Travel Health

Before You Go

For general travel health information, details on current disease outbreaks, and the most current shot recommendations for different areas of the world, see:

• The Health Canada Travel Medicine Program (TMP) Web site at www.phac-aspc.gc.ca/tmp-pmv/index.html.
• The U.S. Centers for Disease Control and Prevention (CDC) Web site at www.cdc.gov/travel.
• The World Health Organization (WHO) Web site at www.who.int/en.

Preparing for a journey takes planning and time. Proper planning is the best way to stay healthy during your trip. See a doctor at least 6 weeks before you go so that you'll have time for immunizations and other health precautions you may need to take in advance. Better yet, talk to your doctor as soon as you know you will be travelling. There are some shots that need to be given more than once, and you may need more than six weeks in some cases. There are several factors to consider in preparing for a trip.

Your individual health needs

If you have any chronic diseases or other health concerns, such as birth control or allergies, see your doctor. You may need to adjust your itinerary to accommodate your health needs. For example, if you have heart failure or a history of blood clots, you may need to take shorter flights with more stops to avoid long periods of sitting. If you have asthma, chronic obstructive pulmonary disease (COPD), or other lung diseases, you may need to avoid stays in polluted cities or at high altitudes.

Evaluate whether you will be physically able to meet the rigours of your particular trip. Most travel, even if you are going on a professionally led tour, typically demands more physical effort than is required at home. Boost your fitness by starting an exercise program, such as fitness walking, in advance.

If you have health problems, carry a letter from your doctor describing your conditions, a list of your routine medications including their generic names, and written prescriptions for refills if you will be gone long. People with heart conditions should travel with a copy of their most recent electrocardiogram (EKG, ECG) for comparison should they have chest pain or other symptoms. If you have diabetes, you can take precautions to prevent problems while travelling.

Leave your prescription medications in the original containers—your name must match the name on the bottle—and pack them in a waterproof container in your carry-on luggage. Take extra amounts of your routine medications packed in checked luggage in case of theft or loss.

If you are pregnant, talk to your doctor before making any travel decisions. If you decide to travel, take some general precautions while travelling, such as notifying the airline of your condition before you fly and taking occasional walks while on a long flight to increase the blood circulation in your legs (good advice for all travellers).

Many doctors recommend that you take a first aid kit with items such as pain relievers, sunscreen, insect repellent, moleskin, antifungal and antibacterial ointments, and antidiarrheal medications, especially if you will be travelling to areas where modern medical care is not readily available.

Potential health risks

Preparing for health risks is especially important if you are visiting developing countries, such as those in most parts of Africa and Asia and many parts of South and Central America, where expert medical care may not be readily available.

Before you go, you should be aware of any needed immunizations or medications, disease outbreaks, food and water precautions, and any other preventive measures to take. Check your local travel clinic or health unit at least 6 weeks before travelling so that you'll have time for immunizations and other health precautions that may need to be done in advance. Better yet, talk to your doctor as soon as you know you will be travelling. There are some shots that need to be given more than once, and you may need more than six weeks in some cases. Most of these clinics can give immunizations and prescriptions for antimalarial drugs. If not, ask to be referred to a clinic that specializes in travel health.

Make sure all of your routine immunizations are up to date for you and your children. These immunizations can protect you from diseases such as polio, diphtheria, measles, whooping cough, and rubella that have been virtually wiped out in developed nations but are still prevalent in some developing countries. If you will be travelling to a country where these infections are still common, check your immunity status. Some adults have not received all of these vaccines (especially measles, mumps, and rubella) and may be susceptible unless they have had the disease. Your tetanus immunization should be updated before travelling if you haven't received one in the last 10 years.

See the recommended schedules for routine immunization from Health Canada's Division of Immunization at www.phac-aspc.gc.ca/im/index.html.

For more information, see the topic Immunizations.

Hepatitis A vaccine is recommended for most travellers to developing countries where the disease is prevalent. You can help protect yourself from hepatitis A while travelling by taking basic precautions such as boiling your drinking water, making sure food is well-cooked, and eating only raw fruits that you have washed and peeled. The hepatitis A vaccine is two shots. The second shot is given six months after the first shot. If you know you will be travelling more than six months before you leave, getting both shots is best. But if you don't have six months before you leave, it is still important to get the first shot. The first hepatitis A shot usually works in about six weeks and protects most people from getting hepatitis A. If you only had the first hepatitis A shot before you left the country, make sure you still have the second one when you get home (within three years of the first shot).

A vaccine for typhoid fever is also recommended for all travellers who will be spending time in areas that may have contaminated food and water.

The yellow fever(What is a PDF document?) vaccine is currently required for travellers who plan to visit countries in South America and Africa where the disease is active.

Additional immunizations may be needed depending on the area you are visiting, how long you will be there, and the purpose of your journey. For example, if you will be trekking in rural Asia for more than 3 months during the summer or fall months, you may need the vaccine for Japanese encephalitis.

Ask about a prescription for antimalarial drugs if you will be visiting an area that has malaria. Malaria-risk areas of the world include large areas of Central and South America, Haiti and the Dominican Republic, Africa, the Indian subcontinent, East Asia, Southeast Asia, the Middle East, and many South Pacific islands. You may need to take one of several different preventive medications depending upon the type of mosquito inhabiting that part of the world. These medications need to be taken daily during your travels and for a specified time after you return. It is important to take all the tablets you were given. This may mean taking antimalarial tablets for several weeks after you get home.

In Canada and some other countries, an oral vaccine (Dukoral) that protects against traveller's diarrhea caused by E. coli and cholera bacteria is available for anyone age 2 or older.

If you are taking a cruise, check your ship's sanitation inspection scores at Health Canada's Web site at www.hc-sc.gc.ca/hl-vs/travel-voyage/general/inspection/cruise_ship-navires_croissieres_e.html. You can also check the CDC Web site at wwwn.cdc.gov/travel/contentCruiseShips.aspx.

Medical care in developing countries can be below standard. Before you go, check the Health Canada Travel Medicine Program (TMP) Web site at www.phac-aspc.gc.ca/tmp-pmv/index.html.

In some cases, provincial health plans may not provide coverage for out-of-country travel or may restrict the coverage provided. If your provincial health plan does not cover you in other countries, you may want to think about buying private travel health insurance.

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Author:	Douglas Dana Monica Rhodes	Last Updated: July 9, 2007
Medical Review:	Wajeeh E. Nasser, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine W. David Colby IV, MSc, MD, FRCPC - Infectious Disease
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