If you have a sore throat, you go to your primary care physician.  If you need a yellow fever vaccine before your business trip or your semester abroad, where do you go?  Most physicians aren’t trained in travel medicine.  Hardly any of them has ever seen a case of yellow fever, rabies, typhoid, bacterial meningitis or Japanese encephalitis.  Travelers don’t want to see a case of these diseases on their trips either. Fortunately, there are safe and effective vaccines that can prevent every one of these serious diseases.  Who should administer them?   Travel medicine physicians are your answer.  These doctors have special training and expertise in travel vaccinations and travel safety. They immunize travelers going to destinations throughout the world.  Make sure you see one of them several weeks before departure.   

Sure, the CDC website is a great general resource for travel vaccination recommendations, but it doesn’t customize the advice to the traveler’s specific itinerary.  In other words, international travelers may not need all of the vaccinations that the CDC advises. Travel physicians can cut through all of this so you get the vaccinations that make sense for you.

• Choose a physician trained in travel medicine. 
• Verify that the physician is a certified yellow fever vaccine provider.
• Visit us for links to trained travel doctors in your community and for a wealth of travel safety advice.

Travel vaccines prevent serious diseases abroad.  Travel medicine physicians can ‘call the shots’ for you.   Make sure an appointment with one of them is on your itinerary. 

Last week, we were at the AAFP (American Academy of Family Practice) medical convention in Boston.  Usually, we doctors are attending the medical lectures at these conferences to keep current on medical knowledge. This time, however, we were manning a booth in the exhibit hall in a sea of pharmaceutical and medical device booths, who were hawking their products to thousands of physicians. Physicians flocked to our booth, even though we were not giving away free pens, T-shirts, restaurant coupons or hot buttered popcorn. Our organization, Travel Clinics of America, attracted physicians because of our concept. We didn’t need a free giveaway.

Doctors wanted to join with us. Travel Clinics of America has a network of physicians across the country who are trained in travel medicine. These doctors administer travel vaccinations and provide patients with important travel safety tips. Our website has a wealth of information that every international traveler should review to stay safe abroad. The network is expanding rapidly, and there may be one of our trained physicians in your community right now.  Put your zip code in the search box on our website and find out.

Doctors in our network enjoy travel medicine. It makes their medical practices more interesting and is an important opportunity to protect the health of international travelers. Most travelers in America leave the country without any travel shots or safety advice. These folks never thought in advance about questions like these:

• Which restaurants are safe to eat in?
• How do I find an English speaking physician in my destination?
• Can I trust medications in foreign countries?
• Do I need every travel vaccination that the CDC recommends?
• Should I get ‘swine flu’ (H1N1) vaccine before I leave?

Many of these answers are right on our website. Get informed, get vaccinated and then get your bags packed for your great adventure abroad. Safe travels!

Just yesterday, two nurses approached me and asked if my kids would be getting the H1N1 vaccine.  These ladies are medical professionals.  Both worked many years as intensive care unit nurses.  They believed in and practiced modern medicine.  Why did they have hesitancy about the vaccine for their kids?

The H1N1 virus has created two illnesses.  The first disease is the viral illness, which typically causes fever, headache, cough and fatigue.  The second illness is fear.  Initially, there was so much press hype, that many of us feared that H1N1 would roll over the country like the Black Plague did in Europe several centuries ago.  Our press, who were hypnotized by H1N1, seemed to have overlooked that the yearly seasonal flu would claim nearly 40,000 American lives this year.  The regular ‘flu’ was a footnote.

Now that fear of an H1N1 national catastrophe has ebbed, a fear of the protective vaccine has emerged.  Folks are recalling the swine flu vaccine in the 1970’s that was associated with severe neurological side effects in a very small percentage of vaccine recipients.  

The pharmaceutical manufacturers have done an outstanding job in preparing mass quantities of H1N1 vaccine on very short notice.  The has been a spectacular public health success. The vaccines have been deemed to be safe and effective by our nation’s health experts.   Here are some facts.

• H1N1 is a highly contagious infection and every one of us is vulnerable
• Certain populations are at higher risk of H1N1 complications
• The H1N1 vaccine is safe and effective
• When deciding on if your kids should get vaccinated, go for the facts, not fear.

Consult objective sources for H1N1 information.

This is medicine, folks.  There is no 100% guarantee of safety or effectiveness.  Personally, I think that the risks of H1N1 are much higher than the theoretical risks of the vaccine.  We’ll see what my 2 nurses decide.  I’m okay with the vaccine for my own kids.  And if it’s good enough for them, then it’s good enough for me also.

I remember as a young child in grade school, swallowing the sugary oral polio vaccine.  Since then, the only times I’ve thought about polio were in preparation for exams in medical school.  As a doctor, I’ve never seen a case of it.  Since I don’t treat kids, I’ve never prescribed the polio vaccine.  It’s simply not part of my medical universe.

For many international travelers, however, polio may be in the center of their universe.  Polio exists in many regions of the world.  Travelers to these areas must discuss their polio vaccine history with their travel doctors before departure.  Even those who were fully vaccinated as kids may need a booster injection, if they will be traveling to a high risk polio region.  These adult travelers, who were vaccinated decades earlier, may not realize that they are at risk. The stakes are high.  While most polio infections are mild, devastating paralysis is a rare complication. 

Polio persists to this day in Afghanistan, India, Nigeria and Pakistan.  Infected people in these countries have spread polio to several other countries in Africa, Southeast Asia and the Middle East.  For a complete list of countries where polio boosters may be necessary, consult the CDC polio information page. 

Polio outbreaks are still occurring.  Polio vaccination and disease prevention are essential since there is no treatment for the disease!

Traveling abroad soon?  Here are 3 important stops on your pre-travel itinerary.

• Write down your vaccination history.
• See a qualified and up-to-date travel doctor.
• Get the travel vaccinations and booster shots you need.

Travel vaccinations are like the armor that warriors used to wear in battle.  They protect international travelers from assault and injury from microscopic germs that are lying in wait.  If fact, the knights in shining armor of yore had it easier.  At least they could see their adversary directly and could mount a directed challenge to their opponent.  Not so, for travelers who must protect against invisible enemies – yellow fever, hepatitis, rabies, typhoid and Japanese encephalitis.

Travel doctors have safe and effective travel vaccinations against all of these diseases. Yet, most travelers at risk never receive them.  They book their hotels, renew their passports and arrange for sightseeing tours.  They remember to cancel newspaper deliveries and for neighbors to pick up their mail.  Shouldn’t  protecting their health rank as a higher priority?

Airlines, travel agents and touring agents do not routinely advise their clients to obtain travel vaccinations in advance of their departure – but they should.  It’s up to travelers themselves to get wise to this issue and get vaccinated.  Would you ever consider not having your kids receive their routine vaccinations?  Of course, not.  Then, make sure that you protect yourself as well.  

Travel Clinics of America physicians know that planning trips is complicated and time consuming. Preventable illness can ruin it all. Viruses and bacteria are waiting to sabotage your months of preparation.  Make sure that you have a strong ‘suit of armor’ to disarm them.  Get your vaccinations!

Here’s a quiz that is so easy that a school child could ace it.  Please write your answers to the 4 quiz questions in the comments section below.   In a week or so, correct answers will appear in the comments section of the next quiz.  The first contestant to respond correctly will be offered an opportunity to compete on the game show Jeopardy, not in the studio but in their own home watching their own TV!  As always, cheating is permitted. Good luck!

This quiz is about a famous building located in a famous country.  A serious health risk for international travelers in this country is malaria.  Chloroquine, the best known antimalarial in the world, doesn’t work there.  Travelers have many effective strategies to prevent malaria.  Take a peek at this link before you start the competition.

Let the quiz begin!

 

(1)   The name of the magnificent building pictured above is

(a)    The Great Domed Cathedral of Kashmir

(b)    The Taj Mahal

(c)    The Basilica of St. Gregory

(d)    The Islamabad Museum of Art

(e)    The Royal Palace of Budapest

 

(2)   The spectacular dome is made of

(a)   Granite

(b)   Marble

(c)   Paper Mache

(d)   Ivory

(e)    Gold with alabaster overlay

 

(3)   The building is located in

(a)    New Delhi

(b)    Old Delhi

(c)    The Corner Deli

(d)    Agra

(e)    Mumbai

(f)     Istanbul

(g)    Emerald City

                 

(4)   The building serves as a

(a)   Mausoleum

(b)   Museum

(c)   Seat of government

(d)   Movie backdrop

(e)   Functioning house of worship

One sure fire way to have adventure on your trip abroad is to catch a case of malaria.  For those who are planning an adventure travel vacation, we’d suggest mountain climbing, scuba or white water rafting instead. 

Malaria is a serious disease that is present in parts of Asia, Africa and South America.  International travelers, including students studying abroad, need to review their intineraries with a travel doctor several weeks before departure.  The characteristic symptom of malaria is fever.  Hundreds of millions of people throughout the world contract this disease every year, including 1 million fatalities.  There are important steps you can take to make sure that you are not added to this list

Please write your answers to the 4 quiz questions in the comments section below.   In a week or so, correct answers will appear in the comments section of the next quiz. The first contestant to respond correctly will have the next discovered strain of malaria named after him. 

Internet use, collaboration and all forms of cheating are permitted.  Good luck!

(1) Malaria is transmitted to humans by:

(a) Contaminated drinking water

(b) Mosquitoes

(c) Food handlers

(d) Unlucky people infected with malaria

(e) Fresh water lakes and streams

(f) Scientists still have no clue

 

(2) Travelers to which of the following destinations do not face malaria risk?

(a) Kenya     (b) Haiti     (c) Czech Republic    (d) Rwanda

 

(3) Which of the following might explain why travelers develop malaria? (There may be more than 1 correct answer here.)

(a) Many strains of malaria are resistant to typical medicines prescribed

(b) Malaria can develop resistance against insecticides used on clothing

(c) Travelers do not take their medicines as prescribed, particularly after returning back home

(d) Discounted antimalarial medicines purchased on the internet may be impure and less effective

 

(4) To prevent malaria, international travelers are strongly urged to

(a) Obtain the malaria vaccine 6 weeks before departure (unless allergic to eggs)

(b) Start your antimalarial medications 4 weeks before visiting the National Parks in the western United States

(c) Drink only pasteurized eggs and juices and avoid salads and street foods

(d) Determine the malaria risk in their specific destinations

(e) Use sunscreen with SPF of at least 35, which repels the malaria germ

Photo credit

The only country in the world that requires that international travelers receive the bacterial meningitis vaccine is Saudi Arabia. This is to protect the Saudi public, not the individual traveler.  International travelers to many other foreign destinations also need the bacterial meningitis vaccine.

Millions of Muslim pilgrims will head to Mecca this year for the the Hajj pilgrimage this November. Muslim travelers all over the world will roll up their sleeves for the bacterial meningitis vaccine before departure, but there will be far fewer pilgrims than in years past.

There will be fewer Muslim travelers this year because of concerns of ‘swine flu’ (H1N1) in Saudi Arabia. About 2000 Saudis are infected with H1N1, including 16 fatalities  Fear and hysteria are spreading throughout the Muslim world.  Iraq and Iran have already banned travel to Saudi Arabia for the Umrah ceremony during the current holy month of Ramadan.  Businesses in the Mecca and Medina regions are now suffering, as Ramadan was historically a very profitable month for them.

Last month, Arab health ministers banned children, older citizens and those with medical conditions from attending the Hajj pilgramage to Mecca this November.  Depending how ‘swine flu’ plays out in the coming weeks, various governments may widen the ban on the Hajj pilgramage.  The Hajj is the fifth pillar of the Islam faith and is a solemn obligation of all Muslims.  It must be performed at least once by every Muslim who has the health and means to do so.  The H1N1 pandemic has wreaked medical and financial havov throughout the world.  It may also prevent observant Muslims from keeping the faith. 

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Here’s a quiz, a little harder than our first ones, but still within reach.  Please write your answers to the 3 quiz questions in the comments section below.   In a week or so, correct answers will appear in the comments section of the next quiz.  The first contestant to respond correctly will be publicly congratulated and will enjoy national fame.

Internet use and collaboration are permitted.  Good luck!

For a perfect score, one will need some knowledge of travel vaccinations.  The country that is the subject of this week’s quiz is the only nation in the world that requires a vaccination against a specific disease.  Enough hints!  Let the quiz begin!

This is a holy site of one of the 3 Abrahamitic faiths.

It is called:

(1)   The Black Onyx of Heaven

(2)   The Kaaba

(3)   The Throne of Islam

(4)   The Holy of Holies

(5)   The Tomb of the Unknown Warrier

 

It is located in:

 (1)   Damascus

(2)   Jerusalem

(3)   Jakarta

(4)   Mecca

(5)   Istanbul

 Visitors from abroad to this holy site are required to receive:

(1)   Yellow Fever vaccine

(2)   Meningitis vaccine

(3)   HIV testing

(4)   Malaria prophylaxis

(5)   Oral typhoid vaccine

 

Photo by Muhammad Mahdi Karim

Travel abroad is often a journey back through time.  Ancient ruins are scattered throughout the world and offer a glimpse of the great civilizations that preceded us.  Visiting these sites is a fantastic travel experience.  Read about them in advance.  Prepare an itinerary that doesn’t cram in too many places in a limited time.  Bring a journal to record your thoughts and observations.  And, of course, consult with a travel doctor for travel vaccinations and important travel safety advice, before your departure. 

Here’s a quiz, a little harder than our first one, but still within reach.  Please write your answers to the 3 quiz questions in the comments section below.   In a week or so, correct answers will appear in the comments section of the next quiz and on Facebook.  The first contestant to respond correctly will be publicly congratulated.

Internet use and collaboration are encouraged.  Good luck!

Please review the site pictured below.

 

If you are wandering through nearby streets, the language you are most likely to hear is

(1)   Danish

(2)   Italian

(3)   Greek

(4)   Estonian

(5)   Hebrew

This site served as the:

(1)   Temple to Zeus and Athena

(2)    City square and marketplace

(3)   Royal palace with menagerie

(4)   Site of the Second Temple in Jerusalem

(5)   Medievil Trappist monastery

A few steps away from the ancient site above, is a famous arch.  Here is a famous incription from the arch depicting a monumental historical event.

 

This scene is carved into the

(1) Arch of Constantine

(2) Arch of Titus

(3) Arch de Triomphe

(4) Hadrian’s Arch

Top photo credit