5 tips on travel health

4. Malaria is the insect-borne disease you need to worry about most.
It is found everywhere in the developing world, including Central and South America, southern Mexico, Haiti and some areas in the Dominican Republic. Use insect repellents that contain Deet, to help prevent malaria. Canadians can buy products containing a maximum of 30 per cent Deet (which means they last four to six hours); these can be used on babies as young as two months of age.

Mosquitoes that transmit malaria are almost all resistant to chloroquine, an older antimalarial drug, so other drugs, such as atovaquone-proguanil (malarone), mefloquine (Lariam) or doxycycline, are prescribed instead.

Another mosquito-borne virus, dengue fever, is common in southeast Asia and Latin America. Unlike malaria, which is found mainly in rural areas, the virus that causes dengue fever is largely urban and is transmitted by mosquitoes, which bite in early morning and late afternoon. Use insect repellent at these times -- but put the sunblock on first.

5. Carry the antidiarrheal drug Imodium and an antibiotic for self-treatment of diarrhea.
The most common problem that travellers face is traveller's diarrhea because we all need to eat and drink. Still, try to stick to some basics: don't drink the water; skip the ice cubes; keep salads and consumption of food from street vendors to a minimum; and don't consume unpasteurized dairy products. "You should also brush your teeth either with the hottest tap water or bottled water," adds Keystone.

Even if you do everything right, you still may not be out of the woods. Thus, Keystone's No. 1 rule when travelling: Don't leave home without Imodium and an antibiotic for self-treatment of diarrhea. Anything from the quinolone class of antibiotics (ciprofloxacin and levofloxacin are two examples) will be effective against any bug that will give you traveller's diarrhea -- except in Thailand, where the bacteria are resistant to these antibiotics but azithromycin is effective. At the first sign of trouble (any diarrhea that interferes with your daily activities qualifies), take one dose of antibiotic with a dose of Imodium. "If you are better after your first dose," says Keystone, "you don't even need the next two doses."

Where to go for vaccines
• Visit a travel health clinic or family doctor six to eight weeks before your trip, so that any vaccines or immunizing agents you need will have time to take effect.
• To find a clinic near you, see the Travel Medicine Program section of Health Canada's website at www.travelhealth.gc.ca.
• If you're not near a clinic, ask your health-care provider about vaccines, where to get them and costs.
- Carlye Malchuk

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