’ve had MRSA, you’re more likely to have future occurrences.

Staph normally lives on human skin and in the nose, but it’s capable of surviving on surfaces from hours to months, depending upon conditions. Untreated, MRSA can be extremely serious, resulting in blood infections; even death. Antibiotics aren’t always successful at treating even regular staph, because they often can’t penetrate deep enough within the tissue to reach an abscess. That’s why incision-and-drainage (I & D) is critical if you have a large abscess.

The fact is, most healthy people aren’t going to get MRSA, because their immune system will prevent it. Repeat: You don’t need to wear a Hazmat suit in public, or stockpile Purell. I’m a firm believer that our society’s anti-bacterial-everything obsession is a leading cause of superbugs like MRSA, and many researchers and members of the medical community agree.

This time of year, however, stress, holiday fun fatigue and travel make our bodies more susceptible to germs, be they the common cold, flu or staph. Additionally, there are two types of MRSA: HA (Hospital-Acquired), and CA (Community-Acquired). Obviously, it’s the latter that affects the general population.purellCA-MRSA can enter body through prolonged skin-on-skin contact (it’s not considered a sexually transmitted disease, however); a cut, nick, scrape or puncture, or via contaminated items like towels, razors, gym equipment or clothing. Although not considered a threat to travelers, per se, crowded conditions on public transit can potentially be a source of infection, particularly if you’re high-risk (MRSA can also be transmitted via coughing if the person’s lungs are infected). Some people are merely carriers of the bacteria, and never suffer symptoms.

I think I’ve become susceptible to MRSA for two reasons. I recently learned that those with eczema (aka, me) are more prone to staph infections, due to breaks in the skin. Since relocating back to Colorado, the dry climate has kickstarted my dormant eczema.

I also have a somewhat overactive immune system, the result of a serious infectious disease I acquired in Ecuador nearly four years ago. So, although it goes against my dirtbag backpacker “a little dirt/roaches/mouse turds/undercooked chicken/filthy hands will make my immune system stronger” credo, I’ve learned to carry a large stash of Purell. I’m also vigilant about hand washing, and wiping down gym equipment. I prepare for long-haul flights by swilling Emergen-C before and after. That’s what made my MRSA diagnosis so surprising.

Now that I’m on the right antibiotics, I’m fine, but I’ve stepped up the precautionary measures. My infectious disease doctor suggested I buy some OTC chlorhexidrine cleanser – Hibiclens is a popular brand – for the shower. I’ve accepted that I need to do laundry even more frequently (gym clothes, for example, should be washed after every wearing if you have MRSA). Bed linens must be changed with monotonous frequency. But, you know what they say: a gallon of Purell is worth not spending a day in the ER.

For information on MRSA symptoms, treatment and prevention, click here.

[Photo credits: staph, Flickr user mollyluise;passenger, Flickr user miss karen]

Ten bizarre travel diseases that can ruin your next vacation

travel diseasesOn some level, catching a weird disease or picking up a little-known tropical parasite on your travels gives you bragging rights. “Look at me, I’m so hardcore!” Trust me, I’ve been there. But with Multidrug-Resistant Tuberculosis (MDR TB) making headlines worldwide, I’d like to remind fellow travelers that these diseases are no joke, and even those of us with healthy immune systems and access to industrialized medicine aren’t impervious.

The reality is, you never know what you might be susceptible to. In my case, my doctors and medical research indicate that I may be lacking an enzyme that made me vulnerable to an extremely rare but serious tropical disease caused by the bacteria Bartonella bacilliformis, which causes Oroya Fever (and its precursor, Verruga Peruana). I’m still recovering from a three-year battle with the disease that has resulted in permanent organ damage because of a failure to protect myself against sand flies in the Amazon Basin region of Ecuador. Regular applications of DEET could have prevented that, as well as the various misdiagnoses of tuberculosis, histoplasmosis, and Hodgkin’s lymphoma, but that’s another story.

A lot of tropical and uncommon travel-related ailments are difficult to diagnose, and sometimes even more problematic to cure (if they don’t kill you, first). Statistically, however, most travelers–even if they’re in extremely sketchy parts of the world–will stay healthy if they take the necessary precautions. Having a trustworthy travel doctor is also helpful if you spend a lot of time in developing nations.
Being prepared before you leave home is key. You should never take travel wellness lightly, but don’t let fear ruin your trip. I certainly don’t follow every bit of medical advice out there (I honestly don’t see the point of traveling if not to eat epic quantities of street food.). If you’re going to be completely paranoid and don’t own a Hazmat suit, perhaps it’s better to stay home. But don’t ignore CDC warnings for recommended (or required) vaccinations, and if you know you’re going to be in a malarial or otherwise-dangerous insect-or-disease-inhabited region, prepare accordingly.

Just remember to do your research before you go, and remember that while it most likely won’t happen to you, it’s not impossible.

After the video (graphic, but it illustrates just how devastating TB can be, as well as provides important information on Multidrug-Resistant Tuberculosis), a gallery of bizarre diseases you’ll want to avoid during your travels.


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Top five things to look for in a travel doctor, and why you should have one

travel doctorsDespite writing about food and adventure travel for a living, I used to be somewhat blasé about the concept of travel medicine. Multiple incidents of Giardia/dysentery/traveler’s diarrhea/full-body outbreaks of mosquito and sand fly bites just taught me to carry a serious stash of antibiotics in my first-aid kit. At least I’ve always been conscientious about travel immunizations and educating myself about the primary diseases indigenous to my destination.

When you’re young and healthy, it seems silly to have a travel medicine specialist. Although this article is primarily directed at adventure travelers, odds are, the worst thing you’ll come home with is a backpack full of crappy souvenirs. But no one’s invincible, and should you require a specialist for something not responding to conventional treatment or with progressive symptoms, time is of the essence. Many “exotic” diseases progress rapidly, and can cause irreversible damage or death if not properly diagnosed and treated. Even with incurable diseases, the earlier you catch them, the easier it will be to manage symptoms and prevent them for worsening.

No, I’m not a doctor, although I come from a medical family. But I got seriously schooled after visiting Ecuador two years ago. After a fantastic month of adventure activities in remote parts of the Andes and Amazon Basin, I fell seriously ill the last day my trip. Two years of at-times crippling symptoms, 10 CT scans, five medical facilities, dozens of specialists, four surgical procedures, two surgeries, one cancer diagnosis, and near-medical bankruptcy later, I’ve become an expert at being my own advocate.

My infectious disease doctor believes that I contracted a form of bartonellosis called Oroya Fever after being bitten by sand flies. The good news: My health is currently stable, but we don’t know if the disease is in remission or not. But I have permanent cognitive damage, scarring or tumors on most of my internal organs, and intermittent arthritis. But believe me, I feel lucky.

I don’t want anyone to go through the health and medical nightmare I’ve endured, so I’ve compiled a list of essentials in a travel medicine doctor. Ergo, number one with a bullet:

1. Is he/she a travel or tropical medicine specialist?
Pre-bartonella, I used an internist as my GP/prescriber of antibiotics. If you can find an internist, gastroenterologist, or infectious disease doctor who is also a specialist in travel medicine, that’s a huge plus.travel doctors 2. Does he/she have personal experience traveling or practicing in developing nations?
There are a lot of practicioners who aren’t globally aware, so to speak. You can’t diagnose what you don’t understand, know about, or have first-hand experience with. Period.

3. Is he/she a good listener and empathetic?
It’s difficult to find these qualities in any doctor, especially in today’s medical climate. But it’s imperative to find someone you can communicate with, and who understands what you’re going through if you’re suffering from a mystery travel ailment. Don’t settle, even if you need to travel to another state or country to seek treatment (what stumps doctors here is often commonplace in the country of origin).

4. Does he/she have a good network of colleagues in multiple specialties (including travel/tropical medicine) to consult for additional opinions?
My current mantra is to seek a third opinion, from at least two different medical facilities. That, and to have a travel physician who actively consults colleagues and does additional research to assist with a diagnosis and/or treatment. My infectious disease doctor talked to specialists at a medical school in Peru on my behalf, and even tracked down a relevant medical paper from 1897 as he honed in on a diagnosis. And while I wouldn’t consider it a deal-breaker if the answer is no, see if your doctor is an active and participating member of the International Society of Travel Medicine.
travel doctors
5. Does he/she return your calls/provide you with email, pager, or office number so you can get in touch directly?
I’ve learned that a good doctor who is invested in your recovery will provide an open line of contact to address questions, concerns, and exchange pertinent information. Tip: Please don’t abuse this privilege. Physicians work insanely long hours, under constant stress. And don’t expect to hear back immediately if you leave a non-urgent message; be realistic. A couple of days, fine (many specialists aren’t in clinic every day). A week? Make a polite follow-up.

Whether or not you end up getting a travel doctor, the International Association for Medical Assistance to Travelers (IAMAT) provides loads of useful information, including a directory of global travel medicine clinics with English-speaking staff, and a destination-specific travel health planner. And depending upon what you plan to do on your trip, where you’re traveling, and your financial situation, you may want to invest in travel insurance.

[Photo credits: blood transfusion, Flickr user CarynNL;patient, Flickr user kk+; legs, Laurel Miller]

The Ultimate Travel First Aid Kit

Top five immunizations for adventure travelers

immunizationsSpending a lot of money to get poked with a needle may not be at the top of your pre-trip to-do list, but it should be. While some countries require proof of certain immunizations before they theoretically permit entry (details later in this post), there are a couple of vaccinations all travelers should get, barring any prohibitive allergies.

Getting vaccinated greatly reduces or virtually eliminates the odds of contracting certain serious illnesses or travel-related diseases, and helps prevent the spread of contagions. This is especially critical in developing countries, where there is generally little in the way of preventative or active health care, and lack of sanitation provides a fertile breeding ground for disease. As is true at home, infants, children, the elderly, and immuno-compromised are at greatest risk.

I consulted with Dr. John Szumowski, Clinical Fellow of the University of Washington Medical Center’s Division of Allergy and Infectious Disease, for expert advice before compiling the following list. As he pointed out, it’s tricky to generalize which immunizations are most important, since it depends upon where you’re going, and what you’re doing there.

That said, all of the immunizations on this list are a good idea if you travel frequently to developing nations, even if it’s for business or budget travel. They are especially important to have if you eat street food or visit rural areas.

The top five, after the jump.

[Photo credit: Flickr user johnnyalive]immunizations1. Flu
With flu epidemics making annual headlines, there’s no reason not to get a flu shot. This is especially true if you fly frequently or use other forms of public transit. Think of an airplane as a flying petri dish; why risk ruining your trip, or exposing others if you’re coming down with something? If you have an underlying health condition such as asthma, diabetes, or other lung or heart disease, it’s of particular importance to get immunized.

2. Tetanus
I grew up on a ranch, so tetanus shots have always been a part of my life. Many people don’t think about getting a tetanus vaccine, however, and as Dr. Szumowski points out, “It’s under-appreciated, and worth getting prior to travel given challenges of obtaining adequate, timely wound care.” Beats lockjaw, any day.

3. Hepatitis A
“Hepatitis A is common and can occasionally be quite serious,” cautions Dr. Szumowski. “For anyone with underlying liver disease (e.g. chronic hepatitis B or C) this is an especially important vaccination.”

4. Polio
Polio hasn’t been fully eradicated in parts of the developing world, so an inactivated poliovirus booster is important when traveling to areas where it’s still a problem, such as Nigeria and India.
immunizations
5. Typhoid
This vaccine can be taken either orally or by injection. Be aware that you must avoid mefloquine (an anti-malarial) or antibiotics within 24 hours of the vaccine doses.

Additional vaccines
Depending upon your destination, you may also require, by law, a Yellow Fever (tropical South America and sub-Saharan Africa), or Japanese Encephalitis/JE vaccination (parts of Asia and the Western Pacific). Dr. Szumowski recommends JE vaccine if you’re traveling for an extended (over one month) period in rural areas of affected countries.

Rabies vaccine isn’t usually recommended, but if you travel extensively in developing nations or have/expect frequent contact with animals, it’s a good idea. I’ve had a couple of canine-related experiences that have sold me on the idea. Dr. Szumowski notes that “excellent wound care and post-bite medical evaluation are still needed,” even if you’ve had a rabies pre-exposure vaccination.

Tips
It’s critical to allow ample time before your trip to allow the protective effects of the vaccines to establish themselves. Go to the Centers for Disease Control and Prevention’s vaccinations page for more information on what’s required and epidemic updates, if applicable. Often, your GP, internist, or local drugstore can provide some of these vaccinations; others require a specialist. For locations of a travel medicine clinic near you, click here.

Carry your immunization card with you as proof of vaccination, and email yourself a scanned copy, as well. The same goes for copies of your medical insurance cards.

Practice good hygiene and get enough rest, inasmuch as possible, while traveling, to maintain a healthy immune system. Airborne and Emergen-C are great immunoboosters to carry with you.

Consider travel insurance if you’ll be in a remote or sketchy area, or engaging in high-risk outdoor pursuits.

[Photo credits: swine flu, Flickr user ALTO CONTRASTE Edgar AVG. (away); polio, Flickr user Cambodia Trust;