THE THRILL OF TRAVELING is one of life's most exciting delights. But it can also have a downside. Some travelers, particularly those headed to remote or exotic foreign destinations, may end up dealing with an infectious disease during or after a trip. These illnesses can range from just a nuisance to life-threatening, so it's important to be prepared before you travel and know what to look for when you return to keep an infectious disease from ruining your travel buzz.
Dr. Lisa Maragakis, senior director of infection prevention at the Johns Hopkins Health System in Baltimore, says the term infectious disease refers to "any disease caused by a pathogen." These pathogens may include viruses, bacteria, fungi and protozoa. "Any of these kinds of microorganisms that can cause disease in humans – we would term that disease an infectious disease," she says.
The world is full of these pathogens and the vectors, or agents, that can introduce them to our bodies. Some infectious diseases transfer from human to human – though sneezes, coughs and bodily fluids. This is how many viruses, such as colds and the flu, make us sick, and respiratory infections are common among travelers visiting a wide range of destinations. Maragakis notes that even though influenza is a disease we typically see in the wintertime, it's prevalent the world over at various different times of the year. "Travelers who are going from one hemisphere to another need to keep in mind that there's always flu somewhere in the world and they may be traveling to areas where there's ongoing transmission."
Other common infectious diseases, including many bacterial infections such as E. coli, and listeria, can be transferred via the foods we eat. Protozoa such as giardia, which causes gastrointestinal symptoms, may be transferred via tainted water and other beverages. Still other infections can be transferred through mosquitoes, perhaps the deadliest vectors of infectious disease, responsible for spreading many potentially life-threatening diseases including yellow fever, dengue fever, West Nile virus, Zika and others. Ticks are another common disease vector, transmitting Lyme disease and several other kinds of illnesses.
Preparation and Prevention Is Paramount
Clearly, there's vast variety in the realm of infectious diseases, and some may be more prevalent in certain regions than others. With all of them, as the saying goes, an ounce of prevention is worth a pound of cure. Many of these diseases can be stopped in their tracks through the use of appropriate preventive measures and avoidance.
Preparing appropriately ahead of time may also go a long way toward keeping you healthy while traveling, says Dr. Antonio Crespo, an infectious disease specialist with Orlando Health. He recommends meeting with a travel medicine specialist before your trip. Aptly named, travel medicine doctors specialize in "diseases that can happen when you travel," Crespo says. The idea is to work with this doctor before you go somewhere to learn how to prevent the most common or likely diseases or conditions you might pick up in the specific location you'll be visiting.
"We see travelers individually or in groups and we go through their itinerary and their medical history," Crespo says. The doctor is looking for which vaccines you've already had and which ones you might need depending on where you're headed as well as underlying medical issues that could make the contraction of an infectious illness more dangerous to the patient. This specialist might also be able to prescribe you prophylactic medicines, such as antibiotics, anti-diarrheal or anti-malarial medications, to take while you're traveling to keep an illness from wrecking your trip.
In addition to helping you avoid common ailments like traveler's diarrhea or malaria, the travel medicine doctor can also advise you on other health threats, both infectious and non-infectious, such as sexually transmitted diseases and whether the country has a high crime rate or political unrest that could pose a safety concern. "It's very comprehensive," Crespo says of the advice he gives patients prior to a trip. "People don't realize how important it is to do that before you travel." He says it can be helpful to see this doctor well before the trip, too, as some vaccines may require several weeks to build immunity to a specific disease. For example, the World Health Organization advises that the cholera vaccine be administered two weeks prior to departure to prevent development of this potentially deadly disease caused by the water-born bacterium, Vibro cholerae.
Maragakis also recommends checking out the Traveler's Health resources available from the Centers for Disease Control and Prevention. "Particularly if you're traveling out of the country, you can choose the country and learn more about the diseases that are potentially acquired when traveling to that region," and learn about the "vaccinations you might want to get before you travel and medications you might need to take when you travel to that region and other issues," she says.
Even if you've taken steps to avoid getting sick, it's still possible you'll pick something up while traveling and start feeling sick soon after a trip. In these instances, Crespo says a travel medicine doctor would be a good option for treating you.
Maragakis says your primary care physician, family doctor or child's pediatrician will also likely be able to help and can refer you on to the appropriate specialist if your condition requires more intensive care or expertise.
"If symptoms are mild," Maragakis says over-the-counter remedies, like Pepto-Bismol, may be enough to help manage your symptoms. "But the more severe things to watch out for, especially after you've traveled, is if you develop a fever and if you develop what we call 'malaise,' or feeling bad all over, such that it makes it hard getting out of bed." She says the development of rashes or other skin irritations as well as "severe vomiting and diarrhea would certainly be cause for concern" and should prompt a visit to the doctor.
In addition to seeking advice from your primary care physician, Maragakis says some patients may opt to visit an urgent care center or emergency department, and depending on the severity of the symptoms, either may be the right place to start in getting help. No matter which doctor you start with, the key is to be sure to communicate with the treating physician your recent travel, "because it's a big factor in what might be causing the symptoms. It really broadens the possibilities depending on where they traveled," she says.
Local Travelers Not Immune
Although infectious disease can crop up during foreign travel, staying local can also pose a threat to your health, as infectious agents are everywhere. Mosquito-borne disease diseases like West Nile and Triple E (also known as Eastern equine encephalitis, a potentially-deadly virus that causes inflammation of the brain) have increased in prevalence in the northeastern United States over the past several years. Similarly Lyme disease, which is transmitted by ticks, is on the rise across the country and can put a damper on your summer activities, even if they only involve hanging out in the backyard.
To reduce the chances that you'll contract an infectious disease at home this summer, Glatt recommends removing standing water, such as might collect in empty flower pots or old tires, from your property to eliminate mosquito breeding grounds. "Remove them or fill them in with dirt." And just as you would while traveling in a malaria region, Glatt says it's important to use "appropriate mosquito repellent or mosquito netting to prevent from getting bitten as much as you might be otherwise." This can help cut down on not only the number of itchy bites you'll get, but possibly stop the spread of potentially serious infectious diseases our local mosquitoes can deliver with each bite.