Whether you’re traveling to the next state over or heading across the world, one of the most important things you should prepare for is your health. I’m not only thinking of insurance, which is essential, but all of the other things you can do to start, stay, and arrive home safely and in good health.

We all know the basic drill – vitamin c, probiotics, stay hydrated, exercise, sleep well, avoid dodgy food situations, purify your water in some places, eat your vegetables (I can sooo see everyone’s parents saying this). But what should you do for travel that is not as easy to prepare for, health-wise – perhaps a place where you have to get shots, or bring your own medical supplies, or be extra careful about food and water?

I wanted the answers to these hard questions (because we want to think of travel as exciting and an adventure, which it is, but we also need to be smart about our health, so we can keep going on adventures. We all don’t have a ring to rule them all, alas). So I reached out to a travel health expert, Dr. Stuart Rose, MD, for advice. He’s the director of the International Travel Clinic at Noble Hospital, Assistant Professor of Emergency Medicine at Tufts New England Medical Center, the author of The International Travel Health Guide, and the CEO of a fantastic and useful resource, Travel Medicine. 

Here’s what Dr. Rose had to say about travel and health, a surprising travel fact, and his excellent book...

I'm intrigued by your book, the International Travel Health Guide. Can you please share more about it - why you wrote it, and why people need to be aware and educated about travel and health?

When I was in medical school at Columbia, I had the opportunity to take a 4th year elective in tropical medicine in Africa and spent 6 weeks at a remote missionary hospital in western Ethiopia, on the border with Sudan. I saw illnesses (such as malaria, TB, river blindness) that one rarely sees in this country, and there was the challenge to do the best you could with limited resources. You also had to be wary of the crocodiles in the adjacent river! Being there also whetted my appetite for more travel to exotic lands.

In the 1980s, I had the opportunity to start a travel Clinic at Hillcrest Hospital, in Pittsfield. I soon discovered that there was very little information available about what risks travelers faced when going to tropical and lesser-developed countries. This was before the Internet. I decided a source of information was needed about tropical and infectious diseases and country by country disease risks, so I wrote the first edition of my book, the 1989 International Travel Health Guide, which I published annually in paperback until 2001 and then online where it is currently available at www.travmed.com.

In 2005, the publishing company Elsevier (world’s largest medical publisher – think the Lancet) published the Health Guide both in English and in Chinese (would you believe) but they could not promote the book successfully to the mass market of travelers, which I will explain.

In the late 1990s, I started an online business selling products to keep travelers safe and comfortable. These products (mosquito repellents, medical kits, water purifiers, etc.) complemented the advice I was giving to travelers.

I left the Travel Clinic in Pittsfield in 1991, but decided in 2009 that I would start to see travelers myself in my office in Northampton where I would review their itinerary and counsel them about staying healthy by preventing insect bites, drinking safe water, taking pills to prevent malaria and what to do if they got sick (We encourage everyone to buy a MEDEVAC policy from International SOS, and I get them a 20% discount.). I tell all of them to “wear your seat belt--if there is one!” Why? Because accidents are the cause of excess mortality in travelers. You can have your heart attack anywhere, but crossing the street or driving in New Delhi is much scarier, and dangerous than here.

Now, I am well-positioned to provide travelers 3 essential things myself, under one roof at one time. 

•    In-depth country-by-country information with a printed database and other handouts. Detailed review of itinerary. How many days? Staying in deluxe hotels in major cities or backpacking in remote rural areas where there is the risk of not only of tropical and infectious diseases, but also rabies. Also, people going to high altitudes (think Cuzco, Peru) need meds to prevent altitude illness

•    Immunizations and medications to prevent malaria and treat travelers’ diarrhea, should it occur (the most common disease of travelers)

•    Products from my store (insect repellents, water filters, electrical adaptor plugs, rehydration salts, etc.) to keep them healthy and comfortable.

What are the most important health things travelers need to know before heading abroad?

• Get all your shots, as needed. Don’t wait until the last minute. Call 6 weeks before departure because some vaccines (e.g., rabies, Japanese encephalitis) are administered in several doses over 3-4 weeks.
• Bring an antibiotic to treat travelers’ diarrhea, if it occurs. (A single 2-tablet dose (1,000 mg) of azithromycin is usually curative in 85% of cases.)
• Wear your seatbelt  – if there is one! Excess mortality in travelers in related to accidents, especially MVAs.
• Buy a medical evacuation (air ambulance) policy if traveling to lesser-developed/remote countries. We can get you a 20% discount from International SOS.
• See a doctor if you develop an unexplained fever or other symptoms (abdominal pain, fever) after returning home, especially if you have traveled to a country with malaria...and even if you took malaria pills.

As an international travel and health expert, what might surprise readers regarding travel and health?

Flying long distances does not dehydrate you from “dry cabin air” and it’s OK to have coffee and or a couple of drinks enroute. Travel writers over the many years have cautioned about this, but studies show that average traveler gains about 2 oz. of weight during the flight without forcing fluids.[Wandering Educators note: YAHOO!]

What international health trends should travelers watch out for?

I suggest travelers check with the CDC about any recent disease outbreaks (Alerts) at http://wwwnc.cdc.gov/travel/notices/.