Stay Healthy While You Travel With Basic Safety Precautions, Internet Tools

Healthy travel is something not talked about much until travelers get sick. Flying commercial airlines, passing through airports or even taking a cab to a hotel in a big city, domestic travelers have the potential to be subjected to a variety of germs. But some basic precautions can reduce your chances of getting sick.

Common sense healthy travel precautions like washing hands frequently, keeping hands away from eyes and face and having a flu shot can help. Being sure to get plenty of rest, water and nutrition can help too. Taking advantage of some online tools can add an extra barrier of protection as well.

The Centers for Disease Control (CDC) has online travel help with their Guide to Safe and Healthy Travel that encourages travelers to be “Proactive, Prepared and Protected when it comes to your health – and the health of others – while you are traveling.” The CDC says learning about your destination, seeing a doctor and considering any health issues before traveling is critical.

Having a travel health kit with remedies for possible illnesses like colds or flu along for the ride is not a bad idea either, especially when traveling to an unfamiliar area. Including bandages, gauze, antiseptic, tweezers, scissors and cotton-tipped applicators can come in handy too.

Thinking of international travel, we can add insect-borne diseases, a threat that received little attention until recently. Now, a new website called the Vector-Borne Disease Airline Importation Risk Tool (VBD-Air) tracks mosquito-borne diseases spread globally by air travel, offering international travelers a source to check possible health risks before flying.

The tool promises those concerned about healthy travel a better definition of airport and airline roles in the transmission and spread of insect‐borne human diseases. Designed from travel data and research done at the University of Florida, Gainesville, the tool asks users to enter an airport, select a disease (currently Dengue, Malaria, Yellow Fever or Chikungunya) and an airport to produce a map

“The researchers note that the global air-travel network has likewise contributed to the spread of serious and deadly diseases including influenza and Severe Acute Respiratory Syndrome (SARS) which are not spread by mosquitoes,” says Larry Greenemeier, associate editor in Scientific American.

The VBD program hopes to be able to identify passengers arriving at any given airport who may need additional screening before being admitted to a country. The data could also be used to warn travelers of areas in the world to avoid.

Even if not planning international travel, with cold and flu season right around the corner, some basic precautions can help travelers avoid picking up an illness along the way. It’s not a souvenir anyone wants to bring home.


[Flickr photo by Wootang01]

Passengers sick again, cruise line cancels sailing

Last weekend nearly 700 passengers, on three different ships, contracted the flu-like Norovirus causing Princess and Royal Caribbean cruise lines to delay departure of this week’s sailing for extensive cleaning. Now, another outbreak on one of the same ships has caused its cancellation, mid-sailing, and an early return to port for even more cleaning.

Princess Cruises Crown Princess was on a seven-night Caribbean cruise when the outbreak occurred and will skip calling at the ports of Curacao and Aruba to come back two days early.

“In consultation with the US Centers for Disease Control (CDC), who has informed us that there are widespread outbreaks of Norovirus occurring in the US, it was agreed that the best course of action to stop the spread of the illness is for the ship to undergo a two-day extensive sanitization,” said Princess Cruises in a statement on their website.

To make that happen, Crown Princess, scheduled to return to Fort Lauderdale on Saturday, February 11 will come back two days early, ending the current sailing on Thursday, February 9th.

Passengers on the current sailing will receive a full refund, assistance re-booking flights if they had been booked through the cruise line as well as hotel accommodations if necessary and 25% of what they paid as a credit to use on a future cruise.”On the current sailing 114 passengers (3.70% out of 3,078) and 59 crew (5.01% of 1,178) have reported gastrointestinal illness,” said Princess. On the previous cruise, 364 passengers (11.73% of 3,103) and 30 crew (2.57% of 1,168) were affected.

The move by Princess is unusual but not unprecedented. Norovirus, which causes vomiting and diarrhea, is a common illness that is easily transmitted in closed environments like nursing homes, schools and cruise ships.


Photo: Princess Cruises

Ten bizarre travel diseases that can ruin your next vacation

On 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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Knocked up abroad: pregnant travel in the first trimester

For more on pregnant travel, see parts 1 and 2 of Knocked up abroad: pregnancy in a foreign country here and here.

There’s no question that having a baby changes you: your body, your lifestyle, even your shoe size. One thing I hoped not to change altogether was traveling, as long as it was reasonably safe and comfortable for me and the baby. From the beginning of my pregnancy in Istanbul, my doctor has okayed travel, as long as I get up to stretch frequently on flights and try not to overdo it. Most doctors (and mothers) agree that the second trimester is the most comfortable time for pregnant travel but the first trimester can be a good time as well (while you can still squeeze into pre-maternity clothes and walk without waddling) with a little extra precaution and a little more babying (of the mother, of course).


The first trimester of pregnancy is a tricky time for many women: the risk of miscarriage is highest up to 10 weeks, morning sickness is common, and hormones are running wild. It’s too early to tell anyone outside family or close friends and without a visible belly, it’s impossible for strangers to tell as well. At later points in your pregnancy, a baby bump acts as the international symbol for pregnancy and can make it much easier to express your condition when traveling abroad. If you travel in the early months before showing, you may want to learn the local language words for “I’m pregnant” to avoid a Bridget Jones-esque “mit kinder” scene if you need extra help while traveling.


Over this past December, my husband and I were looking for a good trip to take over the holidays, when I was around 10 weeks pregnant. Our location in Istanbul changes the list of short-haul destinations considerably from what we would have considered from New York, and we debated between a warm-weather beach destination (husband) or a snowy and “Christmassy” European city (me). We ruled out Egypt (not warm enough and not Christmassy), New Zealand (even less convenient to get to than from New York), and Sri Lanka (not enough time to plan properly and some risks of disease I couldn’t be vaccinated against). In the end, we chose…Russia.
Going to Russia in winter while pregnant may seem crazy to some, but for me it made sense: Moscow and St. Petersburg are a few hours from Istanbul by direct flight, my husband speaks fluent Russian in case of any problems, and there was no risk of malaria or eating any food that had spoiled in the sun. While it was cold and snowing during our trip and I couldn’t take advantage of some of Russia’s cold-weather remedies like vodka and saunas, a week in Moscow and St. Petersburg was a perfect mix of exotic and comfortable.

Nearly every cafe had a variety of non-alcoholic and caffeine-free beverages for me to choose from, I even had non-alcoholic sangria, mojitos, and mulled wine in addition to fresh juices and herbal teas. Both cities are beautiful to explore in the snow, with plenty of museums and cafes to warm up in, and the New Year holiday displays made it festive.

If you are planning a trip to a foreign country while pregnant, it makes sense to keep in mind the following guidelines. Always discuss plans with your doctor before booking and err on the side of caution when choosing a destination.

Check airline restrictions – Most airlines allow pregnant women to fly internationally up to 28 weeks, after which you must provide a doctor’s note issued within a week or so of departure. 35 weeks (earlier for women carrying multiples) is the cutoff for nearly all airlines to prevent women from giving birth on board. Most US domestic carriers will allow pregnant women to fly up to the final month; hilariously, Continental will not let women board if “physical signs of labor are present” though they don’t specify what.

Consider travel insurance – If your medical insurance doesn’t cover you overseas, you may want to look into supplementary medical travel insurance, but be sure it covers pregnancy as many policies do not. Additionally, if you are traveling to a country where English is not spoken, you may want to research the name of a clinic or doctor in case of emergency as well.

Be prepared for jet lag – Before pregnancy, I had little issues with jet lag, trying to get on local time as soon as possible. I discovered when flying back from the US to Turkey that it hits you much harder as a pregnant traveler, especially as you can’t use sleeping pills or alcohol to help you sleep. Factor this into your schedule and give yourself plenty of time to acclimate and adjust to time changes.

Realize your limits have changed – On a usual trip, I’d be up early to walk around a city all day, have a late lunch (or maybe just a big afternoon beer) followed by more museums and exploration, and still be up for checking out the local nightlife. Once pregnant, I required more sleep and three solid meals a day (plus maybe some snacks, I am eating for two!), tired after walking short distances, and was ready to call it a night long before last call. If you have an itinerary, pare it down to the must-sees and double the time to see everything; better to take it easy and enjoy your trip than feel exhausted and sick.

Look for destinations that don’t require vaccinations – One of the first tests your doctor will give you after confirming pregnancy will be for immunizations to hepatitis and rubella. If you haven’t had the vaccines, they will have to wait until after the baby is born as they are not safe for pregnant women. I have not had the hepatitis vaccine yet, and thus have a greater risk of contracting it, which rules out much of Africa and southeast Asia for travel, but also means I must avoid raw vegetables including salad in Istanbul. Most other medications and vaccines commonly given to travelers before going to an area prone to Malaria, Typhoid or Yellow Fever are not advised for pregnant women. But there’s still a big world out there, check the CDC for destination-specific information.

Be extra aware of food and water safety – Pregnant women are more susceptible to food poisoning the average person, as the immune system is suppressed so it doesn’t reject the fetus. This is the reason most pregnant women are told to avoid sushi and food that is not prepared in sanitized conditions. Even adventurous eaters should play it safe while pregnant and drink bottled water when in doubt. I recently had an opportunity to visit Mumbai, India but after consulting with a few friends who had lived there, I worried I’d spend the trip inside my hotel room eating pre-packaged food. Again,

check the CDC and use the same common sense you’d use anytime while traveling: stick with food that is freshly prepared in restaurants full of people.


Stay tuned for more on pregnancy travel, including Turkish superstitions and customs, travelling in the second trimester, where to do pre-baby shopping, and more on having a baby in a foreign country. Check here for further updates.

[Photo courtesy Mike Barish from the Istanbul tram]

Measles infected passenger puts five airports on alert

Health officials have issued a warning to passengers and airport workers at five cities after a 27 year old woman flew from London to New Mexico infected with measles.

She had not been immunized for the disease and arrived in Albuquerque quite ill.

The Centers for Disease Control and Prevention are working with the airlines to notify all passengers who were seated in her vicinity on the plane, but there are plenty of other opportunities to catch what she was traveling with.

Anyone that was within five rows of the woman is at risk of catching measles. Most people are immunized for measles at an early age, but those who did not receive the shot are now especially at risk, including babies and pregnant women.

The routes the infected passenger flew on are:

February 20 – London – Washington Dulles
February 22 – Baltimore – Denver
February 22 – Denver – Albuquerque

The CDC recommends that if you were on any of these flights you contact your family doctor. Symptoms include a runny nose, small red spots all over the body and a fever. If left untreated, the disease could lead to ear infections, pneumonia or even death.