Don’t need travel insurance? What’s your risk comfort level?

Traditional medical insurance policies seem to be constantly in “flux” to put it kindly. It is your responsibility as a policy holder to know what is covered whether you travel or not. Never assume anything. If you travel abroad, call customer service and ask very specific questions such as: Does my policy cover treatment, surgery, anesthesia, doctor bills and medications in foreign medical facilities. How about pre-existing conditions. Does it cover medical evacuation by air back to the U.S. for emergency treatment. Yes, or no? Occasionally you can get a “rider” to cover you for the trip…up to the point of evacuation. Medicare does not cover travel medical costs. It could cost more than $10,000.00 to transport you back to your destination for treatment. Providers overseas often charge money upfront for services. Does your insurance cover high-risk activities like scuba-diving, sky-diving, zip-lining, and others?

Can the U.S. government help me if I become disabled, incapacitated or seriously ill overseas? A U.S. consular officer can only assist in locating medical services and informing family back home.

Finding a reputable medical provider can be daunting in countries where English is not the primary language, there is social and political problems, and healthcare is scarce or non-existent. www.ISTM.org lists medical providers in over 50 countries. US embassies and consulates do maintain lists as well. Bear in mind, decent medical treatment for your particular issue could be hundreds of miles away and you must find our own transportation, sometimes separating you from the group with whom you traveled. Are you traveling alone? With a family of 6? Medical crisis and now a potential financial disaster. Still don’t think you need evacuation insurance? What is your comfort of risk?

The travel insurance you purchased with your tickets insures you for trip cancellation and the incidental baggage and transportation problems, most likely NOT medical care.  www.cdc.gov  does have a list of U.S. Based Air Ambulance or Medical Evacuation companies. You can compare various companies at www.insuremytrip.com

Define your level of comfort with the risk of your travel itinerary. Having a back up plan just makes good sense! Pennies a day= peace of mind. Get that extra insurance! 

What Flu season?

Getting a slow start to “flu season”…not entirely unusual….   The CDC  reports only sporadic outbreaks in a handful of states so far for 2012. The actual map of surveillance can be seen on the CDC website.

However, let’s not get too complacent yet,  this could be only the beginning! But, hey, it’s never too late to get your flu shot. Especially true for new parents; newborns have little immunity and can be extraordinarily vulnerable to complications of the flu. Also, if you live with an immunocompromised person, if you care for children, elderly or ill people, its important to protect yourself AND them from the flu virus. Air, land and sea travelers have constant exposure to all virus’, especially the seasonal flu! The pesky virus is spread via droplets from the respiratory system of the infected person by coughing, sneezing, into the air, on to their hands and other surfaces within 5-6 feet of another individual. The virus affects the next victim, you, within 1-4 days!  Next thing YOU know, you have sudden aches and pains all over, maybe a fever, a dry cough, sore throat and just want to crawl into a corner for a couple of days of sleep!

Pneumonia, a complication from having the flu, can be potentially deadly for the medically fragile population such as those who live with chronic disease that are still in the work force, surgical patients, cardiac and respiratory compromised persons, the elderly, diabetics, infants and children, just to name a few.  Whether these folks are readily identified or not, its a good idea to protect ourselves and those around us.  Its affordable, available, safe and highly recommended! Contact us at www.HealthSmartVaccines.com and get your flu shot. If you already have, well, thanks for protecting us both!

Travelers Diarrhea TD

Up to 50% of travelers to Asia, Africa, Central America and the Middle East report 1 or more bouts of “travelers’ diarrhea” (TD). 3-4 watery stools in a matter of hours, sometimes accompanied by nausea, vomiting and bloating characterize this annoying illness. Mis-handled food contaminated with fecal matter ingested by the traveler takes only a few hours to cause the rapid onset of diarrhea. Travelers with underlying stomach and intestinal problems may want to get advice from their personal physician as to self-treatment of diarrhea. Unfortunately, there is NO vaccine for diarrhea.

Contaminated, raw or undercooked food, raw seafood, salad washed with contaminated water, icecubes and drinking water contribute to this illness.  If you think your destination is an “at risk” place, where there is a possibility that food and drink would not be safe, be prepared. Eat only thoroughly cooked foods, avoid salads and eat cooked veggies, Don’t save leftovers, don’t eat food exposed to outdoor heat or flies, drink and brush teeth ONLY with sealed bottled water. Consume only pasturized dairy products.

“Probiotics” and intestinal health has been all over the media. Unofficial, individual reports are positive for limited prevention of diarrhea!  Your trip preparation may include bringing over the counter probiotics and a few lightweight food items that will help with fluid replacement following diarrhea. Oatmeal packets, soup packets, dry Pedialyte® or CeraLyte®that you can add boiled or bottled water to. Salty crackers are good to have handy. If you have a fever or bloody diarrhea, seek medical help immediately. The WHO states handwashing alone can lower the incidence of TD by as much as 30%.

 Boil it, cook it, peel it OR forget it!

Hepatitis A/B/C/E/Did you know….

Hepa=Liver     -itis=Inflammation of….

There are 5 known types of Hepatitis disease. Most travelers are familiar with Hepatitis A & B, the only 2 which are vaccine-preventable…. but what do we know about the others and can we get them during travel?

Hepatitis C is aquired by blood to blood and body fluid contact with an infected person or instrument such as needles shared by drug users. Travelers who use tatoo/piercing facilities, receive blood transfusions or organ transplants from poorly screened donors, or participate in surgical procedures overseas may be at risk.  Usually there are no symptoms, it is lifelong and can result in death. The baby-boomer generation is most at risk along with anyone who may have received a blood transfusion prior to the 1990′s. A blood test can confirm that a person has aquired Hepatitis C. There is treatment available.

Hepatitis D can only occur if a person already has Hepatitis B. Open wounds, blood and bodily fluid exchange with an infected person can result in acute or chronic Hepatitis D for which there is NO treatment.

Hepatitis E is an uncommon virus in the United States. Water contaminated with feces can be common in Africa, Central America, South America and parts of Asia and the Middle East. Hep E can be extremely serious for pregnant women and there is NO treatment.  Travelers should take care to avoid water from unknown sources. Drinking only bottled water, boiling or use of chlorinated tablets is the only way to avoid Hep E.

Hepatitis A is prevalent all over the world. Prior to the vaccine being available in the 1990′s,  it was a very common illness aquired during travel outside the US.  Mild to severe symptoms can occur following ingestion of food or drink contaminated with feces of an infected person. Never assume that other nations have the same strict food handling standards as we do in the US. Eat well cooked foods, stay away from raw salad and seafood unless sure of the source. Drink bottled water. Heat can destroy the virus, freezing does not!

Hepatitis B. Since the introduction of the vaccine in the early 1990′s, there has been an 82% decrease in reported hepatitis B infections in the US. Remarkable! Globally, about 2 billion have Hep B. Most have chronic infection, are carriers and many have died as Hep B can lead to cirrhosis and death. Travelers are at high risk. There may be NO “standard precautions” in facilities outside the US.  Contact with blood and body fluids during sex, medical procedures using contaminated instruments during medical tourism, dental procedures you didn’t expect or accidents in which you are hospitalized and may possibly face blood transfusion from unknown resources. You cannot tell by looking at someone they carry the Hep B virus, therefore BE PREPARED-GET VACCINATED!

What is Pertussis?

‘Whooping Cough’ is the short answer. Talk to anyone over 50 and chances are, they’ve had pertussis as a child. A real rib-breaker cough as I recall! Before we had the vaccine, there were nearly a quarter million cases a year in the US alone. Vaccine use in the US had brought that statistic to an all-time low in the 1970′s.  Sadly, there are still more than a quarter million deaths of infants and children worldwide because of pertussis. Non-availability, misuse, and underuse of the vaccine in underserved nations leave many without protection against pertussis. It is highly communicable and especially dangerous  for infants with tiny respiratory tracts.  They are unable to clear trapped mucus preventing adequate oxygenation of the infant.  Infants at the beginning of immunization series are not fully immune to pertusis and the bacterium invades quickly, lingers for weeks or more and can lead to very serious complications such as pneumonia, bleeding in the brain, or death. The CDC reports that from 2004-2008 there were 111 deaths from pertussis, and 83% were infants under 3 months of age. (US DHHS Epidemiology and Prevention of Vaccine-Preventable Diseases/Pink Book/12th ed. p.217)

It was previously thought that once you contracted pertussis, a life-long immunity ensued. However, there has been a resurgence of pertussis for several reasons.  First, we now know there was only temporary protection from reinfection. While we routinely immunized children and adolescents with Tdap (Tetanus, diptheria and pertussis), we reimmunized adults with “Td” leaving them vulnerable for pertussis.  Second, disease is only a plane/ship/car ride away and a traveler can be in close contact with an infected individual of any age, anywhere.  Unpresidented numbers of international travelers can transport diseases across continents within hours infecting communities. (Remember H1N1 in 2009?) And finally, some families have opted out of vacination for their children, leaving their children and countless others around them at risk for contracting pertussis and other vaccine preventable diseases. The World Health Organization and our own CDC has recommended a Tdap for all adults especially grandparents, child and healthcare workers, anyone who lives with or cares for immune compromised folks, and travelers. Ask your primary care MD about pertussis and when you travel call HealthSmartVaccines 703-961-0733 to discuss this and other recommended travel vaccines!

Travel Safety for Women

For most comprehensive look at womens’ travel safety  see http://www.kevincoffey.com/women

This experienced detective spells out important security issues and ways women can protect themselves while traveling!  The entire website is well worth a look. Happy trails!

For travel vaccine needs call HealthSmartVaccines 703-961-0733

Safe vehicle travel

The leading cause of death to travelers abroad is vehicle accidents.  Often, there are no seatbelts available, overcrowded roadways, no speed limits, poor road conditions, poor signage, vehicles too large or unsafe for roads and bridges, innattentive local drivers, distracted travelers and then, theres driving on the opposite side of the road to contend with! Good safety decisions when it comes to car rental does come with a higher price. Are you worth it?

Malaria

The CDC has extensive information on geographical location, risk, prevention both with topical preparations and prescription medication for particular types of malaria. No drug  guarantees 100%  protection even if taken correctly. If you develop a fever after returning home from a known malaria area, be sure you tell your doctor you visited a tropical area and may have been exposed to malaria. It may take several blood tests to confirm or eliminate malaria or other tropical disease.

Medical care items to take on your trip

Take enough of your everyday prescription medications plus a weeks worth in case of unexpected delays or diversions. Bottles must be properly and professionally labeled with the name of pharmacy, the med, your name and your doctor’s name. Hand carry the doctor’s written prescription which can be beneficial in the case of certain medications which could be confiscated in any country without identification. Especially true with controlled substances. If you require insulin, protect the vaccine potency by properly storing it. Take enough syringes for your journey, never assume you will be able to buy sterile or even legitimate diabetic supplies overseas. If you have questions about taking injectable medications on a plane, the size containers and contents allowed, contact TSA via their web page www.tsa.gov   Don’t put all of your medication in one place. Split them up so you’ll have some in case a bag is temporarily lost. Pack an extra Epi-pen. Carry other prescription medications from your doctor such as anti-malaria tablets, travelers’ diarrhea antibiotics or altitude meds. Be extremely careful of purchasing medicine overseas. Standard prescription medication in the US may be over the counter in other countries but its difficult to know counterfeit from legitimate. Contents and strength may not be appropriate so its best to carry you own. 

Depending on your destination and planned itinerary, you may need to pack a basic medical kit in your checked baggage.  This may include a variety of bandaids, gauze rolls, tape, pair of scissors, tweezers for removing splinters, a few disposable gloves, antiseptic for wound cleaning, “ace”wraps for sprains, saline eye drops, and a thermometer (especially if you travel with children). Over the counter medicines may include those for reducing a fever, pain relief, antacids, anti-diarrheals, stool softeners, motion-sickness medicine, sleep aids, oral re-hydration packets, hand sanitizer, decongestants/antihistamines, foot powder or anti-fungal cream, topical anti-itch preparation with 1% hydrocortisone for bites and stings, swimmers” ear drops, sunburn relief lotion just to name a few. Travel health supplies can be purchases in pharmacies, on-line or customized based on your destination, length of stay, access to medical assistance and plans for adventure! Travel healthy, travel smart!

Children and travel

Children are likely to face most of the same health issues during international travel as adults.  Caregivers should be acutely aware of signs of distress or illness of infants and children in their care. If the little travelers have chronic conditions or are immunocompromised, special consideration must be given to their needs. Children can quickly become dehydrated, fussy and febrile. A few important tips come to mind, for example, only serve pasteurized dairy products and thoroughly cooked foods. Infant formula must be mixed with bottled water. Bring: your own car seat for safe travel, quick snacks to satisfy a hunger emergency, oral rehydration solution packets(check out www.ceraproductsinc.com), childrens’ medicines appropriate to treat a fever or pain. Antimalaria medication prescribed by the child’s doctor will be based on weight and destination.  www.cdc.gov/travel has detailed information on malaria  including avoidance measures for mosquitoes and other pesky vectors. Repellants containing at least 25% DEET  is appropriate and safe for exposed skin on children over 2 months of age according to the CDC and American Academy of Pediatrics.  Sunblock with SPF >15 is a must along with appropriate clothing to prevent sunburn. Keeping little hands clean is a near insurmountable task, yet exposure to disease from sand, soil and solid surfaces is common. Teach children  to keep away from animals that can potentially carry rabies. www.arlingtonpediatrics.com has some wonderful tips for a variety of common concerns. My hands-down favorite guide for parents traveling with children is found at www.kidsTravelDoc.com