Thursday, July 12, 2012

Travel Health

I'm more than a bit compulsive when it comes to travel health. 

1.  I think a pretty good overview for any traveler to read in advance is Wilson-Howarth, The Essential Guide to Travel Health.  I brought with me a first-aid guide that allowed me to diagnose a fellow traveler with a form of heat stroke.  I always bring a comprehensive first aid kit that I assemble myself.

2.  Go to a good travel clinic at least four months before your trip. 

3.  We did get rabies shots, but I don't think that is absolutely necessary.  The reason to get rabies vaccines is that if you do get bitten by an animal you may need to be airlifted out of the country to obtain an injection immunoglobulin; otherwise, if you get bitten you can certainly get the additional rabies shots in Kigali (note -- rabies shots are not in the stomach as they were half a century ago).

4.  We took antimalarials in Rwanda, but I didn't perceive the malaria risk where we were to be unreasonably high.  That said, I had my son get a prescription filled in advance of our trip for Co-artem, the leading malaria treatment today, though he is staying in the country for a couple of months.

5.  We took probiotics heavily in advance to avoid travelers' diarrhea.  We were reasonably careful in eating during our stay, but not quite fanatical.  Neither of us had any problems (but we only drank bottled water and used bottled water for tooth-brushing).

6.  I did get stung by a bee or wasp (not my fault).  It was very painful.  I traveled with a "Sawyer Extractor" which I used to remove venom on the first day and pus on the second.  The tissue appeared to me to later turn necrotic (i.e., it turned black), so I used my standby Cipro to guard against and control and infection.  Whether this was really necessary I don't know, but I then had no real problems with the area that was stung.

7.  I traveled with a prednisone/steroid pain pack.  As it turned out, I twisted my knee or hurt my knee on one of our hikes.  It was incredibly painful subsequently when I hiked downhill.  So, I used the prednisone and ace bandages (and pain medication), and I was then able to manage fine.

8.  All of our clothing was treated with permethrin in advance.  This is a tedious process, and ends up being expensive.  That said, we didn't have substantial insect bites (my sting notwithstanding).  I always do this before traveling to malarial areas.  The treatment  lasts about 6 weeks.  I strongly recommend doing this for peace of mind (and it reduces the need to slather on DEET).

9. We took Diamox to prepare us for the change in altitude.  There is also some new data supporting use of ibuprofen as an aid to change in altitude, and we used ibuprofen too (this is the active incredient in Motrin and Advil).  We had no problems from the change (other than trying to process oxygen), so no headaches or the like.

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