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Q
Health Risks of Traveling Abroad?

I am planning a trip to sub-Saharan Africa next year. I understand I will need to get some vaccines. How do I find out which ones? Do I really have to have the shots? What other health risks should I be concerned about? And what medications apart from my prescriptions do you suggest I take with me?

A
Answer (Published 1/27/2011)

Originally published, January 2011.

International travel, especially to developing countries in Africa, Southeast Asia and South America, can offer great experiences, but can also present a variety of health risks. You might prepare by consulting a physician who specializes in travel medicine, a field that focuses on the prevention and management of health issues for international travelers.

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I discussed your questions with Paul Abramson, M.D., an integrative medical doctor and travel medicine specialist in San Francisco who is a graduate Senior Fellow of the Arizona Center for Integrative Medicine. Dr. Abramson suggests you begin by researching your vaccine needs through the website of the U.S. Centers for Disease Control and Prevention (www.cdc.gov). You can enter the specific countries you'll be visiting to learn what shots are required in advance of your trip. British travelers can get the same type of information at http://www.fitfortravel.nhs.uk.

Beyond that, a good travel medicine doctor can help you to sort through the often long list of recommendations you'll find at these government sites and advise you on which immunizations are most important. Take these recommendations seriously, since some of these preventable diseases can be serious or even fatal. Some countries may even refuse you entry if you can't present evidence that you've had the yellow fever vaccine, Dr. Abramson explained.  You should also seek advice on measures to avoid other diseases (such as rabies) even if you are not receiving a vaccination ahead of time.

Dr. Abramson says that all international travelers may want to take along medications or dietary supplements to treat or prevent common ailments such as traveler's diarrhea, malaria, jet lag, and altitude sickness. But what you take with you depends on where and when you're going because health risks vary with geography, altitude, and season. Bear in mind when you make your travel plans that no vaccine or preventive medications exist for dengue fever, Chikungunya fever, amebic dysentery, and many other serious infectious diseases. Dr. Abramson adds that a travel medicine specialist can educate you about appropriate preventive measures for specific destinations, such as avoiding mosquito bites, dealing with equatorial sun exposure, being careful about swimming in fresh water, and avoiding high-risk food and drink.

He recommends seeing a travel medicine doctor at least six weeks before you leave, because some vaccination sequences take three or more weeks to complete. (In some cases more rapid options are available for those leaving on short notice, so do visit a doctor even if you're departing for Africa next week.) You can find a clinic via the International Society of Travel Medicine.

International travel can enrich your life in many ways. Being prepared for potential health risks can ease your mind and enhance your enjoyment of the trip.

Andrew Weil, M.D.

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