It’s a good idea to make an appointment with a travel nurse at least a month before traveling to make sure you have the necessary vaccinations. Some need to be taken far in advance of travel. The travel nurse will tell you about the country you are visiting in terms of health, common diseases, risky behaviors to avoid, and what you can do if you get sick. They will make you afraid. Once you spend a few days in country, though, it’s not as bad as they make it seem.
I’ve traveled to Vietnam, Thailand, and Belize, so I’ve gotten the lectures a couple times. Travel to Europe is easy, but the rest of the world needs some planning.
General advice
What the travel nurse will say
- Don’t drink tap water
- Don’t get ice in your drinks (because it’s made from tap water)
- Don’t eat raw fruit or vegetables (unless it has a protective peel, like a banana) (because food handling practices aren’t the best and even if it was washed, it was washed in tap water)
- Don’t eat food from street vendors (but it’s the best food you can get! why do travel nurses do this to us?)
- Even if people say the water is safe, it might not be.
- Don’t get mosquito bites. AT ALL. Wear DEET all the time
- Don’t pet animals, and if they break the skin at all you’re going to the doctor.
- Don’t swim in any fresh water; chlorine-treated pools and oceans are ok.
Reality
All those horrible warnings really aren’t so bad, and you can adjust your level of protection as you get more comfortable with the place and understand what the actual risks are.
- It’s easy to avoid water and ice, and if you’re in the tourist bubble, it’s especially easy. Water bottles will often come with plastic seals on them to show the water bottle hasn’t just been refilled and super-glued shut on site (if you’ve seen Slumdog Millionaire you know what this means). Waiters who have foreigners regularly already know the drill. Hot tea, carbonated drinks, and beer are perfectly fine. If you live in an apartment complex with other foreigners, meet the neighbors and strike up a conversation to find out about the water.
- The raw fruit and vegetables and street food is really disappointing and difficult to avoid. You’re probably fine if you are very picky about it and only go to the cleanest vendors. Don’t do it regularly. Every encounter is like Russian Roulette with your gut, so have just enough that you don’t feel like you’re missing out.
- DEET all the time is silly. You’re probably going to be inside all day and night anyway, so just be observant.
- Encounters with animals is sketchy. Petting them will give them a few seconds of happiness, but could give you all kinds of parasites or infections.
- DON’T have sex with anything unless you brought it (or him/her) with you.
- DON’T go playing with monkeys, shaking hands with chefs that handled raw pork, visiting poultry farms, or doing anything that will later become a hollywood horror movie. Outbreak, Contagion, I Am Legend, and 28 Days Later were plenty, thank you.
Vaccinations and prescriptions
Many countries have requirements about vaccinations, and there are some diseases that haven’t yet been eradicated.
- Flu – very good idea. The flu vaccine also has bird flu protection, so that’s a plus.
- Hepatitis A and B – Very good idea, but these shots take a while to go through the series of 2 or 3. Get started early. They have life protection, so once you get them over with you’re done.
- Typhoid – A calculated risk. It’s bacterial and treatable, and unlikely you’ll get it. There’s two shots, which will give you a couple years of protection, or there’s an oral series that takes a week but gives you five years of protection. For $70 it was worth it to me. Sure the chances are low, but I don’t know where else I’ll go within five years, and I’d rather not have to deal with it while I’m on travel.
- Japanese Encephalitis – Another calculated risk. Don’t get bitten by mosquitos at night in rural areas.
- Rabies – Stay away from animals! Even if you do get a vaccine, you should still get attention immediately after a bite or scratch. Rabies WILL kill you if not treated immediately.
- TDAP (Tetanus, Diptheria, Pertussis) - yes please.
- MMR (measles, mumps, rubella) – Most people have had these already when they were young. If you went to school in the U.S. you probably already had these shots.
- Malaria – there are a couple options for malaria, but they’re mostly in the frequency of how often you take a pill. You’ll get a map of where malaria is prevalent. If you won’t be in an affected area, don’t worry about it.
- Dengue – transmitted by daytime mosquitoes. Stay away from them.
- Cipro – a medication for travelers diarrhea. It’ll happen eventually. You can’t live overseas without eating, and every meal is an opportunity for infection. Just accept that it will happen and that when it does you have the tools to deal with it.
You may get other information or recommendations from your travel doctor. Your goal when overseas is to not ruin your travel by spending it sick in a hotel room or hospital, and if you do get sick have the ability to get over it quickly.