Are you planning to travel abroad? Whether you’re leaving the country for work or a well-earned vacation, it's a good idea to see a travel medicine specialist first. There are still countries where drinking the water is not a good idea. In some cases, you may need to get certain immunizations or take medication to protect you from Malaria. A travel medicine specialist can help you plan for a safer, healthier international trip.
In this segment, Rina Marfatia, MD, describes the steps you need to take before your trip to protect your health and safety abroad.
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Travel Medicine Tips
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Learn more about Rina Marfatia, MD
Rina Marfatia, MD
Rina Marfatia, MD, is an Internist with clinical interests in travel medicine and complex diseases and a member of the medical staff at MarinHealth Medical Center.Learn more about Rina Marfatia, MD
Transcription:
Bill Klaproth (Host): Travel time is here! Whether it's business or pleasure, there are ways to have safe and healthy travel, and here to share travel medicine tips is Dr. Rina Marfatia, an internist with clinical interests in travel medicine and complex diseases and a member of the medical staff at Marin General Hospital. Dr. Marfatia, thank you so much for your time today. So, let's start with this: why is it important to learn about your destination, especially if it's out of the country before you travel?
Dr. Rina Marfatia (Guest): Thanks for having me. One of the most important things to know is where you're going. Every region has a specific disease profile, especially when it relates to infections, and things that are common to that region. So, knowing where you're going helps your travel medicine doctor determine what precautions you need to take before you start your travel.
Bill: So knowing the disease profile of that country is very important, and speaking of the travel doctor -- what is a travel doctor and why should we see that person instead of our primary care physicians before a trip?
Dr. Marfatia: So travel doctors generally are specialists in infectious diseases as well as other travel-medicine related issues. So, when you go to see a travel doctor, they can formulate a plan for you based on where you're traveling, which places you're going to stay longer, what your elevation is, which cities you're going, and they can make a very specific plan as to what medications you need to take with you, what kind of vaccines you need to take before you go, and also what kind of precautions you may need to take for the trip. So, getting all the pre-travel advice reduces the number of diseases you get when you're traveling. So, it's for safer and healthier travel.
Bill: And the travel doctor will know the disease profiles as well?
Dr. Marfatia: Right. So, usually, for example if you are going to Brazil, we'll know that in Brazil the common diseases are malaria, there's chikungunya, there's Dengue. In certain parts you may also need to have a vaccine for yellow fever, but it depends on if you're going to that part. So, when you go to the travel doctor, they go over your itinerary and decide which medications or vaccines you need prior to traveling.
Bill: And then does the travel doctor administer those vaccines right there generally?
Dr. Marfatia: So, depends on the size of the travel clinic. Most travel clinics will be equipped with all the vaccines that are needed. A lot of the vaccines are carried by pharmacies, so you can get them at the pharmacy before you go, and some clinics make recommendations and find you where to get the vaccines. As the vaccines -- the way they're carried -- they're stored it's very important that a certain temperature is maintained – a certain chain is maintained -- so that the vaccine remains viable. If they don't have too much travel traffic, they may not carry all the vaccines.
Bill: And sticking with international travel, what should we pack in our travel health kit?
Dr. Marfatia: So, generally a first-aid kit is always good to have with you. Once you've seen your travel doctor, depending on where you're going, they may give you medications which you have to take. Some start prior to travel, continue through the entire duration of travel, and you have to take some after you return. Some are for spot treatments as for traveler’s diarrhea, you may need antibiotics if you have traveler's diarrhea and your travel medicine doctor can prescribe that. In addition to whatever the travel doctor gives you, you should always make sure you have enough supply of medication for your routine medical issues for which you're seeing your primary care doctor, so you don't run out of medications when you are traveling. A good idea is also to keep a list of all the medications with the current doses, so if you do run out, you can see a local doctor and get those medications, and you don't lose any time, or you don't lose any days without medication.
Bill: And what happens if you do get sick while on vacation? Any advice for that?
Dr. Marfatia: A lot of the visit with the travel doctor should address that. What we talk about is what are the precautions you take to not get sick. Certain illnesses – if you get sick -- we anticipate that this could happen, and we give you medications for it. For most of the part, there are certain precautions you take to prevent diseases. If those fail, you could see a local doctor, so it's also one of the things that you can get at your travel doctor’s appointment, where you may get local contacts, what numbers to call in which country, and they can help out figure where you can get your care.
Bill: That's really good information, and of course, Zika is one of the hot topics right now. What if you're traveling to an area with the Zika virus? How should we pack to prevent Zika?
Dr. Marfatia: So, this is a very important topic right. A lot of questions regarding this. This all depends on what your status is. A lot of the side effects due to Zika are noticed in the fetus. So, the unborn child is basically the one who bears the brunt of the disease. So, when you're traveling you’re classified as someone who is planning to get pregnant, who is pregnant, or not planning to get pregnant.
So, if you are someone who is planning to get pregnant, the usual first recommendation is to try to avoid travel to that area. If it's unavoidable, then you basically take insect precautions where you're going to take precautions of using a good mosquito repellant. You can wear long sleeve shirts. Stay in a room which has air conditioning. You can use mosquito nets, so everything that you can do to reduce the number of mosquito bites you have -- because that's the primary mode of transmission. The second thing to do would be avoid sexual transmission. So, sexual encounters with people who are not known to you, whose status is not known to you, the only way to prevent it would be use of condoms, and all oral, anal, and vaginal sex could transmit it, so precautions with each act is required.
Bill: And Dr. Marfatia those are great tips, and what about other common questions such as food and beverage precautions while traveling?
Dr. Marfatia: So, that's very important, especially because a lot of the diseases such as traveler’s diarrhea, E. coli, Salmonella, Shigella these are all transmitted via the fecal-oral route so foods that are contaminated with possible fecal material or these bacteria are what transmit the disease. So, it's very important to have filtered water. You can boil it if you don't know where it's coming from to try to eliminate as many pathogens as you can, or use bottled water. The problem usually is when you're visiting friends and family because that's when you have water from taps or things like that. So, being careful with that is important. Also, when you're brushing your teeth, it's important to use bottled water because that is also where you can still be exposed to those bacteria.
In terms of food, it’s washing food really well, especially raw foods or trying to avoid raw foods, leafy vegetables. Well-cooked foods eliminate a lot of the pathogens -- so you're safe there, but avoiding raw foods is really important.
Bill: And if you could wrap it up for us, what other travel medicine tips should we know about?
Dr. Marfatia: In general, before you go, it would be important to do some research as to where you're going. See what safety features are needed. A lot of them, if you go to the CDC website, they give you a lot of travel advice, so that's a good resource if you can't go to a travel doctor; however, I would recommend going to a travel doctor as they can go over all the diseases that you could potentially be exposed to. They can vaccinate you in time, and that could prevent a lot of illnesses. The other things to keep in mind is the political situation, unrest, things that otherwise you need to be safe. Apart from that, just pick a good destination and enjoy yourself.
Bill: [Chuckle]…and that is the main thing, and be healthy and safe. Dr. Marfatia, thank you for your time today. For more information, visit maringeneral.org. That's maringeneral.org. This is the Healing Podcast brought to you by Marin General Hospital. I'm Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): Travel time is here! Whether it's business or pleasure, there are ways to have safe and healthy travel, and here to share travel medicine tips is Dr. Rina Marfatia, an internist with clinical interests in travel medicine and complex diseases and a member of the medical staff at Marin General Hospital. Dr. Marfatia, thank you so much for your time today. So, let's start with this: why is it important to learn about your destination, especially if it's out of the country before you travel?
Dr. Rina Marfatia (Guest): Thanks for having me. One of the most important things to know is where you're going. Every region has a specific disease profile, especially when it relates to infections, and things that are common to that region. So, knowing where you're going helps your travel medicine doctor determine what precautions you need to take before you start your travel.
Bill: So knowing the disease profile of that country is very important, and speaking of the travel doctor -- what is a travel doctor and why should we see that person instead of our primary care physicians before a trip?
Dr. Marfatia: So travel doctors generally are specialists in infectious diseases as well as other travel-medicine related issues. So, when you go to see a travel doctor, they can formulate a plan for you based on where you're traveling, which places you're going to stay longer, what your elevation is, which cities you're going, and they can make a very specific plan as to what medications you need to take with you, what kind of vaccines you need to take before you go, and also what kind of precautions you may need to take for the trip. So, getting all the pre-travel advice reduces the number of diseases you get when you're traveling. So, it's for safer and healthier travel.
Bill: And the travel doctor will know the disease profiles as well?
Dr. Marfatia: Right. So, usually, for example if you are going to Brazil, we'll know that in Brazil the common diseases are malaria, there's chikungunya, there's Dengue. In certain parts you may also need to have a vaccine for yellow fever, but it depends on if you're going to that part. So, when you go to the travel doctor, they go over your itinerary and decide which medications or vaccines you need prior to traveling.
Bill: And then does the travel doctor administer those vaccines right there generally?
Dr. Marfatia: So, depends on the size of the travel clinic. Most travel clinics will be equipped with all the vaccines that are needed. A lot of the vaccines are carried by pharmacies, so you can get them at the pharmacy before you go, and some clinics make recommendations and find you where to get the vaccines. As the vaccines -- the way they're carried -- they're stored it's very important that a certain temperature is maintained – a certain chain is maintained -- so that the vaccine remains viable. If they don't have too much travel traffic, they may not carry all the vaccines.
Bill: And sticking with international travel, what should we pack in our travel health kit?
Dr. Marfatia: So, generally a first-aid kit is always good to have with you. Once you've seen your travel doctor, depending on where you're going, they may give you medications which you have to take. Some start prior to travel, continue through the entire duration of travel, and you have to take some after you return. Some are for spot treatments as for traveler’s diarrhea, you may need antibiotics if you have traveler's diarrhea and your travel medicine doctor can prescribe that. In addition to whatever the travel doctor gives you, you should always make sure you have enough supply of medication for your routine medical issues for which you're seeing your primary care doctor, so you don't run out of medications when you are traveling. A good idea is also to keep a list of all the medications with the current doses, so if you do run out, you can see a local doctor and get those medications, and you don't lose any time, or you don't lose any days without medication.
Bill: And what happens if you do get sick while on vacation? Any advice for that?
Dr. Marfatia: A lot of the visit with the travel doctor should address that. What we talk about is what are the precautions you take to not get sick. Certain illnesses – if you get sick -- we anticipate that this could happen, and we give you medications for it. For most of the part, there are certain precautions you take to prevent diseases. If those fail, you could see a local doctor, so it's also one of the things that you can get at your travel doctor’s appointment, where you may get local contacts, what numbers to call in which country, and they can help out figure where you can get your care.
Bill: That's really good information, and of course, Zika is one of the hot topics right now. What if you're traveling to an area with the Zika virus? How should we pack to prevent Zika?
Dr. Marfatia: So, this is a very important topic right. A lot of questions regarding this. This all depends on what your status is. A lot of the side effects due to Zika are noticed in the fetus. So, the unborn child is basically the one who bears the brunt of the disease. So, when you're traveling you’re classified as someone who is planning to get pregnant, who is pregnant, or not planning to get pregnant.
So, if you are someone who is planning to get pregnant, the usual first recommendation is to try to avoid travel to that area. If it's unavoidable, then you basically take insect precautions where you're going to take precautions of using a good mosquito repellant. You can wear long sleeve shirts. Stay in a room which has air conditioning. You can use mosquito nets, so everything that you can do to reduce the number of mosquito bites you have -- because that's the primary mode of transmission. The second thing to do would be avoid sexual transmission. So, sexual encounters with people who are not known to you, whose status is not known to you, the only way to prevent it would be use of condoms, and all oral, anal, and vaginal sex could transmit it, so precautions with each act is required.
Bill: And Dr. Marfatia those are great tips, and what about other common questions such as food and beverage precautions while traveling?
Dr. Marfatia: So, that's very important, especially because a lot of the diseases such as traveler’s diarrhea, E. coli, Salmonella, Shigella these are all transmitted via the fecal-oral route so foods that are contaminated with possible fecal material or these bacteria are what transmit the disease. So, it's very important to have filtered water. You can boil it if you don't know where it's coming from to try to eliminate as many pathogens as you can, or use bottled water. The problem usually is when you're visiting friends and family because that's when you have water from taps or things like that. So, being careful with that is important. Also, when you're brushing your teeth, it's important to use bottled water because that is also where you can still be exposed to those bacteria.
In terms of food, it’s washing food really well, especially raw foods or trying to avoid raw foods, leafy vegetables. Well-cooked foods eliminate a lot of the pathogens -- so you're safe there, but avoiding raw foods is really important.
Bill: And if you could wrap it up for us, what other travel medicine tips should we know about?
Dr. Marfatia: In general, before you go, it would be important to do some research as to where you're going. See what safety features are needed. A lot of them, if you go to the CDC website, they give you a lot of travel advice, so that's a good resource if you can't go to a travel doctor; however, I would recommend going to a travel doctor as they can go over all the diseases that you could potentially be exposed to. They can vaccinate you in time, and that could prevent a lot of illnesses. The other things to keep in mind is the political situation, unrest, things that otherwise you need to be safe. Apart from that, just pick a good destination and enjoy yourself.
Bill: [Chuckle]…and that is the main thing, and be healthy and safe. Dr. Marfatia, thank you for your time today. For more information, visit maringeneral.org. That's maringeneral.org. This is the Healing Podcast brought to you by Marin General Hospital. I'm Bill Klaproth. Thanks for listening.