Walking barefoot in the sand may be a liberating experience here in the Kawarthas, but beware of parasites if that beach is somewhere in the tropics. Recent headlines about tourists to the Dominican Republic who contracted larva migrans from their beach exposure serve as reminder that travel carries its risks – some minor, others not – and there’s nothing like some pre-departure preparation to help prevent both illness and injury when you are away from home.
Anecdotally, I’ve learned that people in Peterborough love to travel – whether it’s families heading south for a holiday, young people heading out for an adventure, or retired individuals booking exotic cruises or tours. To keep our residents safe during and after travel, Peterborough Public Health offers travellers targeted counselling depending on destination and itinerary. An important caveat: It’s important to book early – at least eight weeks before departure – to allow time for the administration of vaccines, like hepatitis A, typhoid or even Yellow Fever which may be mandatory for entry at a border. Other immunizations, though not mandatory, are recommended depending on the risks present at the destination. Travel is also a great opportunity to make sure all of your routine immunizations like influenza, tetanus or measles are up to date, as the risk may be increased in many countries without universal healthcare and immunization programs.
Rabies is on our list for potentially warranted pre-travel immunizations, especially for travel to remote and rural areas of Asia or Africa where tens of thousands die each year from rabies, 99% of it transmitted by domestic dogs. Japanese Encephalitis and Meningococcal Meningitis vaccines may also be recommended, depending on destination and time of year. But some infectious diseases do not have vaccines. Many are spread through insect bites, like mosquito-borne Malaria, Dengue, Chikungunya, Zika and West Nile disease. Others are carried by ticks or sand flies. Some by small parasites released by snails into fresh water. Different strategies can help prevent these illnesses, including the use of anti-malarials, repellents and bed nets or avoiding the exposure in the first place by not swimming in fresh water where schistosomiasis is present.
Whether a country has safe water and sanitation determines the risk from food and water. Being able to safely drink water from the tap can’t be taken for granted in many parts of the world. A two-step process of filtration and disinfection may be required for those who can’t purchase safe bottled water. Bottled water poses its own risks on this planet as plastics threaten ecosystems and vulnerable species. As do plastic bags and other garbage that beg us to reduce our consumption, whether we travel or not, and use biodegradable products whenever possible. Food can be a source of illness both at home and abroad – and there are destinations where avoiding all street food, any uncooked vegetables or unpeeled fruit may be recommended. Remember to pack the hand sanitizer and use it liberally!
Although bugs and germs seem to be more worthy of human fear and disgust, actually injury is a serious risk for travellers and accounts for 18%-25% of traveller mortality abroad. Motor vehicle collisions, poorly maintained or regulated equipment or random violence are often greater risks than infectious diseases. We can’t depend on the same protection available to us here at home when it comes to the operation of roads, vehicles, boats, or sporting and entertainment venues. It’s “buyer beware”, and maybe even “buyer best to wait till back at home to try it” when it comes to activities that come with inherent risks.
The longer we stay in foreign countries, the greater the risk, usually. A quick one week in an all-inclusive resort will be less risky that two or three months of living with a local family or back-packing. Know your risks before you go, and make sure you are knowledgeable and prepared. If you are planning on being sexually active, protect yourself. Our most treasured resource is our health – travel should enhance it, not ruin it. Visit www.peterboroughpublichealth.ca for more information about our Travel Clinic.
by Dr. Rosana Salvaterra, Medical Officer of Health, Peterborough Public Health
For more information about Dr. Salvaterra, her bio is available on this webpage: