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Take Precautions to Avoid Travel-Related Illnesses on Your Next Trip

Posted on: Wednesday, 24 August 2005, 15:00 CDT

For The Patriot Ledger

Wearing surgical masks, airline personnel sprayed a chemical into the cabin of the plane as Thomas J. Corbett sat uneasy in his seat. That was the summer of 2003 and Corbett was en route to Hong Kong from China. The "fogging" of the cabin was a mandatory health precaution against SARS, the disease that spawned an epidemic of illness and fear in 2003, killing nearly 800 people worldwide and shutting down stores, airports, schools, factories and hotels across Asia.

Corbett, 45 of Abington, is an international project engineer for Gillette and works with executives in nine countries, including Russia, Germany, China and India. He travels at least seven times a year. He said he never gave the fogging incident another thought until eight months later when he began to experience unusual symptoms - night sweats, sore back, a persistent, low-grade fever, and inexplicable lumps under his armpits. That's when doctors diagnosed him with a particularly aggressive form of non-Hodgkin's lymphoma. Exposure to a foreign object or chemical was probably the cause, doctors told him.

"I didn't know they were going to spray that plane. I had no idea what they were spraying for or what the cans said on them. They sprayed me and the cabin. If I had known (beforehand) I would have taken a different plane," Corbett said. "It is the traveler's responsibility to know what they're heading into. Now, I would have checked ahead. I would have worn a mask." Safety first

While Corbett's case is an extreme example, health experts agree travelers need to take precautions to ensure health and safety. More than 20 million people will travel abroad this year to places where they may contract a potentially serious disease, reports a recent survey by the American Society of Travel Agents. Many travelers do not know which countries carry which disease risks and a majority of people are unaware malaria and hepatitis can be contracted in some popular destinations, the survey reveals. In addition, a large number are unsure or misinformed about how some common travel diseases are transmitted. "The most important thing to remember is your risk of infectious disease depends on where in the world you go," said Dr. Douglas Salvador, an infectious disease specialist, epidemiologist and infection control director at Northeast Specialty Hospital in Braintree. The World Health Organization says malaria is one of the most serious health threats to international travelers. Others are Hepatitis A, Dengue Fever, typhoid fever, Yellow fever, Chagas disease, Japanese encephalitis, plague and cholera, among others. Traveler's diarrhea is the most common ailment.

Hepatitis A and B, which can lead to liver failure and even death, occur mostly in underdeveloped countries where sanitation is extremely poor. Fortunately, it can be prevented with a vaccine, Salvador said. "Because it is vaccine preventable, even if you were to potentially get it, you would have a mild, preventable case," Salvador said. Know the enemy

Many illnesses are contracted through food and water. Cholera, salmonella, and typhoid fever can be found in food and drinking water throughout Eastern Europe. The most common infectious disease in Mexico is Montezuma's Revenge, or severe diarrhea.

Tickborne encephalitis, a viral infection of the central nervous system, is common throughout Central and Western Europe. People mostly at risk are those who visit or work in forested areas and who consume unpasteurized dairy products, reports the Centers for Disease Control and Prevention. Avian influenza ("bird flu") is another health risk for globe trekkers in certain regions of China and Southeast Asia where people are readily exposed to infected poultry on farms and in open-air markets. "This is largely a disease of people who live there and take care of poultry. There have been very few cases of person-to-person transfer," Salvador said. "If you should get it, we have antivirals, the same things to treat influenza in this country." Travelers are at low risk of getting sick from the virus, Salvador said. The risk is even less so if they take special care not to come into contact with live or dead poultry, and maintain good hygiene throughout their trip, Salvador said.

Since late 2003 the disease has sickened 109 humans, killing at least 55. Report show the disease has moved from Southeast Asia into China and Russia. There is also a cholera outbreak in Niger. The World Health Organization reports 49 cases, five deaths.

Get your shots

In many countries travelers are required to present a certificate of vaccination or booster shots against certain infectious diseases such as Hepatitis A and B and yellow fever. For anyone planning a trip to a foreign country, Salvador said, it is important to do the research and make sure all vaccines are current and, in many cases, required for entry into a foreign country. Many clinics and hospitals offer travel medicine programs.

"The way that you reduce the risk is you understand the way these things are transmitted, the likelihood of getting them, and how preventable they are," Salvador said. Whenever and wherever people come into contact with each other in large numbers - especially in closed quarters - the risk of spreading an infectious disease increases. Travel by cruise ship or passenger jet can spread many diseases like measles, rubella, respiratory and gastrointestinal illnesses, and exotic strains such as bird flu. Young children and older adults are especially at risk given their weaker immune systems. Corbett, an Abington selectman, said there is no way he will ever know if the chemical fog he encountered aboard the Chinese jetliner two years ago caused his non-Hodgkin's lymphoma. "It's just as possible that I got it from the chemicals I used to kill weeds," he said. Since he was diagnosed in 2004 Corbett has undergone aggressive chemotherapy and his cancer has been in remission for about a year.

He is a world traveler, who has been to Russia, hiked through the rainforests along the Amazon River in Brazil, and experienced the cultural splendors of Europe, Mexico, India and China. He will keep traveling, too, and urges other to do the same. "Take the precautions. Don't be afraid to experience life. The world is such a beautiful place," Corbett said.

Stay healthy tips

Wash hands often with soap and water. Drink only bottled water, boiled water or carbonated drinks in cans and bottles. Avoid tap water, fountain drinks and ice cubes. Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Do not eat food purchased from street vendors. Do not eat dairy products that have not been pasteurized. Pay special attention to mosquito protection between dusk and dawn. Wear long-sleeved shirts, long pants and hats. Apply insect repellents that contain DEET. Do not swim in fresh water. Salt water is usually safer. Do not handle animals, especially monkeys, dogs and cats. Wear sunblock to protect skin. Sources: Center for Disease Control and Prevention and The World Health Organization

HOW AN ILLNESS SPREADS

Carried by insects - Dengue, Plague, Malaria, Yellow Fever

Carried in food or water - Cholera, Hepatitis A, Typhoid Fever, E.Coli, Schistosomiasis

From person to person contact - Hepatitis B, HIV/AIDS

Source: Patriot Ledger, The; Quincy, Mass.

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