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 Health & Beauty | February 2007 
Most Serious Travel Maladies Can be Prevented
 Susan Heinrich - The Vancouver Sun
Travellers looking for the simple pleasure of a week's holiday in the warm tropical sun are being given a chilly reminder: Even a short getaway to the Caribbean or Mexico can bring with it the risk of serious illnesses such as malaria and dengue.
"Five-star resorts are by no means exempt from these diseases," says Dr. Sarah Thrasher, medical director of the travel clinic at Continuum Medical Care in West Vancouver.
The Public Health Agency of Canada has issued several travel advisories in recent weeks. On Jan. 29, it warned that three Canadians had contracted malaria in the popular Punta Cana area of Dominican Republic. They were not taking anti-malarial medication or precautions against mosquito bites.
That same week, on Feb. 2, Public Health warned of a dengue outbreak in the Mexican seaside resort of Puerto Vallarta (though it is not yet known whether any Canadians were infected). The advisories highlight a need for travellers to consult a doctor or travel clinic before going on vacation.
"Our mantra is go and see a travel health specialist four to six weeks before they go," says Alain Desroches, a spokesperson for Public Health in Ottawa. Here's a primer on the potential health risks of a trip south:
- Malaria -- This mosquito-transmitted disease can be fatal, but only in the most serious cases. Public Health advises all adults and children going to the province of La Altagracia, Dominican Republic (which includes the popular Punta Cana and Bavaro Beach areas), to take anti-malarial drugs: not always an easy sell, Thrasher says.
"When people show up in the travel clinic who are going to the D.R., sometimes it is difficult to convince them to take prophylaxis. Now, with these new cases, we'll be more vigilant again."
Anti-malarials require a prescription and are typically taken starting one week ahead of departure, once a week while away and for four weeks after the return home. Though highly effective, anti-malarials don't provide 100 per cent protection, so avoiding mosquito bites is still important. Jamaica has also reported recent cases of malaria, though they have been confined to Kingston, the capital.
- Dengue -- A flu-like illness common in tropical and subtropical countries, dengue is also transmitted by mosquito, but there is no vaccine or medication to protect against it. Cases are not usually serious but can occasionally lead to dengue hemorrhagic fever, a severe, often fatal, complication.
Public Health notes higher than normal incidents of dengue were reported last year in Dominican Republic, Cuba and several countries in Central and South America, as well as Mexico.
"We recommend a repellent product with 30 per cent DEET for adults and 20 per cent for kids," Thrasher says.
The Canadian Dermatology Association suggests sunscreen be applied first and allowed to absorb into the skin for at least 20 minutes, with the bug repellent applied afterward. (Products that combine sunscreen and bug repellent aren't recommended because DEET can decrease the efficacy of sunscreen.)
- Hepatitis A and B -- If you think you're home free because you're not travelling somewhere with a risk of dengue or malaria, think again.
Hepatitis A and B are a hazard in any southern destination.
"Even for resort areas, it's a good idea to have the hepatitis A vaccine, since the disease is transmitted by food and water," Thrasher says.
Hepatitis B is less common but more serious. It is transmitted by contact with infected bodily fluids, which may lead travellers to think they are not at risk. In fact, anyone treated in hospital while on vacation could contract the virus.
"There's a chance that if you get in a motor-vehicle accident and need medical care that you get a dirty needle," Thrasher says. "It's a remote risk, but something to think about."
A combination vaccination that immunizes against both A and B is a good investment for any traveller. But it is an investment: A Toronto pharmacy quoted the price for an adult treatment at just over $200.
- Diarrhea -- Though a lesser threat, diarrhea can put a damper on any holiday and cause dangerous dehydration in extreme cases. Thrasher says it's a myth that "travellers' diarrhea" is a normal part of getting used to the food in a new place. What it usually means is that you have ingested a bacterial pathogen and your body is trying to flush it out.
Experts recommend drinking and brushing teeth with bottled water only, and avoiding ice cubes. Other culprits are the fresh fruit and vegetables that may look lovely on the buffet table but can harbour bacteria. And all meat and seafood should be well cooked.
"There's that popular adage: Boil it, cook it or peel it," Thrasher says.
As a prophylactic, a doctor can prescribe antibiotic medication to use only if you get sick.
"It works very fast," Thrasher says. "You usually feel better after the first pill. But with kids we always caution that if they have diarrhea and are not doing well, they need to see someone. They get dehydrated much more easily than adults."
Consultations with travel clinics are usually not covered by provincial health care. At Thrasher's clinic, for example, the fee is $40 to $50 per person. Alternatively, travellers can see their family doctor.
For a complete list of travel medical clinics in Canada, go to phac-aspc.gc.ca/tmp-pmv/travel/clinic_e.html. |
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