TORONTO - Dr. Jay Keystone is a close friend and my most valued mentor in the field of tropical medicine. When he speaks, I listen — and so should you — especially when it comes to his 10 Commandments for international travel. Dr. Keystone’s 10 travel commandments rival Fulghum’s All that I needed to know I learned in Kindergarten — simple in text; profound in application. Prepare ahead, post these reminders on your fridge, and practice the principles as you travel. By following these health rules you will either prevent or ameliorate most if the ailments that could disrupt the tranquility of your international sojourn.
1 - Thou shalt consult with thy physician
There is an array of darts that can be tossed your way in the war against vaccine preventable diseases. Accept all and you may need a loan to afford your trip. Be practical. Routine vaccinations should be current. WHO’s list of required vaccines is now limited to Yellow Fever but proof of vaccination is only a consideration for travel between 15 degrees above and below the Equator in Africa and South America. Meningococcal infections are of epidemic proportion in Sub-Saharan Africa but only pilgrims to Mecca will be forced to splurge on this vaccine. Recommended vaccines should be administered in the context of risk, not destination. Hepatitis A and B, viral infections that are ubiquitous and virtually 100 per cent preventable, should rank highest on your list of priorities. Some diseases, such as rabies and Japanese encephalitis, are very rare but could have devastating consequences; therefore, careful risk appraisal will help determine when these pricey vaccines should be considered.
2 - Thou Shalt acclimatize thyself.
Consider in particular sun, heat, humidity and altitude. Tropical rays can be particularly powerful and indiscretion in this regard could mess up your trip. SPF B sun block supersedes rivals. Avoid dehydration at all costs, and bottled water can be expensive. Advise your physician if your intended destination is above 8,000 to 10,000 feet.
3 - Thou Shalt protect thyself from insects. DEET still reigns supreme in the war against day and night biting mosquitoes and ticks, the most notorious of vectors.
4 - Thou Shalt purify the water that thou drinkest, including thy cubes of ice.
5 - Thou Shalt cook well thy food and peel thine fruit and vegetables.
(Commandments 4 and 5 were among the first of your lessons; easy to learn, hard to practice. About 97 per cent of travellers will overlook this counsel within the first 48 hours of their arrival.)
6 - Thou Shalt carry an antibiotic for self-treatment of traveller’s diarrhea.
Even if all of the commandments are obeyed, at least 30 per cent of travellers will be haunted by memories of an ill-fated trip because of this annoying affliction. Self-treatment with an appropriate antibiotic could transform your experience. Don’t leave home without it.
7 - Thou Shalt take thy prophylaxis.
Malaria, the deadliest of all parasitic infections, is confined to very specific geographic regions. Your consultant can help you to select one from an array of drugs that virtually eliminate your risk of death while reducing the risk of side effects that could make death an enviable state.
8 - Thou Shalt NOT swim in fresh water or walk in thy bare feet.
Some parasites are particularly adept at wending their way into your body through your skin. Don’t be afraid, they won’t kill you but they can be a source of misery.
9 - Thou Shalt be concerned about thy security.
Avoid being conspicuous. Your beautiful gold necklace or diamonds enhance your appeal and your risk.
10 - Thou Shalt be wary of thy conveyance
Never drive after dark, select road-worthy vehicles and sober drivers. Injury is responsible for the majority of deaths related to international travel. Remember, all you need to know you learned in Kindergarten.
Have a safe trip!