Know Before You Go
Safe trips to exotic destinations

Andrea Kenney

Guess who spent close to $10 billion in 2006 on almost seven million trips to destinations other than the U.S.? According to Statistics Canada, Canadians. Many trips were for fun in the sun in spots such as Mexico, and many led to encounters with that common tourist’s nemesis, traveller’s diarrhea. The turista, the trots, Montezuma’s revenge, guppy tummy. By whatever name, this can rank anywhere from inconvenient to incapacitating. Depending on your destination, you have a 15% to 50% chance of spending part of your hard-earned holiday exploring not rainforest waterfalls but rest-stop washrooms!

Photo by Mark Leibowitz/Masterfile

Dr. Karl Weiss, an infectious-disease specialist and associate professor of medicine at the University of Montreal, points to the risk of more serious diseases as well. “Malaria is a big killer without proper treatment. In some countries, meningitis and both dengue and typhoid fevers are important concerns.”

Why these threats in foreign lands? Standards of hygiene may differ, food and water may be contaminated, and the climate may favour disease organisms not previously encountered and adapted to in Canada.

But don’t panic. The routine immunizations most Canadians receive from birth offer some protection. These include shots for various childhood diseases, the tetanus/diphtheria vaccine (which should be boosted every 10 years) and the flu vaccine (given annually between November and March).

If you’re under age 65, have kept your routine immunizations up to date and are travelling in industrialized areas such as North America, Western Europe, Japan, Israel, Australia and New Zealand, you probably don’t need travel vaccines, says Weiss. These countries pose a disease risk similar to Canada’s and provide high-quality medical care in case of illness. “But in countries with poorer hygiene standards, it can actually be more dangerous to be treated than not, so vaccines against hepatitis A and B are essential — even if you’re going to a five-star resort,” he says.

Weiss recommends other specific vaccines depending on your destination, accommodations, activity plans, length of stay and personal health history. “Regional risks are a moving target from year to year,” he says. For instance, with about 400 cases of malaria reported annually to the Public Health Agency of Canada over the past decade, this fever has emerged as a risk in popular getaway spots such as Mexico, the Dominican Republic and Jamaica. Travellers may require anti-malaria medication and lessons in insect avoidance, as the parasite that causes malaria is transmitted by mosquitoes.

As for cholera and traveller’s diarrhea vaccines, these may be indicated for “very select travellers at high risk,” says Weiss. Consult your doctor or a travel clinic six to eight weeks before departure, the lead time needed for immunizations to take effect.

Vaccines, however, are never a substitute for avoiding the food- and water-borne bugs that cause turista, so your doctor may prescribe an antibiotic or advise you to take along an over-the-counter remedy in case your prevention plan falls short.

If you return to your country of birth in the developing world after a long absence, you may have lost your immunity to local bugs, so exercise care, Weiss advises. “If you’re travelling with children under  three, who can quickly dehydrate with diarrhea, be especially careful.”

Like many travellers thrown off their eating and sleeping routines, you may experience a bout of the opposite — good-ol’ constipation — so add a laxative to your travel kit.

Calgary native Lynn Torfason is an avid traveller who has visited 54 countries “and counting.” She’s been sick en route only twice. “Most precautions are taken before you ever step on the airplane,” she says. Inform yourself about what foods to avoid at your destination, get your shots, buy medical insurance, and pack a well-planned medical kit and know how to use it. “After that, it’s all about taking five seconds to think before you eat and drink.”

For travel clinics in your area, check the Yellow Pages or go to www.phac-aspc.gc.ca and click on Travel Health. For a list of required precautions by destination, go to www.tripprep.com.