| Food
and waterborne diseases are the number one cause of illness in travelers. Travelers'
diarrhea can be caused by viruses, bacteria, or parasites, which are
found throughout the region and can contaminate food or water. Infections may
cause diarrhea and vomiting (E. coli, Salmonella, cholera,
and parasites), fever (typhoid fever and
toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking
water are safe.
Malaria
is a preventable infection that can be fatal if left untreated. Prevent
infection by taking prescription antimalarial drugs
and protecting yourself against mosquito bites. Travelers to countries in this
region may be at risk for malaria, even in urban areas, depending on elevation.
For additional information on malaria risk and prevention.
Dengue ,
filariasis, Japanese
encephalitis, leishmaniasis, and plague
are diseases carried by insects that also occur in this region. Protecting
yourself against insect bites will help to prevent these diseases.
If you visit the Himalayan Mountains, ascend
gradually to allow time for your body to adjust to the high altitude, which can
cause insomnia, headaches, nausea, and altitude sickness. In addition, use
sunblock rated at least 15 SPF, because the risk of sunburn is greater at high
altitudes.
Because motor vehicle crashes are a leading cause
of injury among travelers, walk and drive defensively. Avoid travel at night if
possible and always use seat belts.
There is no risk for yellow fever in the
Indian Subcontinent. A certificate of yellow fever
vaccination may be required for entry into certain of these countries if you are
coming from countries in South America or sub-Saharan Africa.
See your doctor at least 4–6 weeks before your
trip to allow time for shots to take effect.
- Hepatitis A
or immune globulin (IG).
- Hepatitis B
,
if you might be exposed to blood (for example, health-care workers), have sexual
contact with the local population, stay longer than 6 months, or be exposed
through medical treatment.
- Japanese encephalitis
,
only if you plan to visit rural areas for 4 weeks or more, except under special
circumstances, such as a known outbreak of Japanese
encephalitis.
- Rabies
,
if you might be exposed to wild or domestic animals through your work or
recreation.
- Typhoid
vaccination is particularly important because of the presence of S. typhi
strains resistant to multiple antibiotics in this region.
- As needed, booster doses for tetanus-diphtheria
and measles, and a one-time dose of polio for
adults. Hepatitis B vaccine is now recommended for
all infants and for children ages 11–12 years who did not receive the series
as infants.
To stay healthy, do...
- Wash hands often with soap and water.
- Drink only bottled or boiled water, or
carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks,
and ice cubes. If this is not possible, make water safer by BOTH filtering
through an "absolute 1-micron or less" filter AND adding iodine
tablets to the filtered water. "Absolute 1-micron filters" are found
in camping/outdoor supply stores.
- Eat only thoroughly cooked food or fruits and
vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or
forget it.
- If you are going to visit areas where there is
risk for malaria, take your malaria
prevention medication before, during, and after travel, as directed. (See
your doctor for a prescription.)
- Protect yourself from insects by remaining in
well-screened areas, using repellents (applied sparingly at 4-hour intervals)
and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and
long pants from dusk through dawn.
- To prevent fungal and parasitic infections, keep
feet clean and dry, and do not go barefoot.
- Always use latex condoms to reduce the risk of
HIV and other sexually transmitted diseases.
To avoid getting sick...
- Don't eat food purchased from street vendors.
- Don't drink beverages with ice.
- Don't eat dairy products unless you know they
have been pasteurized.
- Don't share needles with anyone.
- Don't handle animals (especially monkeys, dogs,
and cats), to avoid bites and serious diseases (including rabies
and plague).
- Don't swim in fresh water. Salt water is usually
safer.
What you need to bring with you:
- Long-sleeved shirt and long pants to wear while
outside whenever possible, to prevent illnesses carried by insects (e.g., malaria,
dengue, filariasis, leishmaniasis,
and onchocerciasis).
- Insect repellent containing DEET (diethylmethyltoluamide),
in 30%–35% strength for adults and 6%–10% for children. Travelers who are
not in air-conditioned or well-screened housing should purchase a bed net
impregnated with the insecticide permethrin. (Bed nets can be purchased in
camping or military supply stores.)
- Over-the-counter antidiarrheal medicine to take
if you have diarrhea.
- Iodine tablets and water filters to purify water
if bottled water is not available. See Do's above for more detailed information
about water filters.
- Sunblock, sunglasses, hat
.
- Prescription medications: make sure you have
enough to last during your trip, as well as a copy of the prescription(s).
After you return home:
If you have visited a malaria-risk area, continue
taking your antimalarial drug for 4 weeks (Lariam®, doxycycline) or seven days
(Malarone™) after leaving the risk area. Travelers who become ill with a fever
or flu-like illness while traveling in a malaria-risk area and up to one year
after returning home should seek prompt medical attention and should tell the
physician their travel history. |