|
Canada,
St. Pierre and Miquelon [France], United States [including
Hawaii]
In 1994, an international commission certified the eradication
of endemic wild poliovirus from the Americas. Ongoing
surveillance in formerly endemic Central and South American
countries (Tropical and Temperate) confirms that poliovirus
transmission remains interrupted.
The incidence of communicable diseases is such that they
are unlikely to prove a hazard for international travelers
greater than that found in their own country. There are,
of course, health risks, but in general, the precautions
required are minimal.
Certain diseases occasionally occur, such as plague, rabies
in wildlife, including bats, Rocky Mountain spotted fever,
tularemia, arthropod-borne encephalitis, and seasonal
outbreaks of influenza. Rodent-borne hantavirus has been
identified, predominantly in the western states of the
United States. Lyme disease is endemic in the northeastern
United States, Mid-Atlantic, and the upper Midwest and
the southwestern provinces of Canada. Occasional cases
have been reported from the Pacific Northwest. Recently,
cases of West Nile virus have occurred around the New
York City area. During recent years, the incidence of
certain foodborne diseases, e.g., E. coli O157:H7 and
salmonellosis, has increased in some regions. Other hazards
include poisonous snakes (see Animal-Associated Hazards
on the Making Travel Safe page), poison ivy, and poison
oak. In the north, a serious hazard is the very low temperature
in the winter.
In the United States, proof of immunization against diphtheria,
measles, poliomyelitis, and rubella is now universally
required for entry into school. In addition, the school
entry requirements of most states include immunization
against tetanus (49 states), pertussis (44 states), mumps
(46 states), and hepatitis B (26 states). Haemophilus
influenzae type b (Hib) vaccine is not required for school
entry but is required in 49 states for attendance in day
care facilities.
All
travelers should take the following precautions, no matter
the destination:
- Wash
hands often with soap and water.
- 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.
- Always
use latex condoms to reduce the risk of HIV and other
sexually transmitted diseases.
- Don’t
eat or drink dairy products unless you know they have
been pasteurized.
- Don’t
share needles with anyone.
- Eat
only thoroughly cooked food or fruits and vegetables
you have peeled yourself. Remember: boil it, cook it,
peel it, or forget it. Never eat undercooked ground
beef and poultry, raw eggs, and unpasteurized dairy
products. Raw shellfish is particularly dangerous to
persons who have liver disease or compromised immune
systems.
Travelers
visiting undeveloped areas should take the following precautions:
To stay healthy, do...
- 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.
- If
you visit an area 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 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. To avoid getting sick...
- Don’t
eat food purchased from street vendors.
- Don’t
drink beverages with ice.
- 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).
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.
- Insect
repellent containing DEET (diethylmethyltoluamide),
in 30%–35% strength for adults and 6%–10% for children,
as well as 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 portable water filters to purify water if
bottled water is not available.
- 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.
|
