Destination #1: Mexico
Land of salsa, sombreros, and so much more. Over 735,000 Canadians visited Mexico in 2001.
DESPITE STRONG EFFORTS BY THE TOURISM INDUSTRY IN DEVELOPING COUNTRIES, MICRO-ORGANISMS IN FOOD AND WATER REMAIN THE NUMBER ONE CAUSE OF DISEASE IN TRAVELLERS. WITH A LITTLE CAUTION, TRAVELLERS CAN AVOID EATING UNSAFE FOODS. HOWEVER, TEMPTING SMELLS FROM STREET VENDORS CAN LURE EVEN THE MOST HYGIENE-CONSCIOUS TOURIST. MOST MICRO-ORGANISMS CAUSE MINOR ILLNESS SUCH AS TRAVELLERS’ DIARRHEA. SOME, LIKE HEPATITIS A, CAN CAUSE SERIOUS, EVEN LIFE-THREATENING DISEASE. CONTRARY TO POPULAR BELIEF, IT IS FOOD, NOT WATER, THAT IS USUALLY THE CULPRIT. THE REASON? MOST TRAVELLERS CAN CONTROL WHAT THEY DRINK, BUT NOT HOW LOCAL COOKS PREPARE AND HANDLE FOOD. TAKE, FOR EXAMPLE, A MEXICAN COOK WHO LIVES IN A SIMPLE HUT WITHOUT PLUMBING. HE COMES TO WORK AT THE HOTEL RESTAURANT AND WITH UNWASHED HANDS PREPARES SOME DELICIOUS DISH. JUST BEFORE SERVING, TO TEST THE TEMPERATURE, HE STICKS A FINGER IN. AS A FINISHING TOUCH, THE COOK ADDS UNCOOKED SALSA AND UNWASHED LETTUCE. THE UNLUCKY TOURIST WHO EATS THIS OFFERING MAY GET MORE THAN A TASTY MEAL.
There are ways to avoid food and water-borne bugs:
PACK IMODIUMTM TO COMBAT MILD DIARRHEA. ANTIBIOTICS MAY BE NECESSARY FOR SEVERE SYMPTOMS.
EXOTIC ILLNESSES LIKE MALARIA AND DENGUE FEVER RESULT FROM MOSQUITO BITES. NIGHT-BITING MOSQUITOES CARRY MALARIA IN SOME RURAL AREAS OF MEXICO, INCLUDING RURAL RESORT AREAS. SYMPTOMS INCLUDE HIGH FEVER, CHILLS, SEVERE FATIGUE, ABDOMINAL PAINS AND HEADACHE. MALARIA CAN BE FATAL AND HEALTH CANADA RECOMMENDS PREVENTIVE MEDICATION. DENGUE FEVER-SPREADING MOSQUITOES PREFER URBAN, SHADY AREAS AND ATTACK MOST OFTEN DURING THE COOL OF THE DAY. NOT USUALLY FATAL, DENGUE SYMPTOMS INCLUDE FEVER, SEVERE HEAD AND MUSCLE ACHE, PAIN BEHIND THE EYES, AND RASH. NO VACCINES EXIST TO PROTECT AGAINST THESE DISEASES.
Here are some tips for preventing mosquito bites and illness.
MANY DEVELOPING COUNTRIES REPORT HIGH RATES OF RABIES. FATAL WITHOUT PROPER TREATMENT, RABIES IS PASSED THROUGH CONTACT WITH THE SALIVA OF AN INFECTED ANIMAL. IN MANY COUNTRIES, GETTING TREATMENT CAN PROVE DIFFICULT. PREVENTION INCLUDES AVOIDING ALL ANIMALS, EVEN THE MONKEY SOMEONE OFFERS TO PUT ON YOUR SHOULDER FOR A SOUVENIR PHOTO, OR THAT CUTE LITTLE STREET DOG. ALWAYS SEEK IMMEDIATE MEDICAL ATTENTION FOR ANY BITE, SCRATCH OR LICK (ESPECIALLY ON BROKEN SKIN) AND HAVE THE WOUND RE-EXAMINED AFTER RETURNING TO CANADA. LONG-TERM OR HIGH-RISK TRAVELLERS (CAVE EXPLORERS, ANIMAL HANDLERS) SHOULD CONSIDER HAVING RABIES VACCINATION BEFORE LEAVING CANADA.
Destination #2: Caribbean Islands
The blue water and friendly islanders attracted over one million Canadians in 2001. This destination poses many of the same health challenges as Mexico, with a few differences.
EXCEPT FOR HAITI AND RURAL AREAS OF THE DOMINICAN REPUBLIC, THE CARIBBEAN IS MALARIA-FREE.
MOSQUITOES IN RURAL AREAS OF TRINIDAD HAVE BEEN KNOWN TO CARRY THIS FATAL DISEASE. A SAFE AND EFFECTIVE VACCINE IS AVAILABLE TO PROTECT AGAINST YELLOW FEVER. THE CENTERS FOR DISEASE CONTROL AND PREVENTION RECOMMEND VACCINATION FOR ALL TRAVELLERS WHO GO OUTSIDE URBAN AREAS IN TRINIDAD AND TOBAGO.
When humans infected with schistosomiasis pass urine in fresh water, these parasites enter the water where they invade and multiply in snails. The snails then pass the parasites back into the water where they look for a new host. Anyone swimming, bathing or wading in infected fresh water is at risk. Travellers should plan to swim only in salt water and properly chlorinated pools. Symptoms vary depending on what body organs the parasites lodge in. Medication can treat the disease but not prevent it. (Note: there is no schistosomiasis in Anguilla, the Caymans, Saint Kitts-Nevis, Saint Vincent and the Grenadines, Trinidad and Tobago, Turks and Caicos, and the U. S. Virgin Islands.)
Health Advice for Travellers published by Capital Health Authority, Edmonton.
Travelling Healthy: Health Advice for the Global Traveller (Nov/Dec, 1997; Sept/Oct, 1999; Mar/April, 2000): This is a bimonthly publication by Travel Medicine, Inc., 369 Pleasant Street, Northampton, MA 01060. E-mail: [email protected]
Health Information for International Travel, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, 2001-2002.
Re-Evaluation Decision Document, Personal insect repellents containing DEET,
Health Canada, 2002, April 15.
Control of Communicable Diseases Manual, 17th Edition. Chin, J. (Editor). American Public Health Association, Washington, D.C. 2000.
Malaria, Montezuma and Me: A Medical Guide for Travellers. Canada, 2000. Wise, Mark, MD.
International Travel Health Guide, 12th Edition, Northampton, MA: Travel Medicine, Inc. 2001. Rose, Stuart R., MD. E-mail: [email protected]
Don’t Drink the Water. . . The complete traveller’s guide to staying healthy in warm climates, 5th Edition. Keystone, J. S., MD (Editor). Canadian Public Health Association and the Canadian Society for International Health, 2000.
Travellers’ Health Services, Capital Health Authority, Edmonton, Alberta: www.cha.ab.ca/travellers
•McGill University Health Resource for International Travellers: sprojects.mmi.mcgill.ca/tropmed
Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Travellers’ Health: www.cdc.gov/travel
A TYPE OF FISH POISONING, CIGUATERA RESULTS FROM EATING AFFECTED FISH. IT IS FOUND ACROSS THE CARIBBEAN. OVER TIME, FISH BECOME INFECTED FROM INGESTING A TOXIN PRODUCED BY TROPICAL WATER PLANTS. NO TESTS CAN DETECT THE TOXIN, AND IT IS NOT DESTROYED BY COOKING OR FREEZING. COMMON SYMPTOMS OF CIGUATERA INCLUDE ABDOMINAL PAIN, VOMITING, DIARRHEA, REVERSAL OF THE SENSATION OF HOT AND COLD TEMPERATURES, NUMBNESS AND TINGLING AROUND THE MOUTH AND LIMBS, SLOWED HEART RATE, SEVERE ITCHING, AND MUSCLE PAIN. SYMPTOMS LAST FROM TWO WEEKS TO SEVERAL YEARS. THERE IS NO SPECIFIC TREATMENT.
There are ways to reduce the risk of ciguatera.
Destination #3: Arizona
Canadian snowbirds flock to Arizona to escape winter health problems. Even this “safe” destination has some risks. Never leave Canada without purchasing travel insurance, even for trips to the U.S. Seniors can also purchase insurance and it is worth the extra cost. Anyone over age 65 or who suffers from chronic health problems should also be sure their flu and pneumonia shots are up-to-date.
ALSO KNOWN AS DESERT FEVER OR POSADA’S FEVER, THIS ILLNESS AFFECTS BETWEEN 25,000 TO 100,000 AMERICANS EACH YEAR. THE DISEASE IS CAUSED BY A FUNGUS THAT LIVES IN DESERT SOIL - MOSTLY IN SOUTHERN CALIFORNIA, ARIZONA, NEVADA, NEW MEXICO AND WEST TEXAS. IN 2001, ONE CASE OCCURRED IN AN EDMONTON TRAVELLER TO ARIZONA. WHEN WINDS STIR UP DRY SOIL, PEOPLE BREATHE IN THE FUNGUS. IN MOST PEOPLE IT CAUSES A MILD PNEUMONIA, BUT SOME DEVELOP SERIOUS, EVEN FATAL, DISEASE. PREVENTION INCLUDES DUST CONTROL MEASURES AND STAYING INDOORS ON WINDY DAYS.
One final bit of advice for all countries you visit - know the rules of the road. Worldwide, traffic collisions cause the most injuries and deaths in travellers. Before you drive, spend time learning about driver etiquette in your host country. It could save your life. In many countries drivers never stop to help at a traffic accident, whether or not they were the cause. A mob at the scene might kill them. Instead, go to the nearest police station and give a report. You might not agree with the logic, but these are the rules. If using public transportation, stick to well-known taxi or bus companies. Also travel during the day - thieves lie in wait for night traffic.
A cruise to Mexico or the Caribbean is a popular choice for many tourists. While staying on the ship may be just like travelling in Canada, remember that once you step on shore you must take all the precautions for that destination. Flu shots are also recommended for cruise ship passengers, especially those over 65 or with chronic health conditions that might lead to complications. Among others, these conditions include well-controlled asthma, heart and lung conditions and diabetes.
On your next trip, travel wisely. Talk to a travel health specialist about your destination. Then relax and have a great time!