Your individual health needs
If you have any chronic diseases or other health concerns, such as birth control or allergies, see your doctor. You may need to adjust your itinerary to accommodate your health needs. For example, if you have heart failure or a history of blood clots, you may need to take shorter flights with more stops to avoid long periods of sitting. If you have asthma, chronic obstructive pulmonary disease (COPD), or other lung diseases, you may need to avoid stays in polluted cities or at high altitudes.

Evaluate whether you will be physically able to meet the rigors of your particular trip. Most travel, even if you are going on a professionally led tour, typically demands more physical effort than is required at home. Boost your fitness by starting an exercise program, such as fitness walking, in advance.

If you have health problems, carry a letter from your doctor describing your conditions, a list of your routine medications including their generic names, and written prescriptions for refills if you will be gone long. People with heart conditions should travel with a copy of their most recent electrocardiogram (EKG, ECG) for comparison should they have chest pain or other symptoms. If you have diabetes, you can take precautions to prevent problems while traveling.

Leave your prescription medications in the original containers-your name must match the name on the bottle-and pack them in a waterproof container in your carry-on luggage. Take extra amounts of your routine medications packed in checked luggage in case of theft or loss.

If you are pregnant, talk to your doctor before making any travel decisions. If you decide to travel, take some general precautions while traveling, such as notifying the airline of your condition before you fly and taking occasional walks while on a long flight to increase the blood circulation in your legs (good advice for all travelers).

Many doctors recommend that you take a first aid kit with items such as pain relievers, sunscreen, insect repellent, moleskin, antifungal and antibacterial ointments, and antidiarrheal medications, especially if you will be traveling to areas where modern medical care is not readily available.

Potential health risks
Preparing for health risks is especially important if you are visiting developing countries, such as those in most parts of Africa and Asia and many parts of South and Central America, where expert medical care may not be readily available.

Before you go, you should be aware of any needed immunizations or medications, disease outbreaks, food and water precautions, and any other preventive measures to take. Check your local or state health clinic at least 6 weeks before traveling so that you'll have time for immunizations and other health precautions that may need to be done in advance. Better yet, talk to your doctor as soon as you know you will be traveling. There are some shots that need to be given more than once, and you may need more than six weeks in some cases. Most of these clinics can give immunizations and prescriptions for antimalarial drugs. If not, ask to be referred to a clinic that specializes in travel health.

Make sure all of your routine immunizations are up to date for you and your children. These immunizations can protect you from diseases such as polio, diphtheria, measles, whooping cough, and rubella that have been virtually wiped out in developed nations but are still prevalent in some developing countries. If you will be traveling to a country where these infections are still common, check your immunity status. Some adults have not received all of these vaccines (especially measles, mumps, and rubella) and may be susceptible unless they have had the disease. Your tetanus immunization should be updated before traveling if you haven't received one in the last 10 years.

For more information, see the topic Immunizations or the recommended immunization schedules.

Hepatitis A vaccine is recommended for most travelers to developing countries where the disease is prevalent. It is the most widely reported disease in return travelers that can be prevented by a vaccine.1 You can help protect yourself from hepatitis A while traveling by taking basic precautions such as boiling your drinking water, making sure food is well-cooked, and eating only raw fruits that you have washed and peeled. The hepatitis A vaccine is two shots. The second shot is given six months after the first shot. If you know you will be traveling more than six months before you leave, getting both shots is best. But if you don't have six months before you leave, it is still important to get the first shot. The first hepatitis A shot usually works in about six weeks and protects most people from getting hepatitis A. If you only had the first hepatitis A shot before you left the country, make sure you still have the second one when you get home (within three years of the first shot).

The yellow fever vaccine is currently required for travelers who plan to visit countries in South America and Africa where the disease is active.

Additional immunizations may be needed depending on the area you are visiting, how long you will be there, and the purpose of your journey. For example, if you will be trekking in rural Asia for more than 3 months during the summer or fall months, you may need the vaccine for Japanese encephalitis.

Ask about a prescription for antimalarial drugs if you will be visiting an area that has malaria. Malaria-risk areas of the world include large areas of Central and South America, Haiti and the Dominican Republic, Africa, the Indian subcontinent, East Asia, Southeast Asia, the Middle East, and many South Pacific islands. You may need to take one of several different preventive medications depending upon the type of mosquito inhabiting that part of the world. These medications need to be taken daily during your travels and for a specified time after you return. It is important to take all the tablets you were given. This may mean taking antimalarial tablets for several weeks after you get home.

A new vaccine for traveler's diarrhea and cholera, called Dukoral, has been approved in Canada and Europe. But it is not available in the United States.

Sanitation inspection scores for cruise ships are reported on the CDC Web site at www.cdc.gov/nceh/vsp.

Medical care in developing countries can be below standard. Before you go, get the addresses and phone numbers of embassies and consulates in the areas you will be visiting. If you get sick, these offices can help you find medical care. For a complete list of embassies and consulates, see the U.S. Department of State Web site at www.usembassy.gov. You can also obtain lists of local doctors and medical clinics.

If you have health insurance and you are traveling to another country, you may want to find out how your insurance works outside of the United States. If your insurance company does not cover you abroad, you may want to think about buying travel health insurance.

For general travel health information, details on current disease outbreaks, and the most current shot recommendations for different areas of the world, see:
* The U.S. Centers for Disease Control and Prevention (CDC) Web site at wwwn.cdc.gov/travel/default.aspx.
* The World Health Organization (WHO) Web site at www.who.int/en

Travel Health Before You Go
WebMD Medical Reference from Healthwise
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