International Travel and the Risk of Contracting Infections


By Barry C. Fox, M.D.University of Wisconsin

With the number of international travelers rising each year, particularly traveling to developing countries, how do you know if it’s medically safe to travel to certain areas? Interestingly, demand for international tourism in 2013 was strongest for travel to countries with the most infectious disease potential: Southeast Asia, Eastern Europe, and Northern Africa.

Image of a suitcase, hat, and camera on a table and tropical island in the background.
With international tourism on the rise again, it’s wiser to be fully aware beforehand whether your destination is safe. (Image: Hitdelight/Shutterstock)

International Tourism in Potentially Disease Ridden Areas

The demand for international tourism means that people need to ideally prepare themselves for health risks months in advance and must monitor the situation in these areas on a regular basis. The U.S. State Department posts travelers’ safety and early health warnings; however, they are not the only organization that is constantly monitoring outbreaks and epidemics around the world. 

For example, in 2014, the CDC site posted warnings for over 10 countries with emerging polio. Of course, during the Ebola outbreak, it posted the highest level alert for Sierra Leone, Liberia, and Guinea. It also posts occurrences of natural disasters and potential health implications for travelers. For example, in 2013, the Philippines were already dealing with a significant outbreak of measles when typhoons struck the area, increasing the risk for disease spread.

Silhouette image of a mosquito.
Be wary of malaria if you’ve been bitten by a mosquito. (Image: mycteria/Shutterstock)

The CDC’s travel site allows you to plug in information relevant to your trip, and will give you information about associated infectious disease health risks. For example, if you select your destination as the Dominican Republic, your results would recommend that you should be up to date on all routine vaccinations. 

It also recommends hepatitis A and typhoid vaccines. It alerts you to the possibility of contracting rabies if you interact with certain animals or hepatitis B if you decide to get any tattoos or body piercings. Finally, it warns of the potential of malaria, dengue fever, or chikungunya fever if you are bitten by mosquitos.

This is a transcript from the video series An Introduction to Infectious Diseases. Watch it now, on Wondrium.

Follow CDC Guidelines When Traveling

You can receive helpful recommendations for water precautions like taking a water bottle and water purifying tablets along or buying one that has a special filter. Technologies like the Lifesaver Bottle claim they can remove all bacteria, viruses, cysts, parasites, fungi and waterborne pathogens, and even polio and E. coli, may be useful.

There’s a wise saying that when you eat food in developing countries, you should either peel it, boil it, cook it, or just forget it. For example, don’t eat foods like salads, raw fruits and vegetables, raw or runny eggs, food at room temperature, or bush meat. For drinks, realize that ice cubes are often contaminated, so stick to bottled drinks and pasteurized beverages. Under most circumstances, you should even brush your teeth with bottled water just to be safe.

If you follow the CDC guidelines, will you really be safe? In most cases, the answer is yes, but for special medical conditions, like pregnant women, no. Going to malaria-endemic zones while pregnant is definitely not recommended, as preventative medications are limited, and the health impact on the fetus may be significant.

Learn more about malaria and tuberculosis: global killers.

Visiting a Travel Clinic

Image of a yellow fever vaccine.
Yellow fever is potentially deadly, and only specific travel clinics can administer the vaccine. (Image: Andrey_Popov/Shutterstock)

The CDC website is a valuable place to start, but travel clinics do have special resources as well. A website or book should not be a substitute for a real travel clinic visit, if at all possible. Travel clinics are also especially important if you’re going to an area of either South America or Africa where yellow fever is endemic.

Yellow fever is caused by a potentially deadly virus that is mosquito-borne, that rapidly attacks the liver, and leads to yellow jaundice—hence the derivation of its name. Only certified travel clinics can administer the yellow fever vaccine, and an official booklet stamp is required to enter other countries after visiting countries with yellow fever risk.

Learn more about the nemesis of mankind: HIV and AIDS.

Planning Is Key to Making Sure It’s Medically Safe to Travel

Some vaccines need multiple injections and have to be given in a series, months apart. That means you have to work backward in your timetable in order to be fully protected by the time you leave. Health officials recommend finishing all vaccines at least one week before traveling, in case you have a rare serious side effect, and in order to give your immune system time to form IgG antibodies.

Additional planning is also important so that you can identify medical care available in the area where you are traveling. If you buy traveler’s health insurance, they usually work with specific providers in the country they serve. Otherwise, there is a list of organizations you can contact in case of emergencies, like the U.S. Embassy and the International Association for Medical Assistance to Travelers.

So, it is always recommended to plan ahead if you are traveling to a country that is not medically safe.

Common Questions about International Travel and the Risk of Contracting Infections

Q: How does the CDC travel website help tourists?

By picking where your destination is, the CDC travel website tells you if it’s medically safe to travel there. And if there are necessary precautions that you have to take, like vaccines and anti-insect repellant, the website will inform you.

Q: What should your approach be to eating and drinking in developing countries?

If the country is not medically safe to travel to, then it’s better to not eat anything raw and to know most food can be contaminated, so it should be peeled or boiled. Also, drinking from water bottles is very much advised.

Q: How is planning important when it comes to disease-ridden countries?

In a country where it’s not medically safe to travel to, there is the risk of contamination, so you should vaccinate before going. Some vaccines require multiple injections, so you may have to plan months ahead.

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