"CUIDADO - DENGUE!" The signs warning people about dengue fever were posted everywhere around Managua, Nicaragua, making me extremely anxious after I had gotten several mosquito bites. However, other expats living in the country didn't seem very concerned, despite each knowing at least one person who had this dreaded illness that causes high fevers and aching, painful joints. Was I being overly concerned, or were they living with a false sense of security?
With globalization, there has been a huge increase in the number of people working abroad and traveling frequently. One of the main concerns people express before accepting an overseas assignment is safety for themselves and their families. Security and crime are obvious issues, but health affects everyday life. Everyday, expats struggle to find ways to eat, drink and live while keeping themselves disease-free.
The Biggest Risks
"Without a doubt, the biggest health threat to travelers is diarrhea," says one individual who frequently travels to remote countries. This may be due not only to poor hygiene, but also to change in diet and stress. Food poisoning is another issue, especially with fish and meat products. One traveler told me he has gotten food poisoning a few times and was fairly certain tainted or undercooked meat was the culprit. Some people take vitamins, others frequently apply waterless antibacterial soap gel, and others eat only in restaurants that cater to an international clientele.
How else can you protect yourself from food and water-related illness? Of course, it is common wisdom not to eat food sold on buses or on the street from local vendors. Travelers are also often advised to drink and brush their teeth only with bottled water and to avoid salads and unpeeled fruits. If you cannot get bottled water, you can purify your own by adding a drop or two of chlorine bleach per liter of water and waiting 20 minutes. It is recommended to wash fruits and vegetables in chlorine water too.
The Center for Disease Control's National Center for Infectious Diseases (CDC) has excellent information for travelers, including facts on specific regions and countries, information on outbreaks of various diseases, tips for traveling with children or special needs travelers (pregnant women, individuals with HIV, etc.), details on recommended vaccinations, and many useful links.
Other Health Issues for Travelers
The Sun: If you are going to a tropical climate, it is important to be very careful of the sun. Individuals will burn very easily without protection, and heat stroke can be even more dangerous. Travelers are advised to use a sunscreen, avoid the sun during peak hours, drink plenty of fluids and avoid alcohol while in a hot climate.
Altitude: Traveling to very high altitudes can result in headaches, dizziness, shortness of breath and even insomnia. It can be particularly difficult for the elderly and young children, and even dangerous for those with cardiac or pulmonary conditions. Travelers should take it easy for a few days to allow their bodies to accommodate to the change in altitude, drink plenty of water and avoid alcohol or strenuous activity.
Insects: Mosquitoes are the main culprit here, transmitting diseases such as malaria, dengue fever, yellow fever and viral encephalitis. It is important to check your destination's conditions to see if a malaria prophylaxis or a mosquito net is advised.
Sometimes cities are safer than rural areas, but this is not always the case. According to Brad Cronk, a former US Peace Corps Volunteer in Nicaragua, "Mosquitoes weren't really a problem in the mountains due to [high] elevations and plenty of wind. However, in town, we slept under mosquito nets, turned on fans, used Cutter's containing about 27-40 percent DEET and, when necessary, wore long light pants." He went on to note that in Central America, long pants are more culturally appropriate anyway.
In other countries, certain flies, ticks and biting insects can be dangerous, even fatal. Be sure to check with the World Health Organization or CDC for specific country information.
Blood Transfusions: One individual who has worked in Africa notes the importance of preparing for a possible emergency that could involve a blood transfusion. He says it is important to investigate where to go (hospital, embassy, etc.) to find access to safe blood that has been tested for HIV.
Be sure to research the country you are visiting, learn about vaccinations in time to receive them so they are effective, and familiarize yourself with health risks and medical facilities.
Caution, not paranoia, seems to be the general advice from both experts and frequent travelers. As Cronk says, "The traveler should use common sense but not be so vigilant that it detracts from the visit."
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