Travel Health Tips for Students Studying Abroad (page 4)

Study-abroad programs offer an exciting opportunity for learning and cultural exchange.

 With the number of students studying abroad expected to increase, as well as expand geographically, it is very important for students to be prepared to negotiate cultures and environments that may differ vastly from their own. Moreover, some cultural/environmental differences abroad may contribute to an increased risk of illness or injury, such as climate extremes, the presence of certain insect vectors, inadequate sanitation, or poorly lit roads. This risk is especially so, if travel is to developing regions of the world and for a period of several weeks or months.

Few events can negatively impact the travel experience more than becoming sick or being injured while far away from home. To reduce health risks while studying abroad, the Centers for Disease Control and Prevention (CDC) recommends the following general guidelines for students:

Before travel

• Be sure to check with a healthcare provider to make sure you are up to date with all routine vaccinations (i.e., measles, mumps, rubella, tetanus, diphtheria, pertussis, hepatitis A and B, meningitis, and polio). Diseases such as measles and mumps remain common in many parts of the world, including some developed countries.
• See a healthcare provider or a travel medicine specialist, ideally 4-6 weeks before travel, to get any additional vaccinations, medications, or information you may need to stay healthy. If it is less than 4 weeks before travel, a healthcare provider should still be consulted, as there may be some vaccinations, medications, or prevention information that could be beneficial to you. To locate a travel medicine specialist, see http://wwwn.cdc.gov/travel/contentTravelClinics.aspx.
• Students with complicated travel itineraries (e.g., travel to rural areas of developing countries) or who have medical problems that will need to be managed while abroad are especially advised to consult a healthcare provider who specializes in travel medicine.
• Visit CDC's Travelers' Health website at http://wwwn.cdc.gov/travel to educate yourself about any disease risks and preventive measures for the countries where you plan to study. Students visiting developing countries are at greater risk for illness or injury than those who travel to developed countries (e.g., Canada, Australia, New Zealand, Japan, and Western Europe), where the health risks are compatible to those found in the United States.
• Prepare a travel health kit that includes an ample supply of your prescribed medications in their original containers; an antidiarrheal medication; alcohol-based hand gel (containing at least 60% alcohol); an antibiotic for self-treatment of most causes of acute bacterial illness; a thermometer; insect repellent containing at least 30% DEET if you plan to study in or visit a tropical or subtropical area; the name and telephone number of your primary healthcare provider ; and a copy of your vaccination record.
• Familiarize yourself with basic first aid so you can self-treat minor injuries should they occur.
• Learn how to swim if you are inexperienced and plan to participate in recreational water activities while abroad.
• Consider a health insurance plan or additional insurance that covers medical evacuation in case you become sick or injured, if your plan does not already offer this service. Information about medical evacuation services is provided on the U.S. Department of State web page, Medical Information for Americans Traveling Abroad.
• Identify in-country healthcare resources in advance of your trip in case of a medical emergency. This is especially important if you have a pre-existing medical condition. The U.S. Department of State has a List of Doctors/Hospitals Abroad. The U.S. Embassy or Consulate at your travel destination may also be able to assist in locating these resources. Several private travel medicine organizations provide assistance in locating medical care abroad; see Seeking Health Care Abroad in Health Information for International Travel .
• Register with the State Department’s travel registration website (https://travelregistration.state.gov/ibrs/), so the U.S. Embassy or Consulate in the country you will be visiting is aware of your whereabouts in case of an emergency that makes it necessary for a consular officer to contact you. This registration is especially important if you plan to stay abroad for longer than 1 month or will be visiting a country that has an unstable political climate or that undergoes a natural disaster, such as an earthquake or hurricane.

While residing abroad

To reduce your risk of illness

• In developing areas, boil your water or drink only bottled water or carbonated (bubbly) drinks from cans or bottles with intact seals. Do not drink tap water or fountain drinks or add ice to beverages. Avoid eating salads, fresh vegetables and fruits you cannot peel yourself, and unpasteurized dairy products.
• Eat only food that has been fully cooked and served hot, and avoid food from street vendors. If living with a host family, discuss any food allergies or dietary preferences in advance.
• Do not touch animals, including domestic pets, especially monkeys, dogs, and cats, to avoid bites and serious diseases (i.e., rabies and plague). If you are bitten or scratched by any animal, get medical attention right away, and clean the wound well with large amounts of soap and water and a povidone-iodine solution, such as Betadine®, if available.
• Wash your hands often with soap and water, especially before meals and after going to the bathroom. If soap and water are not available and your hands are not visibly dirty, use an alcohol-based hand gel (containing at least 60% alcohol) to clean your hands. Cleaning your hands often with soap and water removes potentially infectious material from your skin and helps prevent disease transmission.
• If visiting an area which has risk of malaria, use insect repellent and a mosquito net for sleeping, wear long sleeved shirts and long pants outdoors between dusk and dawn, and make sure to take your malaria prevention medication before, during, and after your trip, as directed.
• In areas with avian influenza (bird flu), avoid poultry farms, bird markets, and other places where live poultry is raised or kept. For more information, see the Guidelines and Recommendations, Interim Guidance about Avian Influenza A (H5N1) for U.S. Citizens Living Abroad.
• Be aware that sexually transmitted diseases (STDs), including HIV/AIDS, are among the most common infections worldwide. The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual activity or to be in a long-term mutually monogamous relationship with a partner who has been tested and who you know is uninfected. The proper, consistent use of latex or polyurethane condoms when engaging in sexual activity can greatly reduce a person’s risk of acquiring or transmitting sexually transmitted diseases, including HIV infection.

For your safety

• Do not drink alcoholic beverages and drive, wear your safety belt, and follow the local customs and laws regarding pedestrian safety and vehicle speed. Use helmets when riding bicycles and motorcycles. Automobile accidents are the leading cause of preventable deaths in travelers. The most important risk factor for road traffic injuries is the presence of alcohol in the blood of a driver or pedestrian who is injured.
• Be aware of the cultural impact of being involved in or causing an accident that includes injury to the local population. In unfamiliar or foreign environments, utilize a local driver. It is important to note the legal age for driving varies by country.
• Swim in well–maintained, chlorinated pools, and only if you are an experienced swimmer. Drowning is also a leading cause of death in travelers.
• If visiting an area which has risk of water-borne infections (i.e., schistosomiasis), do not swim in lakes or streams or other fresh bodies of water.
• To prevent infections such as HIV and hepatitis B, avoid receiving tattoos, body piercings, or injections.

After your return

On return from study abroad, if you are not feeling well or have been injured, get medical attention, including psychological support and counseling, if necessary.

• It is especially important for you to get health care if you have a fever, rash, cough or difficulty breathing, or any other unusual symptoms.

If you are returning from malaria risk areas and become sick with a fever or flu-like illness, for up to 1 year after your return, get immediate medical attention and be sure to tell the doctor or healthcare provider your travel history.

Resources from CDC

For more information about CDC health recommendations for travel to specific destinations, see http://wwwn.cdc.gov/travel/destinationList.aspx.

For more information about STDs and HIV, see http://www.cdc.gov/nchstp/dstd/disease_info.htm#facts and Sexually Transmitted Diseases (STDs) in Health Information for International Travel.