HEALTH

EWA Travel Health Recommendations for the Business Traveler

Plan ahead A small medicine kit that includes a pain reliever; antacids; antidiarrheals; cough drops, and any prescription medication being taken can offer relief from common travel-related ailments and prevent minor problems from becoming more serious.

Required vs. Recommended Vaccinations Required immunizations are those legally required by the destination country to protect its citizens from the importation of disease, even if in some cases these requirements may incidentally protect the traveler as well.

The only immunization currently required is the yellow fever vaccine. Some countries require this vaccine for travelers coming from anywhere. In some instances, it is required for travelers transiting a country where yellow fever is present.

It is important to know the country's requirement in advance because if travelers arrive without proof of yellow fever vaccination, they may be turned away at the border, quarantined for 10 days or given the shot on arrival at the airport. Suffice it to say, the needle used to give the shot may be a "reusable" needle -- not clean and sterile -- and hence pose an even greater risk to travelers' health.

The yellow fever vaccine must be received at least 10 days prior to arrival at the destination. It must be received at a certified Yellow Fever Vaccination Center (most travel medicine clinics in the U.S. are certified to give the vaccine).

Proof of yellow fever vaccination is entered onto an International Certificate of Vaccination which is carried with the passport. This certificate is good for 10 years. The only travelers for whom there might be a risk in receiving the yellow fever vaccine are those who are pregnant or immunosuppressed. The decision to receive the vaccine in these cases should be made with a knowledgeable travel health provider.

According to the World Health Organization, no country should require proof of a cholera immunization. However, sometimes when crossing between certain countries' borders, guards may request proof of a cholera shot. This sometimes reflects lack of current information or, in some instances, is a thinly veiled request for a bribe.

Recommended immunizations protect travelers from diseases for which they could be at risk include such vaccines as hepatitis A, hepatitis B, typhoid and, in certain instances, tetanus/diphtheria, polio, measles and meningitis. In other instances, vaccines against Japanese encephalitis, rabies, influenza and pneumococcal pneumonia may be recommended as well.

The best place to get information on vaccines that are recommended for a given trip is the Web site of the Centers for Disease Control and Prevention, at www.cdc.gov. A list of travel medicine clinics can be obtained through the International Society of Travel Medicine's Web site. at www.istm.org.

Economy-class Syndrome Preventions  The issue of blood clots related to air travel is dubbed "economy class syndrome" after the cramped seating often found in airlines' coach sections.

Blood clots can be fatal if they reach the heart or lungs, but travelers can take action to reduce the risk of developing them including moving around during the flight, doing in-seat exercises and drinking plenty of water. Taking aspirin before a flight thins the blood and thus helps reduce the risks of clots, according to many medical professionals. 

People who have just had surgery, women on contraceptive pills and people who are obese or have a history of blood clots are all at increased risk.

Travelers, also, should drink water every hour aboard the plane and avoid or limit alcohol and caffeine intake.

Jet Lag Remedy  Every time he lands after a long flight, professional golfer Gary Player walks 18 holes, even if he's not teeing off. Love of the game? No, "it's the light," says the 64-year-old Mr. Player who has flown some 12 million miles during his career. "I'm a great believer in sunlight to combat the time change."

Light, when used correctly, holds the greatest potential for helping travelers adjust to a new time zone, says Philip Scarpa, medical officer for the Kennedy Space Center. In fact, NASA occasionally quarantines astronauts prior to launch and douses them with light to help prepare their body clocks for space travel. It's "like fuel," adds Charles Czeisler, co-director of Harvard Medical School's Division of Sleep Medicine. "It shifts you to a later or earlier hour."

When headed east on an overnight flight, seek sun or artificial-light in the mid to late morning at your destination, but wait until late afternoon and early evening when headed west.  Also, a new drug may help to reduce jet lag.

Air Quality  Crowded airplanes and airplane terminals can be "mini-incubators" for germs. Although the airlines claim that the air quality within their planes is similar to normal office environments, we disagree. The best air quality exists in 747's and other older models where fresh air is frequently circulated. The newer models provide less fresh-air circulation due to "fuel savings" priority over passengers' health.

Stay connected. It is easy to stay connected to one's home and office in today's high-tech world. By staying in touch with family and friends, business travelers can reduce any stress they feel about leaving loved ones behind. Staying in contact with the office can minimize anxiety about any work piling up.

Wash your hands. Washing hands with soap and hot water during and especially after a flight can help control the spread of germs.

Get some sleep. Surveys conducted by Hilton Hotels indicate that nearly half (48%) of U.S. business travelers suffer from travel-related sleep disorders. Time-zone changes, unfamiliar environments and stress can disrupt sleep. If worried about oversleeping, arrange for a wake-up call and set an alarm clock for double protection.

Eat well-balanced meals. Adjusting to local cuisine can be difficult and often results in problems such as diarrhea. Further, many business travelers find they eat more and drink more alcohol than if they were at home. Eat and drink in moderation and try to have balanced meals. See the Complete Travel Diet for detailed healthy travel info. 

Exercise. For individuals who work out regularly, a disruption can cause stress and leave them feeling sluggish. When staying in a hotel without a gym or pool, consider walking or jogging outside or pack a jump rope and do some rope jumping and stretching in your room.

See DOT advise #8 for additional travel health info.

Some useful health sites on the Web:

  • World Health Organization Information on international health issues, including bird flu

  • The Mayo Clinic's Web site , one of the most popular health sites, offers expert-backed articles on medical conditions and tips for healthy living.

  • WebMD features information, interactive quizzes and articles about health and fitness issues.

  • The RxList is a comprehensive database of prescription drugs, with information on potential side effects and drug interactions.

  • MedicineNet.com's MedTerms has easy-to-understand definitions for over 16,000 medical terms.

  • Quackwatch monitors dubious medical products and treatments, including fad diets.

  • For information on the go, check out Podcast.net's health and fitness directory . Before doing Web research on your own, this WSJ article can help you determine how credible a site's health information is.

  • Alternative Health News Online Information on alternative health treatments
    FertilityFriend.com Interactive tools, articles and a forum on fertility
    International Food Information Council Information on nutrition
    The Merck Manual Searchable online version of the standard medical reference text
    Psych Central Articles, links and a forum about mental health