Forget earthquakes, tsunamis and the possibility of an avian flu pandemic. They may hog all the headlines, but the real health dangers to international travelers are much more mundane — and often avoidable.
The truth is, even when traveling to the most adventurous destinations, the most common health hazards are mosquitoes, water and plain old traffic accidents.
"If you're going to get sick, it's probably going to be from insect bites or from contaminated water," says Dr. Douglas Zeiger, an infectious disease and travel medicine specialist at New York University Medical Center and the Hospital for Joint Diseases. "The most common sicknesses are not tremendously exotic. They include diarrhea, typhoid and dengue fever."
The good news? You can radically cut down your risk of all three by respectively watching what you eat and drink, getting a vaccination and using a good insect repellent.
As travelers range farther and farther afield for both business and pleasure, staying healthy on the road is a rising concern, for individuals as well as the companies sending them abroad.
Most common medical mishaps
As director of resource development for MEDEX Assistance Corp., which provides health insurance and emergency travel assistance, Pascaline Wolfermann says that the two most common medical emergencies she sees among clients are cardiac problems and trauma cases.
The first comes from the increased stress of travel. Whether it's running to catch a plane or deciphering foreign road signs, stress increases adrenaline, which constricts blood vessels, sometimes causing heart attacks in victims who had undiagnosed risk factors.
The vast majority of trauma cases, meanwhile, come from traffic mishaps.
"Road accidents are probably the greatest risk to travelers in the third world," says Dr. Pascal James Imperato, who chairs the department of preventive medicine and community health at SUNY Downstate Medical Center, and who spent six years as a medical officer in West Africa for the Centers for Disease Control and Prevention. "You've got vehicles that are not roadworthy, drivers who were never well-trained who speed and take risks, overloaded vehicles and roads in poor condition."
In fact, traffic accidents are on par with malaria and tuberculosis as a cause of death globally, according to the Commission for Global Road Safety, a coalition of Group Of Eight (G8) representatives devoted to reducing traffic deaths. In a report issued last year, it estimated that 1.2 million people were killed and 50 million were injured in worldwide traffic accidents, with the highest accident rates across Africa, Eastern Europe and Asia.
Staying off the road entirely is often unpractical, but travelers can still take precautions.
"To stay off the road at night would be especially important," says Dr. Joan Pfinsgraff, director of health intelligence for iJET Intelligent Risk Systems, an Annapolis, Md.-based risk consultancy.
She also suggests using a professional local driver whenever possible, and to use common sense.
"It's just as important to wear your seatbelt on vacation as it is at home," she says. That may sound like a no-brainer, but in fact, she notes, a lot of people take a different attitude to risk when they're on vacation. "They tend to do things that they wouldn't in their everyday lives," she says, whether that's bungee jumping, motorcycling or renting a jet ski without proper instructions.
Simple Steps To Prevent Illness
At least six weeks before your trip, visit a clinic specializing in travel medicine, as some immunizations can take that long to become effective. A travel clinic will provide general medical advice about the countries you're visiting, and look at your immunization history to determine what you need.
Some common dangers in developing countries for which immunizations are available include hepatitis A, yellow fever and typhoid, says Dr. Imperato of SUNY Downstate Medical Center. While travel clinics exist in most U.S. cities — they're often run by hospitals or academic medical centers — many health insurance policies don't cover travel medicine. Each shot can cost from $75 to $125.
Speaking of health insurance, many standard U.S. policies often cover only a portion of overseas treatment, and even customers who are covered often have to pay before they can get treatment.
But travelers can purchase additional foreign travel health insurance for the length of their trip, even including coverage for medical evacuation.
MEDEX, which caters to institutional clients like USAID and McCormick & Co., also sells travel health policies to individuals for as little as $4 a day. World Nomads, an insurance broker geared to longer-term travelers, addresses delicate questions on its Web site such as whether your coverage will apply if you were parachuting, attacked by a bear or robbed while breaking local laws. (Answers: no, sometimes and no.)
And what about the prospects of an avian flu outbreak?
"The fear is overblown," Zeiger says. "To be terribly afraid of it right now is certainly out of proportion to the illness."
Worldwide, the disease has affected only about 200 people, and can only be caught from infected birds. If it mutates into a form that can be transmitted by human-to-human contact, "that would be a horrifying event," Zeiger says. "But it would be just as horrifying for a person sitting in front of the television in New York City, because it would be there too in a few weeks."