From the “Travel Medicine “ site at: http://www.travmed.com/
Before departure, your doctor should do the following, where appropriate:
- Review your medical history
medications, and alter current
therapy for travel when necessary.
- Review your travel itinerary in order to advise you regarding the prevention of medical problems. See “The World Medical Guide” below.
- Administer immunizations, as indicated, and complete the International Certificate of Vaccination for yellow fever (if administered) and for cholera (if necessary) to avoid possible border crossing problems.
- Review measures to prevent travelers’ diarrhea, hepatitis, motion sickness, and acute mountain sickness.
- Review methods to prevent insect bites, emphasizing the use of DEET repellents, permethrin, bednets, and insecticide room sprays.
- Prescribe medication to treat travelers’ diarrhea, motion sickness, and other possible problems.
- Perform a physical examination, if there are underlying health
concerns for which an examination would be appropriate. Perform appropriate testing.
for exposure to tuberculosis by administering a PPD skin test if you are traveling for a prolonged period to a risk area. Repeat PPD on return.
- Prescribe drugs for malaria prophylaxis, review the symptoms of malaria, and prescribe, if appropriate, drugs for the emergency
self-treatment of malaria.
The World Medical Guide
lists disease risk advisories for more than 200 regions and countries as well as entry requirements and embassy information.
Preparation Checklist for Medical and Personal Care Items
Use the following checklist as a general guideline and modify it according to your itinerary and specific travel and health needs. A nylon or canvas
pack or a first aid kit are useful for carrying medications and other health care
items. Any medical kit containing medications should be in your "carry-on" baggage so access during travel is not a problem.
Adequate supply of your prescription medications. Carry copies of your prescriptions by generic names. How much of each medication will you need for the duration of your trip? If you will be living abroad, or traveling extensively, will you need to refill prescriptions? Check local availability of medications, but also remember this: in some developing countries, regionally manufactured drugs may be substandard. Therefore, it may be necessary to carry a full supply of crucial medications, such as heart drugs, for the entire trip-or make arrangements for additional drugs to be shipped to you.
Antibiotics for treating travelers' diarrhea-Quinolone antibiotics are the most effective and include ofloxacin (Floxin), levofloxacin (Levaquin), ciprofloxacin (Cipro) and nalidixic acid (Negram). Azithromycin (Zithromax), furazolidone (Furoxone), and cefixime (Suprax) are the best alternatives; the last four are available in liquid form and thus more easily taken by children
Antibiotics for emergency self-treatment of other infections—Levofloxacin is effective against sinusitis, some pneumonias, acute bacterial exacerbations of chronic bronchitis, urinary tract infections, typhoid fever, uncomplicated skin infections, and uncomplicated pelvic inflammatory disease due to gonorrhea and chlamydia. If you have to carry only one antibiotic, levofloxacin is the best choice because of its broader spectrum of activity. Azithromycin is a good alternative multi-purpose antibiotic for travel.
Loperamide (Imodium-AD)—Use to treat mild travelers' diarrhea, or use in combination with an antibiotic to treat more severe diarrhea.
Antimalarial drugs (depending on itinerary, length of stay, etc.)—chloroquine (Aralen), mefloquine (Lariam), atovaquone/proguanil (Malarone), primaquine, or doxycycline.
Medical kit—Carry at least a basic kit that contains a thermometer, Band-Aids and wound dressings, an antibiotic ointment, scissors, tape, and other supplies to treat an abrasion, minor laceration, minor burn, etc.
Oral rehydration salts (e.g., CeraLyte) to prevent or treat dehydration caused by diarrhea.
1-liter plastic water bottle-for storing water or oral rehydration solution.
Epinephrine kit—If you have a history
of severe bee sting reactions or severe food
or drug allergies, have your doctor prescribe an emergency epinephrine self-injection kit (Ana-Kit® or Epi-Pen®). Be sure you learn how to use it before you travel.
Sterile needle/syringe kit—recommended for travel to countries where hepatitis B and C and HIV transmission
are potential threats and where local medical care is substandard and the sterility and safety
of medical supplies are questionable.
Analgesics—such as ibuprofen or acetaminophen, or the newer antiinflammatory drugs, rofecoxid (Vioxx) and celecoxib (Celebrex). Tylenol with codeine is an effective pain medication and also has anti-diarrheal properties. Aspirin can lose potency when exposed to humidity and heat. Acetaminophen (Tylenol) is not affected by these conditions.
Antacids—such as Maalox or Mylanta.
Cathartics and/or stool softeners since constipation is not uncommon, especially in the elderly.
Pepto-Bismol—can be used to prevent or treat diarrhea.
Motion/sea sickness drugs—TransDerm Scop patch (for sea sickness), SCOPACE (scopolamine tablets), Dramamine, Phenergan.
Drugs for acute mountain sickness (acetazolamide, dexamethasone) should be considered for all trekkers to Nepal and other high-altitude destinations.
Jet lag—Melatonin and sleeping pills (e.g., triazolam) are helpful for some people. Temazepan (Restoril), zolpidem (Ambien), and zaleplon (Sonata) may have fewer side effects than Halcion (triazolam).
Antibiotic eye drops (e.g., Ciloxan) should be carried by contact-lens wearers. An untreated infected corneal ulcer can cause serious eye damage.
Nasal decongestant spray—Afrin or Neo-Synephrine (short-term use only).
EarPlanes—Pressure-regulating ear plugs will reduce pain associated with air travel. Especially recommended if you have trouble clearing your nasal passages.
Antihistamine tablets—for allergic reactions and rhinitis (hay fever). Consider Zyrtec or Claritin-D—they are long-acting and nonsedating.
Vosol solution—to prevent or treat swimmer's ear.
Corticosteroid cream—such as Cortaid, or Topicort by prescription.
Antifungal skin and foot cream—Lotrisone and Nizoral are good choices.
Antifungal tablets—A single
, oral 150-mg tablet of fluconazole (Diflucan) will eradicate a vaginal yeast infection.
Extra pair of prescription glasses or contact lenses. Copy of lens prescription.
The drugs listed in this section are among the most important for preventing or treating many travel-related illnesses (e.g., malaria, travelers' diarrhea, and acute mountain sickness).