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Dr. Jay Keystone: Top 10 Travel Health Tips

By Dr. Jay Keystone on February 01 2018 | News, Travel Health

Simple preparations can help you make the most of your holiday and avoid getting sick. To learn more or to book a Medisys pre-travel health consultation, contact us at 1-800-361-3493 or click here to book. 





Here are Dr. Jay Keystone's top 10 tips for safe travels: 


1. Boil it, peel it, cook it, or forget it! 

When travelling to a developing country, food-and water-borne illnesses (such as Hepatitis A, typhoid fever, as well as toxin-producing E.coli, campylobacter and shigella bacteria ) represent the biggest health risks, says Dr. Jay Keystone, medical director of Medisys Travel Health. Keystone recommends avoiding tap water and ice cubes at resorts, hotels and restaurants, as well as foods rinsed in tap water like salads and food from street vendors. He also recommends avoiding unpasteurized dairy products while travelling abroad. "Nearly 1 in 2 travellers will wind up with travellers’ diarrhea. “You're always going to have some risk of getting sick, no matter what you do," says Keystone, “But proper hygiene, especially washing your hands or using hand sanitizer before meals, and being mindful about what you consume on vacation, can help mitigate that risk”.


2. Get vaccinated

Vaccinations are up to 99% effective in preventing a variety of tropical and infectious diseases. Hepatitis A and B are the key vaccinations for travellers to the Caribbean, according to Keystone. Hepatitis A is transmitted through contaminated food and water, while Hepatitis B can be transmitted through unsterilized injections or sexual contact. Typhoid is another vaccine option, although it's less likely to be required for travel to a Caribbean resort, but a must in Asia. Some travellers also choose to get an oral vaccine called Dukoral, which protects against enterotoxigenic E. coli (ETEC), a common cause of bacterial diarrhea. “Before you travel, and especially if you have a health condition or are travelling somewhere exotic, it’s always best to speak with a health professional that specializes in travel medicine to get advice,” says Keystone. “People with diabetes, respiratory issues, heart conditions, a compromised immune system, babies and young children, or people over 60 have different travel health needs,” says Keystone. “Also, someone heading to a resort in St. Lucia has significantly different risks than someone going on safari in the Serengeti,” Keystone continues. “Travel health varies significantly depending on someone’s current health status, itinerary, destination, even down to the specific area(s) they are visiting.” A population carrying a particular disease, for example, might be restricted to a few square miles within a particular region of a country. 








3. Use proper anti-mosquito measures

Mosquitos can transmit a number of conditions such as yellow fever, malaria, zika, chikungunya. (Alvin Baez/Reuters), or dengue. The best way to protect against mosquito-borne diseases is to avoid mosquito bites. Proper anti-mosquito measures can not only help prevent disease, but can also prevent secondary skin infections caused by scratching.  High-end resorts and hotels tend to spray the surrounding areas for mosquitos, says Assunta Uffer-Marcolongo, president of the non-profit International Association for Medical Assistance to Travellers, but as soon as you go outside the sprayed areas, you are at greater risk. Whether or not you are staying in an area that has been sprayed for mosquitoes, Dr. Keystone still believes it’s important to wear bug spray and cover up  (weather –permitting) if outdoors during the early morning and late afternoon when Aedes mosquitoes (dengue, zika ,chikungunya) are most active. Malaria, on the other hand, is transmitted by an evening and night-biting mosquito Keystone recommends insect repellents containing DEET (25-30%) or Picaridin (20%), which are effective for four to 12 hours( depending on the product) and are safe for pregnant women and children over two months of age. “It’s important to put on insect repellent AFTER you apply sunscreen,” reminds Keystone, “if you want to avoid the double indignity of itchy bites on top of a sunburn”.




4. Shower more often when abroad and use more soap  

Whether you are hiking up a rainforest mountain in Bali, giraffe gazing on safari in Keyna, paddling down a tropical stream in Costa Rica, basking in the sun on the pristine white-sand beach in Bora Bora, or exploring the flea markets of Goa India, you are at risk of coming into contact with cutaneous larva migrans and parasites that live in stray animals like dogs and cats. Parasites can be transmitted to human skin through the sand, by way of animal feces. "When you come back from the beach, a rainforest walk, a paddle, or a hike, you should shower," suggests Keystone. It’s a best practice for minimizing your risk of skin infections.


5. Know your road risk and act accordingly

"The number ONE cause of death among travellers is motor vehicle accidents," warns Keystone. He recommends travellers stay off motorcycles and mopeds entirely, and also recommends avoiding travel on rural roads after dark.  "It really doesn't matter who your driver is," says Keystone. "You might have an excellent driver, but it's the guy coming the other way who's going to knock you off the road.” Also, vacationers tend to drink alcohol more than they otherwise would before getting behind the wheel. Alcohol and motor vehicles don’t mix – ever.  Keystone suggests asking hotel staff to provide a recommended driver, vs. sourcing your own, when abroad.  


6. No glove, no love

Unsafe sex is always a risky endeavour, but particularly so while travelling to a developing country. Of the world’s 36.7 million people living with HIV, 2 million reside in Latin America and the Caribbean, and half live in Eastern and Southern Africa. “1 in 2 travellers who have sex with a new partner while abroad report they did not expect to have sex, meaning they were not prepared," says Keystone. He recommends that all travellers bring condoms, even if they don't anticipate sex during their vacation. “It’s prudent to bring condoms from home”, reminds Keystone, “condoms sold abroad may not meet North American quality standards”. Aside from HIV/AIDS, sexually transmitted diseases that should be on your radar include: chlamydia, gonorrhea, syphilis, mycoplasma genitalium, trichomaniasis, crabs/pubic lice, scabies, HPV, herpes/HSV, hepatitis C, chancroid, bacterial vaginosis, and nongonoccocal urethritis.




7. BYO Medical Supplies

You don't need to bring a surgical kit with you to Montego Bay, but bringing your own syringes when travelling to Africa, India, or Southeast Asia, as well a few well-chosen supplies can’t hurt. Depending on your destination, Keystone recommends a short list of basics:

  • Medications for diarrhea and constipation
  • Bandages and a topical antibiotic
  • Pain medication
  • Something to treat a sunburn
  • Mosquito netting (depending on destination)
  • Syringes/needles (depending on destination)
  • Water purifier
  • An antihistamine for allergic reactions


8. Know your options for local doctors

If you do get sick abroad, the local doctors and medical care might not necessarily be what you are used to. If you have a medical emergency, Keystone recommends going to a hospital in the nearest big cities, and look for a university teaching or high end private hospital, if possible. For peace of mind, you may want to consider a service like Medisys365 24/7 ongoing care – this will ensure you can speak to a trusted Canadian healthcare professional, any time of the day or night, from anywhere in the world to gain immediate medical advice and guidance for you and your family while travelling abroad.


9. Look for red flags in online reviews

It's not hard to find online reviews of popular destinations, hotels, and resorts, and those reviews can sometimes offer insight into recurring health problems at a particular location. "One or two bad reviews, I ignore," says Keystone, “but if there is a pattern of reviews complaining about the same issue, I take it seriously”.


10. Get travel health insurance, and make sure you understand it

We’ve all heard horror stories of someone getting sick abroad, having to spend some time in the hospital, and winding up with an unwieldy bill. “Travel health insurance, including evacuation coverage, is generally a wise choice,” Keystone advices, “but make sure you read the fine print and understand what is covered.” Keystone warns that elderly travellers may be ineligible for travel health insurance, as can people with a wide variety of pre-existing medical conditions. These conditions are not covered if illness abroad results from them.

To learn more or to book a Medisys pre-travel health consultation, contact us at 1-800-361-3493 or click here to book.