Top five immunizations for adventure travelers

by Laurel Miller on

Spending 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]1. 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.

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;

Ten reasons I thought I had malaria symptoms (but I didn’t)

by Annie Scott on

Sometimes, fear of the worst gets the best of you. That’s what happened to me last week when, having recently traveled to Zambia, I thought I had malaria symptoms. Am I crazy? No. Am I usually a hypochondriac? Not at all — but that’s partially due to the fact that I almost never get sick. As a matter of fact, that’s the issue behind #3.

Ten reasons I thought I had malaria symptoms (but I didn’t)

1. I had been in Zambia.

Pre traveling to Zambia, I went to the doctor to get shots for Hepatitis A and Typhoid (that one hurts like a jerkstore), as well as prescriptions for Cipro and Malarone — a malaria prevention medication. Every travel document I received warned me and rewarned me that I was visiting a “malaria zone,” and I definitely came home with a fair few mosquito bites.

2. I missed a pill. Maybe more.

You have to start taking Malarone a couple days in advance of travel, then take one at the same time every day until seven days after you get back. The pill, like most pills, is not 100 percent effective even if you get it right, but I didn’t get it right. One night, I forgot to take my pill until after dinner (I’d been taking it at 6 and took it at 10), and after I got back, I completely forgot to take one on a Saturday. I read my instructions and they said to just skip it and take the next one at my normal time.

And what? And pray?

3. I got a cold.

Most people wouldn’t think twice about getting a cold, but I am one of those lucky folks who almost never (knock on wood) gets sick. When I developed a fuzzy head and a cough about ten days after getting back, I couldn’t help but think, just in the back of my mind: “Do I have malaria?”

4. I Googled.

As anyone with a computer would, I googled the symptoms for malaria. Our friends at WebMD (I know) informed me that the incubation period could be anywhere from nine days to ten months. Great. Symptoms:

  • Fever.
  • Chills.
  • Headache.
  • Sweats.
  • Fatigue.
  • Nausea and vomiting.
  • Dry (nonproductive) cough.
  • Muscle and/or back pain.
  • Enlarged spleen.

I wasn’t vomiting, didn’t know where my spleen was and hadn’t taken my temperature, but the rest was definitely going on. An even less heartening statement followed: “Symptoms may appear in cycles and may come and go at different intensities and for different lengths of time. But, especially at the beginning of the illness, the symptoms may not follow this typical pattern.”

Great.

5. I slept a ton.

I’m a good sleeper and all, but even after my cold symptoms started to diminish, I was suddenly sleeping like 10 hours per night, and feeling sleepy during the day. Does this happen to everyone now and then? Yes. But it was happening to me, Potential Malaria Victim Annie.

7. I felt “different.”

Perhaps it was psychosomatic, but I couldn’t help feeling that something was wrong. I was probably just still getting over the cold (and coping with the side effects of Nyquil), but I didn’t feel “normal.” I was sleepy, as I mentioned, and woozy and had no energy. This continued until a week after the cold hit. I wasn’t even getting as much work done as I should have been. At this point, I wasn’t sure I had malaria symptoms, but I was keeping an eye on it.

6. I had sudden, outrageous bathroom hell.

I’d been feeling nauseous all day. It had been my husband’s birthday the night before, so I attributed it to being out late, but suddenly, at 3:30 PM on a Tuesday afternoon, I was in the bathroom vomiting. It happened once, then again, and I still wasn’t feeling better. I sent an email cancelling my plans for the night, then was back in the bathroom. By an hour later, I had called my husband at work, sobbing and begging him to come home for fear I was going to pass out and choke on my own vomit. I was really sick. And, as the vomiting had finally come, I was pretty sure I had malaria.

8. I couldn’t move.

Unlike with the flu, during which you get a few minutes of glorious “I feel okay” time after you throw up, I was completely incapacitated. I spent twenty minutes just sitting on the bathroom floor with my cat looking at me pensively. When I finally made it into bed, the phone rang and I couldn’t look to see who it was, because even turning on my side made me dizzy and out of breath. I was obviously suffering from a violent strain of malaria, and probably near death. I lay paralyzed, worrying about my spleen.

9. I had a fever.

My husband came home terrified and immediately gauged that I had a fever (and kindly brought me Cheerios and a bucket). That was it. The final nail in my coffin. Even if I got better, I would have this strain of malaria for the rest of my life, however short that might be.

10. I’m an idiot.

My husband said “I’ve never seen you this sick!” … and that triggered me to think of the last time I’d been so sick. I couldn’t think of any instance, any precedent at all until … oh wait … that time I got food poisoning in London and threw up the second I got to Glasgow for about 18 hours straight. As I ate Cheerios one by one, about an hour later, my fever was gone. Shortly after that, I was eating Cheerios by handfuls.

At last, a far less dizzy me ventured into the restroom and had bathroom hell … the other way. I stepped out concerned that though I felt a little better, I was clearly still sick. My husband smiled and said “Honey, I think you’re in the final stages of food poisoning.”

Oh.

Whoops.

So, after a harrowing food poisoning experience and a completely harmless cold, about two days later, I felt completely fine — and I have felt fine ever since. I write this not just to overshare, but to confess, and to assure you that if you’ve ever convinced yourself you have a possibly fatal disease after traveling, you’re not crazy.

Or, you know, we’re both crazy.

[Photo by James Jordan via Flickr.]

Five conflicting British skin care tips for winter

by Tom Johansmeyer on

Okay, spend less time in the shower … but keep your skin moist. And, stay dry. It’s confusing stuff, right? Well, we’re all used to getting conflicting advice, from employers to religious authorities. So, how do you use it? The best way is to pick and choose what’s most convenient, I’ve found, and just accept the consequences when they (inevitably) come.

Well, winter is around the corner – you’ve probably noticed the air getting a little crisper. It’s always a good idea to think ahead, especially if you want to protect your skin from the cruel cold in the coming weeks and months. I stumbled across the following tips in The Sun, and if you can make sense of them, you’ll be all set when the cold wind starts to blow.

1. Manage your temperature: this shouldn’t be too hard, you know, in winter. Make the inside more like the outside by keeping the heat down. Apparently, this will keep your skin from drying out. If you start to shiver, put on a sweater (or sweatshirt … or smoking jacket).2. Stay stinky: if you smell, you’re doing well. Spend less time in the shower, and don’t allow yourself to enjoy the decadence of hot water. Of course, athletes and laborers can shower as much as they want, along with anyone else who sweats like a pig. The Sun suggests: “shower or bathe every other day and spot-wash trouble-spots such as armpits, hands, feet and face.”

3. But, make sure you stay wet: and this is where the fun begins. Keep the temperature down to stay moist (1), and avoid water by not showering (2). Now, The Sun says, “Keep skin moist.” Check this out:

Try Vaseline Intensive Care’s DermaCare lotion (£2.79 for 200ml). Boots’ skincare adviser Steve Barton says: “Slather it on after a bath or shower, preferably before your skin has dried out entirely, so it can trap moisture in.”

4. Wear protection: if you work with detergents a lot (e.g., dishwasher), you again want to avoid the stuff. Throw on some gloves.

5. Keep the water inside you … and stay dry on the outside: it’s important to stay hydrated. So, even though you want to be moist and dry at the same time, don’t forget to put some fluids inside you. On the outside, particularly your clothing, do your best to keep the water away.

[photo by joshjanssen via Flickr]

The good old days were horrible

by Sean McLachlan on


Ah, Merry Olde England! A time and place with happy people, clean streets, and scenes that looked just like they do on BBC historical dramas.

Not!

Premodern England was a grim place of death, filth, and general misery. Actually that can describe pretty much everywhere in the nineteenth century, but the town where the Brontë sisters lived was especially nasty. Some authors write novels to escape reality, and the Brontë sisters had a lot to escape from. Two of their sisters died in childhood thanks to the neglectful conditions at their boarding school. Then the Grim Reaper took the remaining sisters and their brother one by one.

This may have been due to the horrible health conditions in their town of Haworth, Yorkshire. At a time when all towns were unsanitary, Haworth took the prize. Haworth stands on the side of a steep hill with much of its water supply coming from natural springs near the top. Also near the top of the hill is the town graveyard. So crowded was this graveyard that the coffins were often buried ten deep. Water flowing through the graveyard contaminated the public pumps and ensured a steady supply of more dead bodies, which would rot, seep their juices into the water supply, and start the cycle anew. The Black Bull pub contributed to this by using this spring water to brew its own beer. One wonders what it tasted like.

%Gallery-104759%This wasn’t the only spring in Haworth, but the locals managed to ruin the others by placing open cesspools next to the pumps. Although the connection between cleanliness and health was only imperfectly understood, Patrick Brontë, local clergyman and father of the Brontë sisters, realized a place where 41 percent of the population died before age six had some serious issues. In 1850 he brought in Dr. Benjamin Babbage (son of Charles Babbage, who built the first computer) to make an inspection. Babbage was horrified at what he saw and his damning report of the local squalor made reformers take notice. If it wasn’t for Babbage, Haworth probably wouldn’t get so many tourists. People tend not to like smelling open cesspits and drinking decayed bodies while on vacation.

If natural causes didn’t bump you off, the Haworth poisoner might do it for you. John Sagar ran the local workhouse, the place where the poor were forced by law to live. There they were underfed, overworked, and slept in rat-infested little rooms as a punishment for the cardinal sin of poverty. Sagar was a “short, dark, vulgar-looking man” who only had one arm, which he used to beat his wife Barbara mercilessly. Everyone was too afraid of him to come to her aid. When she finally died it wasn’t by beating, but by arsenic poisoning. Sagar was the obvious suspect. Questions were also raised about the deaths of their nine children. Yet Sagar got off due to lack of evidence, and he lived to the ripe old age of 78, a small miracle considering the conditions of the town. Strangely, his is one of the only graves in the cemetery that shows signs of weathering. Some locals say nature is serving justice where the courts did not.

Links to the eerie past still linger. On some old buildings, strange stone faces stare out onto the street. They look like ancient Celtic stone heads, but researcher John Billingsley says they were a continuing folk magic custom that experienced a rebirth of popularity in the area in the 17th and 19th centuries. They were used to ward off evil, and as late as 1971 a head was placed over the front door of the Old Sun Inn to stop a haunting. It’s said to have worked! If you had witch trouble you could also carve a “W” into your door frame, or put pins into a bullock’s heart and bury it beneath the floorboards. Special witch bottles could be used to trap witches. I’ve seen pinned hearts and witch bottles at the West Highland Museum in Ft. William, Scotland, and the Pitt Rivers Museum in Oxford, so the practice was widespread

With all the death and tourists, it’s not surprising that Haworth is full of ghost stories. Not only did I stay in a haunted hotel room, but every single bar I drank at or restaurant I ate in had a resident ghost. Phantom drinkers, gray ladies, even haunted carriages all prowl Haworth at night. There are deeper mysteries than ghosts, however. Witchcraft and folk magic abounded. Fear of witches was so great that local “cunning man” Old Jack Kay, a contemporary of the Brontës, would lift curses for a price. He also told fortunes and could show you your future spouse in a mirror or bowl of water. He and other “cunning men” brewed cures for the sick. Some were herbal medicine that might have been effective, while others had dubious ingredients. The urine of a red cow supposedly cured cancer. I suppose it would be unscientific to dismiss red cow’s urine as a cure for cancer with testing it, but good luck getting volunteers for the clinical trial.

So the next time you’re in some charming historic locale, think back on how things used to be, and be thankful that they’re not like that anymore!

Don’t miss the rest of my series on Exploring Yorkshire: ghosts, castles, and literature in England’s north.

Coming up next: Hiking the Yorkshire moors!

A special thanks to local historians Steven Wood and Philip Lister for all the great stories that contributed to this article, and all the great ones I couldn’t fit in.


This trip was sponsored by VisitEngland and Welcome to Yorkshire, who would have a lot less to brag about if Dr. Babbage hadn’t fixed a few things.

The hidden danger of restaurant kitchens

by Sean McLachlan on

It’s often the dirtiest thing in the kitchen. Infrequently changed, always moist and often with raw food stuck to it, it’s a breeding ground for bacteria, yet it’s the very thing that diligent kitchen workers use to wipe their food preparation surfaces “clean.”

What is it? The dishcloth or sponge.

A new survey by the UK’s Health Protection Agency has found that a large percentage of dishcloths in restaurant kitchens contain potentially harmful bacteria. The HPA visited 120 kitchens and examined 133 cloths. They found that 86 cloths contained fecal bacteria, 21 had E. coli, 6 had Staphylococcus aureus, and 5 had Listeria. Even worse, 24 had been used both on preparation surfaces for raw meat and ready-to-eat foods.

The HPA warns that even restaurants that disinfect their cloths regularly aren’t doing enough, because simply soaking a cloth in bleach doesn’t remove the tiny food particles that attract bacteria. As soon as the cloth is taken out of the disinfectant, the bacteria start coming back.

So next time you’re in a restaurant, or your own kitchen for that matter, don’t ask how fresh the fish is, ask how fresh the dishcloth is.

[Image courtesy Anna Sacheri]