After you’ve made you appointment, consultations for travel medicine begin with a personal meeting with our clinical pharmacist who is well-versed in the details of travel medicine. Patients should bring a detailed list of all medications they are currently taking, including medications for allergies. You should also provide your immunization history, as well as your itinerary listing all the countries you plan to visit. Your Southwest Care Center clinician will review all health and vaccine history and offer recommendations specific to your planned itinerary. This might mean the clinician simply offers advice and tips, and they may also provide you with a list of recommended immunizations, or preventative medications. At Southwest Care Center, we recommend that all travelers carry documentation of certain personal health information, including:

• Personal health status (e.g., age, weight, pregnant)
• Medications and allergies
• Past medical history/preexisting conditions
• Medical handicaps or physical limitations

Immunizations are recommended based on a number of factors, including travel destinations, planned activities, the time of year, any previous immunizations, age and current health status. In general, these immunizations are recommended to protect travelers from illnesses which are present in other parts of the world, as well as to prevent these types of illnesses from being transported across international boundaries.

The following link to the Centers for Disease Control and Prevention’s website provides a comprehensive list of world countries and all of the immunizations which may be recommended or required for travel to that destination. https://wwwnc.cdc.gov/travel/destinations/list

The most common risk for all travelers is traveler’s diarrhea, which can range from mildly unpleasant to drawn out, painful and incapacitating. The CDC reports that every year, approximately 30-70% of international travelers (an estimated 12 million people) develop traveler’s diarrhea, usually within the first week of travel. The primary causes of traveler’s diarrhea are contaminated food and water, typically coinciding with poor sanitation practices. Travelers are advised to only eat food that is hot or boiled and to drink only bottled beverages, remembering to check that the seal has not been broken prior to purchase. These practices, combined with thorough and frequent handwashing, are effective at preventing cases of traveler’s diarrhea. Traveler’s diarrhea commonly presents with the following symptoms:

• Abrupt onset
• Increased frequency, volume, and weight of stool
• Altered stool consistency
• Nausea and/or vomiting may be associated
• Abdominal cramping, bloating, gas
• Fever
• Malaise

Treatment of traveler’s diarrhea The majority of traveler’s diarrhea cases are benign and will resolve themselves within 1-2 days without treatment, and the condition is rarely life threatening. Because traveler’s diarrhea usually resolves itself within a few days, oral rehydration is often the only recommended treatment. Adults with traveler’s diarrhea are encouraged to drink plenty of clear fluids. However, if you experience 3 or more loose bowel movements in an 8-hour period accompanied by nausea, vomiting, abdominal cramps, fever, or blood in stools, you may benefit from antibiotic or antimicrobial therapy, typically lasting about 3-5 days. If vomiting is not well controlled or diarrhea is very frequent, oral rehydration salts (electrolyte powders) are recommended and necessary to prevent dangerous complications.

An essential item that all international travelers should remember to pack is a basic medical first aid kit. Even if you’re not headed to a developing country or where local availability of such resources is questionable, you may still require first aid on the way to your destination. A basic kit should include standard first aid items, over-the-counter medications, as well as items specific to that traveler. In addition, certain countries don’t allow some medications (particularly prescription pain medications) into the country without a letter from your physician and without the medication being in the original pharmacy bottle. A final category of items to consider is toiletries, and we recommend packing a sufficient amount for your entire trip. This would include items such as tampons for women (which aren’t available in many countries), sunscreen, makeup, etc. Many of these items aren’t available in some countries, and language barriers can make purchasing the items difficult. First-aid items to consider include the following:

• Antiseptic wound cleanser
• Antihistamines
• Antidiarrheal medication
• Wound coverings: Adhesive bandages, medical tape, sterile gauze
• Eye drops
• Nasal decongestant
• Hand antiseptic
• Insect repellent/insect bite treatment
• Oral rehydration/electrolyte powder
• Scissors, safety pins/closure devices
• Over-the-counter pain reliever (e.g., ibuprofen, acetaminophen)
• Personal medications (current medical conditions)

Additional considerations include the following:

• Thermometer (oral/rectal)
• Antinausea medication (if any water travel or winding roads anticipated)
• Antifungal medication
• Malaria prophylaxis (based on travel-clinic and/or CDC recommendations depending on destination)
• Sleeping medications/sedatives
• Water purifier/disinfectant