Medic Al
Q&A
How to Protect AgAinst
Bugs, tHugs, And Hugs
QMy company occasional- ly flies internationally. How can I ensure that I’ve taken appropriate
medical precautions
during travel?
The fact that you’re asking this question shows me you already have the first and likely most important layer of defense, which is a healthy awareness of potential increased
threats due to international travel. This traveler’s “situational
awareness” will serve you well whether
walking down streets in Denver or Dakar. You can certainly add another layer of protection by having access to professional advice such as through a Travel
Medicine clinic.
Ideally companies flying internationally on a regular basis will have already
conducted detailed reviews of potential destinations that include food, flora,
fauna threat analysis and contingency
plans, possibly even including in-country assets for medical care. If you do not
have access to such plans, a Travel Medicine clinic can actually assist you to develop one. You would typically want to
contact them at least six months before
travel as some vaccinations have boosters to be accomplished several months
after the initial visit. Be sure your adult
immunization schedule is current to include Hepatitis A and B, especially if
traveling to areas where food and water
sources are of questionable reliability.
Other specialty vaccinations such as Yellow Fever and Meningococal Meningitis may be an entry requirement as well.
You can also do your own research online. Several great
sites include the Centers for Disease Control and Prevention’s (CDC) traveler’s section at www.CDC.gov/travel and
the U.S. Department of State’s site at http://travel.state.
gov. The CDC has country-specific information about health
threats, including its “Yellow Book,” that is often referenced
by Travel Medicine clinicians. The State Department site also
contains invaluable “travel warnings” and alerts based on
civil unrest, etc. If you have the luxury of an internal planning department, they may want to subscribe to commercial
services such as the Travax EnCompass product offered by
Shoreland which allows detailed reports including verified
in-country medical resources where available.
Dr. phil
parker
The CDC site has some useful information about avoiding
food-borne and waterborne diseases. There are also some
guidelines about avoiding counterfeit (fake) medications.
Other advice can vary depending on region such as avoiding cultural items such as “coca tea,” which contains metabolites that would cause a DOT drug test to return positive for illegal substance use. Also, pilots don’t always take to
heart the warnings about avoiding “intimate social” contact
with hired evening escorts. That said, in some areas sexually transmitted illnesses such as hepatitis and HIV are prevalent. A detailed guide for vector-borne
disease (diseases such as Dengue, Yellow
Fever, and Malaria carried by mosqui-toes, sand flies) is way beyond the space
allotted here, but there are some simple
steps aircrew and travelers can take to
minimize risk. Avoiding contact by using
long sleeves, bed netting and repellents
containing DEET is always good advice.
In the case of malaria prevention, when
medications or “chemoprophylaxsis” are
or are not indicated can be a complicated decision. Different species of mosquitos, differing species of malaria, varying
resistance to medications based on geography, time and duration of visit, specific
location of visit... all have to be taken into
consideration. Also, certain health conditions may preclude safe administration
of some of the medications. For aircrew
some medications are not allowed, such
as mefloquine, which is a once-weekly
medication frequently used for travel to
certain areas of Africa. In fact, if this is
used by pilots or controllers while on va-
cation, the FAA requires a four-week wash-out period before
return to aviation duties. Doxycycline, a common antibiotic, is
often used for aircrew, but can have side effects such as gastric
upset and sensitization to the sun.
With a little planning, aviators can see the world without putting themselves at too much risk. Common sense,
risk awareness, and simple hand washing can go a long way.
When considering travel to some of the more exotic destinations, guidance from someone with expertise in Travel Medicine is invaluable. ✈
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dr. Phil Parker (WAI #29733) is the Director of Clinical Services
for Virtual Flight Surgeons, Inc. Dr. Parker is also a private pilot.
Additional information on these topics and others can be found
at www.AviationMedicine.com.
Other advice
can vary depending
on region,
such as avoiding
cultural items such
as “coca tea,” which
contains metabolites
that would cause
a DOT drug test
to return positive
for illegal
substance use.
