Pet Passports Make For Easy Travel, Avoid Fines

Pet PassportsHaving a pet passport can speed up and simplify traveling with animals between countries. A typical pet passport will have the microchip or tattoo number of the animal and a complete record of immunizations and vaccinations required for entrance into most countries. While airlines have inspected that document in the past, look for increased scrutiny going forward after one carrier received a hefty fine in a pet passport related incident.

KLM Royal Dutch Airlines has been fined £1,800 (about $2,800) by a UK court for carrying a cat found to be traveling on an invalid pet passport, reports Barry & District News. On top of that, KLM was ordered to pay costs of £3,000 and a victim surcharge of £120.

A pet passport is just one part of the Pet Travel Scheme (PETS), a system that enables animals to travel between member countries without undergoing quarantine. Started in the UK, the PETS program then rolled out to other European Union countries, the United States, Canada, Australia and New Zealand.

In the case of the KLM incident, the Mexican cat’s passport had discrepancies over its identification and, more importantly, its rabies vaccinations. “Without trading standards’ intervention, the possibility of a rabies outbreak could have been catastrophic,” said Principal trading standards officer Christina Roberts-Kinsey.While the PETS program is a step in the right direction, standardization between countries is still a work in progress. To fly, pets need a wellness exam, food in-transit and they, too, will have to go through security at the airport. Companies that specialize in transporting pets like PetRelocation.com have the most current and accurate information.

The PetRelocation.com approach designs a custom plan for each individual pet, satisfying or exceeding the entry requirements of countries around the world. Clients receive their pet‘s flight schedule the week before the flight detailing all of the flight numbers, departure and arrival airports along with the pet’s “Air Way Bill” (or ticket) number. These 24/7 flight tracking instructions keep pet owners informed.

Flying on United? A first-class lounge for pets recently opened at Chicago O’Hare.

Extreme Dog Grooming

Rabies Pre-Exposure Vaccine: Will Not Getting One Come Back To Bite You In The Butt?

dogRecently, a well-traveled friend of mine, whom I’ll call Jules, went to Belize on vacation. While on an idyllic, live-aboard sailing trip, Jules, her husband, and mother decided to explore some cays by sea kayak. What happened next is one of my worst developing nation nightmares.

While poking around what appeared to be an abandoned cay (this is why poking sans guide isn’t recommended, but few true travelers can resist), two semi-feral dogs “jumped out from beneath an overturned rowboat, barking ferociously.” Jules explains, “They were tied up, and we immediately headed back to our kayaks, when we saw a man. He told us the cay was ‘privado (private),’ and I started apologizing in Spanish as we pointed at our kayaks and picked up our pace. The next thing I knew, one of the dogs was let loose, and barreling after us. I started to run, and it bit the back of my right calf.”

The dog released her leg after Jules’ husband waved his arms at it while yelling, “NO, NO, NO, NO!” Then it re-launched itself at her, so she employed the same tactic, and eventually they made their way to their boats and escaped.

As if this story isn’t harrowing enough, the really terrifying part is that they were 10 miles out to sea and had four days left aboard ship. Fortunately, Jules’ mom is a medical professional. Immediately following the attack, she soaked her leg in sea water to flush the wound, then her mom accessed their first-aid kit and cleaned it with hydrogen peroxide, and applied antibiotic ointment. For the remainder of the trip, her mother repeated this procedure, changing the bandages up to three times a day.

dog biteI asked Jules why she didn’t insist upon returning to land immediately and seeking medical treatment.

“That’s an emotionally hard question to answer,” she explained. “The dogs weren’t foaming at the mouth, they didn’t look rabid, but rather in aggressive/protective mode. My mother was on the boat with us and she nursed my wound and kept checking my vital signs for any dangerous symptoms. Luckily, nothing bad came of it. There were no clinics in Placenia where we were, so I made the decision to go to the hospital as soon as I returned home six days later.”

There, she was advised to get rabies shots, which had to be administered through the ER (general practitioners apparently won’t provide them). Jules said the series of four treatments – eight shots the first visit, and one per follow-up – was awful. “I got one in each shoulder, one in each upper thigh, one in my butt, and three directly into the wound. The serum they inject feels thick and made my blood feel sluggish. I couldn’t think clearly and needed to nap every day.” She also wasn’t up-to-date on her tetanus, so that was the first shot she received.

Since Jules is one of the most energetic people I know, the shots really affected her ability to work, and she had to take a number of sick days on top of her two weeks vacation. That, of course, is the least concern in this scenario, and I asked my infectious disease doctor, John Szumowski, a fellow at the University of Washington, what the best course of action would be in such a situation.

“Once a person has symptoms of rabies, there’s little that can be done,” he says. “Only a handful of persons have survived even with intensive care. But the rabies pre-exposure prophylaxis vaccine series is felt to be very effective if administered to a person who doesn’t have symptoms.”

I’ve been telling myself for years that I should get rabies prophylaxis (a series of three recommended vaccinations) because I’m in what’s considered a high-risk group when I travel. I have a lot of exposure to animals, and I spend extended periods in rural areas where a delay in medical evaluation is likely. Thus, it’s a safe generalization to say that most adventure travelers would do well to get the series, even if they’re not animal lovers (for the record, despite my crazy dog/cat lady tendencies, I usually give creatures in developing nations a wide berth for this reason). I know I’m going to do it before my next big trip.

Getting the series, says Dr. Szumowski, “Also allows for a simpler course of post-exposure prophylaxis following a bite: fewer vaccinations and immunoglobin (which may not be readily available or of good quality internationally) isn’t needed. The pre-exposure series is available in travel clinics, but can be easily given in a primary care setting, too. Clinics may not have it immediately available, so calling the office ahead of time is a good idea.”
dog
Dr. Szumowski is quick to point out that getting the pre-exposure series does NOT mean medical evaluation should be skipped after an animal bite. Aside from rabies, bites can transmit other, primarily bacterial, infections. “Thorough cleansing of the bite site is an important step, regardless of vaccination status,” he adds. “Animal bites, even those that took place some time in the past, should be discussed with your medical provider because the incubation period for rabies can be up to years afterward.”

Need more compelling reasons for why adventure travelers should get pre-exposure shots? I’ve witnessed a puppy play-biting (drawing blood) a fellow traveler while we were visiting a Myanmar refugee camp in Thailand. I’ve seen a late-stage rabid dog staggering down the main street of a small village in Ecuador. I’ve been chased down an alleyway by a pack of mangy Vietnamese dogs, and had to scale a fence to escape. Gadling contributor Kyle Ellison has been chased by a dog while going for a run in a developing nation. I’ve been attacked and bitten two separate times by seemingly friendly cats here in the States, and still had to go to the ER, while animal control was required to quarantine and test the animals.

Rabies definitely isn’t limited to developing nations, nor is it restricted to dogs and cats. You should never get to close to wildlife, wherever you may be, for any number of safety reasons. But animals like raccoons, opossums, and bats are also frequent carriers of this deadly disease domestically.

For more information on rabies and other infectious diseases related to travel, the CDC’s Yellow Book is an excellent resource. And don’t let fear of rabies make you paranoid about indulging your fondness for animals when you travel.

Says Jules, “I’m an animal lover, and even after this horribly scary incident, I’ll continue to look for the wagging tails of approaching dogs. This was a minor blip on our trip, and will in no way stop me from continuing to see the world. It’s a part of traveling that makes us stop and re-evaluate taking precautions. We’re very protected in the U.S., and take that for granted. We need to respect the places that we visit and be our own advocates to protect ourselves and fellow travelers. From now on, I’ll also always consider travel insurance when visiting developing nations.”

[Photo credits: German shepherd, Flickr user State Farm; dog bite, Jules; dog, Laurel Miller]

Ask Gadling: You develop a serious illness while traveling

serious illness while travelingThe very thought of acquiring a serious illness or injury while traveling strikes fear into the hearts of even the most stalwart adventurers. Speaking from personal experience, it’s terrifying to find yourself alone (or not) in dodgy accomodations, in a remote area of a developing country, with a raging fever and/or an uncontrollable case of the runs or other unsavory symptoms. Which isn’t to say the same ailments suffered in the comfort of a five-star hotel in Paris are a picnic, either. Any way you slice it, getting sick in a foreign country sucks.

And sometimes, despite taking precautions, you fall ill anyway, as I can attest. It can be a matter of circumstance (That water my guide “boiled” in a bamboo culm on a Thai Hilltribe trek? Yeah, I pretty much saw the resulting case of dysentery coming), or just bad luck. I’ve been on my own during most of my unfortunate on-the-road maladies. Between my experiences and those of fellow travelers, I’ve accumulated some wisdom over the years for dealing with sudden-onset illness in less-than-ideal circumstances.

For the purposes of this article, I’m not going to include injuries, pre-existing conditions, or focus on food poisoning, which was well-covered in a previous Ask Gadling post by Melanie. I also want to stress that we’re not medical professionals here at Gadling, myself included. For the technical stuff, I turned to Dr. John Szumowski, Clinical Fellow of University of Washington Medical Center’s Division of Allergy and Infectious Disease.

After the jump, tips on prevention, what to do when illness strikes, and how to get yourself home in the event of a full-blown medical emergency.

[Photo credit: Flickr user MoHotta18]

serious illness while traveling

Before you leave home

Hit the internet
Do a bit of research on emergency medical options for a worst-case scenario. The U.S. Department of State produces a list of American doctors and hospitals in foreign countries.

If you have specific questions (about, say, where to find the best dentists in Europe), Lonely Planet’s Thorn Tree travel forum can be a useful place to get ideas (please do additional research before following any advice). Take the diagnostic-related questions directed to forum members with a heaping grain of salt, and save them for your doctor.

Get vaccinated
Check the CDC’s (Centers for Disease Control and Prevention) website to see what, if any, vaccinations you need before your trip. You can also get updates on things like outbreaks of cholera or bird flu. Be sure you allow ample time before your trip for the protective effects of vaccines to establish themselves. Dr. Szumowski also recommends the CDC’s “Survival Guide to Safe and Healthy Travel” webpage.

View more Ask Gadling: Travel Advice from an Expert or send your question to ask [at] gadling [dot] com.

Keep an immunization card on you (some countries require proof of certain vaccinations) as well as an online record, like Google Health.

All travelers should get flu and tetanus shots. If you’re a frequent world traveler, get vaccinated for hepatitis A, typhoid, and polio. Depending upon where you’re traveling, you may require a Yellow Fever or Japanese Encephalitis vaccine, or malaria prophylaxis.

I used to think a rabies vaccination was overkill until I saw a fellow traveler get seriously nipped by a puppy we were playing with in a remote village near the Myanmar border. The deathly silence that followed was sufficient motivation. Adds Dr. Szumowski, “It’s still important to remember that excellent wound-care and post-bite medical evaluation are necessary, even if a person has had prior rabies pre-exposure vaccination.” The International Society of Travel Medicine has a list of global travel medicine clinics.

I also carry an EpiPen, because you never know what could trigger anaphylaxis while you’re abroad. It also bears mentioning that you can develop a life-threatening allergy to something previously benign. A chef I know went into anaphylactic shock after tasting one of his dishes containing taro root, even though he’d been cooking with it for over 20 years.

If you get sick

Stay calm, and assess your symtoms
It’s easy to get carried away and assume the worst, but odds are your sudden fever isn’t malaria.
serious illness while traveling
Try to identify the source of infection or illness

Know when to seek professional medical assistance
In general, says Dr. Szumowski, some symptoms or exposures that should prompt “expeditious” medical evaluation include:

  • high fevers (over 101ºF, especially if sustained or accompanied by shaking or drenching sweats)
  • bloody diarrhea
  • inability to keep food or liquids down in situation of significant vomiting or diarrhea
  • confusion or severe headache
  • severe cough, especially if accompanied by shortness of breath
  • animal bite or other animal-related attack

Tips for self-care

Stay hydrated
If you’re vomiting or have diarrhea, stay hydrated with (purified/bottled water), and Gatorade or other electrolyte beverages. If you absolutely have to travel, take Imodium as an anti-diarrheal.

Eat bland foods
Remember the BRAT diet for gastrointestinal upset: rice, bananas, applesauce, and toast.
serious illness while traveling
Control your fever
To lower a high fever, take the recommended dosages of acetaminophen (Tylenol) or ibuprofen (Advil).

Wear ID
Wear a medical alert bracelet for serious conditions, allergies, etc., Write down your condition in your destination country’s language in both your phrasebook, and place a card in your passport.

Emergency Measures

Know when to self-diagnose
Sometimes, you find yourself in a position where you have no other option. That said, this is something you want to avoid for obvious reasons. Says Dr. Szumowski, “Self-diagnosis and treatment can be appropriate for less serious conditions such as traveler’s diarrhea, but it is important not to delay evaluation by a medical professional for more serious illness [see warning signs above]. If someone chooses to self-treat, it’s important to be aware of potential for counterfeit medications locally.”

What if the only available hospital/clinic/doctor’s office is seriously sketchy?
If you’re in a situation where the medical facility is primitive/lacking in sanitation, you’ve got a tough call on your hands.
serious illness while traveling
I posed this question to Dr. Szumowski. He says, “It depends on the acuity and seriousness of the condition. In general, evaluation and treatment in a facility with adequately-trained staff and more comprehensive resources is preferable whenever possible–this may mean seeking evaluation in the capital, at a private hospital, or even returning home. Aside from limited diagnostics and medications, smaller/less-resourced facilities may have inadequate sanitary practices (e.g. reuse of equipment) and screening of blood products, raising the risk of contracting pathogens such as hepatitis C or HIV. Therefore, having evacuation insurance is advisable, especially for extended travels in the developing world.”

In other words, you may be shit out of luck. But this is why you’re reading this article–so you can be prepared for all kinds of situations! Read on.

OTC antibiotics
In many countries, you can buy OTC antibiotics, and indeed, this may be your only option, but heed Dr. Szumowski’s warning, above. Caveat emptor.

If you need to be evacuated, the U.S. government offers financial assistance and/or repatriation loans. The American Citizens Service and Crisis Management (ACS) is linked to U.S. embassies and consulates all over the globe. It’s a good idea to enroll in the U.S. Department of State’s “Smart Traveler Enrollment Program (formerly known as “Traveler Registration)” if you’re traveling for a long period of time, to a high-risk region, or doing any extreme adventure activities.

Travel prepared

Get antibiotic prescriptions (and carry copies with you) from your primary care doctor or internist, or visit a travel medicine clinic, and pack them in you travel first-aid kit (You don’t have one? REI has some great options). Some people also carry sterile latex gloves and hypodermic needles with them. If you’re diabetic or have another condition that requires injections, this makes sense, provided you have a note from your medical provider. For everyone else, this is a personal choice that comes down to, “How comfortable are you with the knowledge that you’re carrying drug paraphernalia?” If you backpack, travel in places with notoriously corrupt law enforcement, or countries like, say, Malaysia, you may want to hedge your bets.
serious illness while traveling
Email yourself and family or a trusted friend copies of medical insurance, itinerary, and a list of medications, and doctors.

Consider traveler’s insurance.

If the worst happens

In the highly unlikely event you do come home with a mystery disease that isn’t responding to medical treatment, get to a specialist, asap. Depending upon where you’ve been, this may be an infectious disease or tropical medicine doctor, a dermatologist or rheumatologist who specializes in tropical medicine, etc.. You may need to travel–out of state–to find the right specialist. Find someone who has first-hand experience traveling/training or practicing in developing countries, and in diagnosing diseases not found in the U.S.. It may even be best to try and seek medical treatment in the country where you became ill (even if that means a return trip).

Unfortunately, I can speak with authority this subject, because I’m in my 22nd month of diagnostics following a trip to South America. If you do find yourself harboring a travel-related (or not) disease that defies diagnosis, you must be your own advocate. No one is more invested in your health than you are, and doctors are human. They may make mistakes, despite their best intentions. Seek not just a second, but a third opinion, from at least two different medical facilities.

And finally, don’t let anything in this article scare you and put you off travel. Odds are, you’ll come home with nothing more than great memories, and the eagerness to plan your next trip. I know I can’t wait.

[Photo credits: vaccination, Flickr user alvi2047; mosquito, Flickr user tonrulkens; toast, Flickr user snowriderguy; farmacia, Flickr user ibirque; drugs, Flickr user cavale]

Monkey attacks: How to avoid them

Reading about Jason Biggs recent experience being attacked by a monkey in Gibraltar reminded me of my own attack by a monkey. Okay, okay, so it only bit me on my thumb. Lightly. The bite barely broke the skin. But, it did give me anxiety later when I had a brief moment of thinking that I had rabies about two weeks after my two-year stint as a Peace Corps volunteer in The Gambia had ended. My thumb was numb and I felt ill.

The doctors in the emergency room in Rochester, New York where I was visiting a friend assured me that I did not have rabies. Whew! But, as Jason’s story illustrates–and my own points out, monkeys can bite and its best to not get them riled up if you happen to be traveling where they live. In my case, the monkey was a young one that had been captured and being kept as a pet in my village. Not by me, but people who I used to visit.

In other cases, the monkeys and people come into contact because the monkeys just happen to live where the people do, like in some sections of New Delhi, India where they can be like squirrels are in the U.S. You may recall the incident in 2007 when the deputy mayor of New Delhi was attacked by monkeys, fell of his balcony, and died the next day as a result of his head injuries. Monkeys also frequent temples in India.

Or in another scenario you may be hiking in monkey territory. Wherever monkeys are, it’s good to know how not to get attacked. There are ways.

1. Don’t put your hand out in a monkey’s direction. I don’t think I put my hand out, but how did that monkey bite my thumb? It’s a blur by now.

2. If you’re carrying food and the monkey wants it, for heavens sake, give it to the monkey. If a monkey comes at you, it’s likely to want what you have in your hand. Friends of mine recounted a tale where a monkey snatched their young daughter’s milk carton right out of her hand when they were at some park in Thailand. I think, they were in Thailand, or perhaps somewhere in Micronesia where they used to live.

3. As a response to number 2, don’t carry food around monkeys if you can avoid it.

Here are other suggestions I found in a World Hum article from last December:

  • Make sure you keep water bottles hidden from a monkey’s view
  • If the monkey thinks you have food, but you don’t, show your empty palms.
  • Stand your ground if a monkey does attack. Show your teeth as a sign of aggression. Showing weakness brings them on.
  • If a monkey shows aggression, i.e, blinks, shows its teeth, yawns or smiles wide, don’t make eye contact and walk away.

This Slate.com article also offers advice if you are attacked.

  • Shake a stick at the monkey, and if that doesn’t work, rap it on the head with the stick.
  • Form an O shape with your mouth, lean forward and raise your eyebrows

For more detailed advice and an explanation of monkey behavior, the World Hum article has excellent information. The post also presents a rundown of where monkeys are most prevalent. Jason Biggs was in one of them. They are:

India, Gibraltar, Thailand, Saudi Arabia and Cape Town, South Africa

Rabies: what to do if you’re bitten

Katerina I were enjoying a beautiful afternoon on a Central American beach, swimming and body surfing the day away. As the sun dipped below the horizon, we finished up with a trip for dinner. In the small town near the restaurant, a man had a pet monkey that he was allowing the tourists to take pictures with for a few bucks. Who doesn’t like monkeys? Of course we went to get a picture with the spider monkey on our shoulder.

Unfortunately, the cute little monkey got excited and bit Katerina on the hand. In that instant, many thoughts flashed through my mind — first and foremost: rabies. After a very close inspection of the wound and a thorough cleaning with soap and water, we saw that the skin was not broken. This, combined with a detailed questioning of the monkey’s handler, made me feel much better about the situation.

Some basic knowledge of rabies, including treatment and prevention, is necessary for any traveler who might come into contact with animals. Rabies is a viral disease carried by warm blooded animals. This is primarily a neurological illness that effects the brain. In North America, bats, raccoons, and skunks are most common carriers. Dogs and cats from all corners of the world are also potential carriers.

Transmitted through saliva, often during a bite, the virus ascends the nerves to the brain. Thus, a bite on the leg will take longer to show effects than, say, a bite to the face. The CDC states that exposure to urine, feces or blood of an infected animal does not constitute an exposure. But an infected animal that licks an open wound can transmit the virus. Symptoms of rabies in humans includes weakness, agitation, fever, headache, and itching at the location of the bite are the most common. A few days later, hyperactivity and hallucinations can occur.

Rabies is a killer, literally. There has been at least one case of a person who had documented rabies and survived, without pre or post exposure treatment. Fortunately, there is an effective treatment if given in time. There’s even a vaccine!

If you’re bitten from an unknown animal, a good, aggressive cleansing with soap and water is first. The next step is to obtain the rabies “shots.” This is a combination of HRIG (Human Rabies Immune Globulin) and HDCV (Human Diploid Cell Vaccine). The first is given as soon as possible after the bite, while the latter is given five times over 30 days.

For those at high risk, such as animal handlers, a vaccine exists. A three shot series, given over 28 days, the pre-exposure vaccine still means you need more injections if bitten. A person who has received the rabies vaccine still requires two addition injections if bitten.

There can be a few problems if bitten in a remote or developing area. Some locations use rabies anti-serum made from duck or horse product, which can cause severe reactions in humans. Of course, this is better than no rabies treatment, but riskier than Human Rabies Immune Globulin. In the event of a bite or exposure in a developing area, notify your consulate and ask where you can get HRIG. Some consulates even stock it, themselves. The International Society of Travel Medicine may also be of help locating a clinic.

Having a game plan is key. Bites often occur unexpectedly and in unprovoked circumstances. This is also an unfortunate complication of a curious child who is raised to not be scared of other animals. If bitten, especially by an unknown animal…seek help immediately.

Resources:

CDC Traveler’s Health Rabies