Ask the Doctor: Your Most Pressing Questions About Travel Health – Answered!

You asked…and we answered! Our clients consult with us on a daily basis to discuss some of their most pressing questions about travel health and potential medical issues that could arise while their travelers are abroad. In this Q+A, our Medical Director, Dr. Michelle Nathan, shares answers to some of our favorite questions that recently came our way, including advice, resources, and strategies to help keep your travelers safe, healthy, and well informed for their upcoming travels.

What exactly is the difference between an outbreak, a pandemic, and an epidemic?
Dr. Nathan: An outbreak happens when a disease occurs in greater numbers than expected in a community or region or during a season.  It is similar to an epidemic, but is in a limited geographic area.  An example of an outbreak would be the U.S. Zika outbreak of 2016 (7 cases identified in Florida and Texas). On the other hand, an epidemic occurs when a disease spreads rapidly to many people. The key to this definition is the rapid spread of a disease.  A current example is the Ebola Virus in the Democratic Republic of Congo. And a pandemic is a global disease outbreak. Examples include HIV/AIDS, and the Spanish influenza pandemic of 1918, which killed 40-50 million people.

What should I do if my travelers run out of allergy medication while overseas?
Dr. Nathan: It is good practice to travel with a list of medications, copies of all prescriptions, and a note from a doctor explaining medical conditions and the medications taken for those conditions. When possible, travelers should take more medication with them than is needed for their trips. If they require a refill, On Call clients can contact us for assistance with finding local resources for medication refills.

We dispatch travelers to all areas of the world, including more developing areas. Should we be worried about Malaria?
Dr. Nathan: Malaria, a disease caused by parasites, is prevalent throughout the world in tropical and subtropical countries, particularly Africa and South America. Humans contract the disease after a bite from an infected mosquito. The disease starts by infecting one’s liver and slowly attacks their red blood cells. While there is a small risk of contracting the disease anywhere, one is at a higher risk if they travel to countries known to be at risk with Malaria, including countries in Africa.

Africa has the highest amount of the deadliest species of the Malaria parasite. The climate in Africa is ideal for the transmission of Malaria; the mosquito can easily survive and multiply, and the parasite can complete its growth cycle in the mosquito. The costs of intervention and prevention for Malaria can be high, and difficult to manage in poorer countries, and they often do not have the infrastructure to manage the disease.

Adult men and women are equally vulnerable to and affected by Malaria infection. However, pregnant women are at greater risk for severe Malaria due to decreased immunity during pregnancy. Malaria during pregnancy results in anemia, a higher risk of miscarriage, stillbirth, premature delivery, and low birth weight infants. Young children, pregnant women, and those with HIV/AIDS are also at an increased risk.

What are some preventative measures against contracting Malaria?
Dr. Nathan: Research the countries they are visiting to find out the risk for Malaria in each destination. If they are traveling to a destination where Malaria is prevalent, they should visit their doctor or travel medicine specialist four to six weeks before departure to determine which medication is best for them. There are several antimalarial drugs available. Some medications take weeks to become effective, but there are also options for those traveling last minute. Additionally, travelers should take extra precautions to prevent mosquito bites when traveling. Wear repellent at all times and use mosquito nets when sleeping.

There are reports of alcohol being tainted at resorts overseas. How can my travelers tell if their alcoholic drinks have been tainted? What symptoms will they experience?
Dr. Nathan: Tainted alcohol is illegally made liquor with the goal of minimizing cost and maximizing profit. It is often mixed with other chemicals or industrial alcohols, which make it more potent. Some of the industrial alcohols are fatal, whereas others can raise a person’s blood alcohol to dangerous levels with a single drink.

Unfortunately, there is no reliable way to know if alcohol is tainted before ingesting the drink. Symptoms of potential tainted alcohol ingestion include:

• • • Feeling excessively drunk relative to the amount of alcohol consumed

    • Vomiting

    • Blacking out or becoming unconscious

    • Out of character behavior and agitation

    • Confusion

    • Slow or irregular breathing

If travelers have been drinking and begin to feel any of these symptoms, they should alert someone they trust and seek medical attention immediately.

How can my travelers reduce the risk of consuming tainted alcohol?
Dr. Nathan: The only way to avoid tainted alcohol is to refrain from drinking alcohol. However, there are steps you can share with your travelers to help them reduce the risk of consuming tainted alcohol:

• • • Avoid hard liquor, as it is most commonly tainted. Consume brands you are familiar with so that you can detect off tastes and avoid strongly flavored mixed drinks that could mask the flavor of the liquor.

    • Insist on having the drink mixed in front of you, and make sure everything comes from a sealed bottle. Insist that beer and wine are opened in front of you.

    • Keep an eye on your drink. If you lose sight of your drink, even briefly, you should discard it.

    • Inspect bottles in your minibar. Do not drink anything that is unsealed or has labels that have typos or are poorly glued onto the bottle.

    • Purchase duty-free alcohol at the airport to drink while you travel.

Want to learn more about travel health and holistic risk management? Contact us today!