International Travel Tips to Prevent Zika Virus, Malaria and Diarrhea

If you’re planning a getaway out of the country, preparing to stay healthy is as important as booking a flight and packing your bags. Figuring out what vaccines you need or what medications to pack can be daunting. Should you worry about Zika virus? And what foods should you avoid so you aren’t running to the bathroom all day? Here’s what to keep in mind when traveling internationally.

Travel Medicine Basics

No matter where your travels take you, there are three major categories to consider, says Thomas Hawn, M.D., attending physician at Harborview Medical Center’s Infectious Disease & Travel Medicine Clinic.

1. Vaccines

Whether you’re going two states away or you’re traveling across the globe, being up-to-date on standard immunizations is key, says Hawn. Also, if you’ve never received the hepatitis A vaccine, which became part of the routine childhood immunization schedule in 1994, consider asking for that vaccine before your trip—especially if you’re traveling to a developing country. Hepatitis A is a liver disease spread by contaminated food and water, and the Centers for Disease Control and Prevention (CDC) recommends receiving the vaccine before travelling to most countries, except Canada, western Europe and Scandinavia, Japan, New Zealand and Australia.

Your primary care physician or a travel medicine clinic provider can fill you in on additional location-specific vaccine recommendations, says Hawn. Be sure to plan ahead when possible, as some vaccines require multiple doses, which can take up to six months.

2. Foodborne Illnesses

Trying new cuisine is one of the joys of international travel, but it can also leave you feeling sick. From serious diseases, such as Hepatitis A and Typhoid Fever, to more benign “traveler’s diarrhea,” you’ll want to be prepared for the worst. Typically, foods that are peeled or cooked have a very low risk of spreading foodborne pathogens, while raw foods that are harder to wash, like salad or Brussels sprouts, come with a higher risk of being contaminated with bacteria that can make you sick, Hawn explains. And even if your food isn’t contaminated, eating foods you aren’t used to can disrupt your gut and mess with your plumbing.

Your doctor may want you to carry an antibiotic or diarrhea control medication with you when your travel, but it’s important to understand when to take these medications, as the majority of diarrhea can’t be treated with an antibiotic, says Hawn.

“It’s surprisingly complicated,” he says. “It really depends on your travel circumstances, and it’s a good idea to have a conversation with a doctor at a travel clinic to understand the pros and cons before you go.”

3. Mosquito-Borne Diseases: Malaria, Zika and Dengue Fever

Mosquito bites are more than an itchy nuisance if you’re traveling in areas where mosquito-borne diseases, such as malaria, Zika virus and dengue fever, are present.

If Malaria is present, your doctor will prescribe you malaria prophylaxis pills to take during your trip, says Hawn. Dengue fever, also transmitted by mosquitos, has no treatment or vaccine available, so preventing the disease is all about taking the proper insect precautions, he explains. Wearing long sleeve shirts during mosquito biting times and using insect repellent are important steps in avoiding mosquito bites.

Zika is another very real travel concern, especially if you’re pregnant or would like to become pregnant. Everyone should take mosquito precautions when visiting any area where Zika is present. Women who are pregnant shouldn’t visit these areas because of the risk of serious birth defects. Those who have experienced symptoms of the virus and who are planning to become pregnant should wait two months after their trip before trying to conceive, while men should wait six months before having unprotected sex, says Hawn. Zika virus can be passed through sex, and the virus can stay in semen longer than in other body fluids, the CDC warns.

Not sure if you should be concerned about mosquito-borne diseases on your trip? Comparing your itinerary to the CDC’s outbreak maps can help you determine where in the world you are at risk for contracting malaria, Zika and dengue fever.

Plan Now, Enjoy Later

Deciding what vaccinations to get, which medications to take on your trip and what, if any, foods you’ll avoid starts by thinking about what level of risk you’re comfortable with, says Hawn. If you’re the cautious type and the thought of winding up feeling uncomfortable in a foreign country makes you flinch, you’ll probably want to pack your meds thoroughly and avoid eating uncooked foods, he says. On the other hand, more “adventurous” travelers may be comfortable packing some Imodium and calling it a day.

“I try to provide usual information to help a traveler with risk assessment,” he says. “I tell my patients: ‘Let’s talk about your destination and your travel and what you’re going to do there, and then decide.’”