New Travel Precautions

Cholera in the Dominican Republic. Dengue fever in the Caribbean. Measles in Ukraine.

With summer travel season here, so are new warnings about health hazards in many exotic destinations. Granted, I’m probably more paranoid than the average middle-aged traveler, having been a bone-marrow transplant patient with a weakened immune system. And my idea of adventure travel is anywhere without a Four Seasons hotel. But in developing countries—and even in many developed ones—many travelers over 50 face special concerns, especially if they have chronic health conditions or take medications such as steroids that suppress the immune system.

“We see a lot of people who, after retirement, want to take the trek of a lifetime in Nepal, but it isn’t the same as going to Kansas City, and a lot of them don’t realize this,” says Phyllis Kozarsky, an infectious-disease expert at Emory University and travel health consultant for the Centers for Disease Control and Prevention, both in Atlanta. Many popular areas lack basic medical care, let alone easy access to a local drugstore.

See Your Doctor

Four to six weeks before foreign travel, it’s wise to visit a doctor for recommended vaccines and cautionary medications such as malaria pills and a prescription antibiotic in the event of a bad stomach bug. But it is also important to pack mosquito repellent and other precautions for outdoor activities in areas where malaria, yellow fever and other insect-borne diseases abound—and to stock up on other important items.

“I walk through the aisles of my local pharmacy and carry the things I’d like to have with me in the event of a minor illness,” such as pain relievers and anti-diarrhea medication, says Dr. Kozarsky.

The CDC travel health website has a regularly updated list of health risks and vaccination recommendations and requirements for specific countries. Some clinics use a software program, Travax, which tracks disease risk data. Paul McKinney, developer of the program and medical director of the travel clinic at the University of Louisville in Kentucky, says it also helps identify vaccine requirements for travelers who may be going from one foreign country to another. For example, travelers going to India from the U.S. don’t require a yellow-fever vaccination, but if they are first visiting countries where yellow fever is endemic, India may require them to be vaccinated.

Vaccine Risk

Live vaccines such as the one for yellow fever can be risky for those over 60 or 65, Dr. McKinney warns, because of a higher likelihood of side effects. Patients taking steroids, which lower resistance to viral infection of any kind, are also less likely to have a good response to a vaccine.

It’s also important to be up-to-date on routine vaccinations such as flu and tetanus before leaving the U.S. A shingles vaccine for those over 65 can reduce the chance of being struck with a painful and debilitating case of the virus, which is related to childhood chickenpox. Measles are also a growing concern in Europe, Dr. Kozarsky says. If you’re unsure whether you had measles or a childhood vaccination for it, a blood test can determine if there are antibodies to the disease.

Travelers also need to be careful about organisms that can penetrate the skin while swimming, or bacteria found in drinking water—as well as raw foods such as salad and fresh fruit.

In Case of Emergency…

For the worst-case scenario, it is also a good idea to consider emergency medical evacuation insurance. Before a trip to Russia last year, Marvin Freedman, a retired Justice Department investigator and avid world traveler, bought insurance from MedjetAssist, on the recommendations of some fellow travelers. He admits he was skeptical it could deliver as promised: evacuation to the hospital of his choosing for the $260 plan.

While poking around historic towns in the Golden Ring area outside Moscow, Mr. Freedman picked up a bug that worsened by the time he got to St. Petersburg. Admitted to a hospital there, he was pumped full of antibiotics by doctors who diagnosed a bacterial infection. But he wasn’t getting better, and after a few days placed a call to MedjetAssist, where he was connected to doctors at the University of Pittsburgh Medical Center who determined he needed to be brought home.

The next morning, a Lear Jet with a flight doctor and a nurse arrived to take him on the first leg of a long journey back to Wisconsin. Doctors there determined it was in fact a viral infection—which doesn’t respond to antibiotics—and discontinued the drugs. After making a full recovery, Mr. Freedman says he is undaunted from globe-trotting and already has a journey to India in the planning stages.

Ms. Landro is an assistant managing editor for The Wall Street Journal and writes the paper’s Informed Patient column. She can be reached at

Jun 11th, 2012 | Posted in Web Resources
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