Insurance
Plan on a medical emergency. That way, you can be pleasantly surprised when everything goes okay.
- Fill out a medical information form. Carry one with you, and leave one with your primary contact in the USA. This could be your "yellow book" but in it notate your insurance information, primary doctor contact information, allergies to medicine, etc.
- Get travel insurance. It's inexpensive and worth it.
- Also, if you do get seriously ill on the trip, immediately contact the local US consulate. Very handy - they'll make sure you get admitted to the best medical care facilities.
Vaccines
CDC recommends the following vaccines (as appropriate for age). See your doctor at least 4–6 weeks before your trip to allow time for shots to take effect. These are all the possible shots you would need ... but you need to check the CDC Traveler's Health website for actual details
- Hepatitis A or immune globulin (IG)
- Hepatitis B (is now recommended ... just in case you might be accidentally exposed to blood)
- Rabies
- Typhoid
- Meningococcal meningitis, for travel to most West African countries from December through June
- Yellow fever, for travel to West and Central Africa ... not needed in Southern Africa
- As needed, booster doses of tetanus-diptheria, measles, and a one-time dose of polio vaccine for adults
- You will also need Malaria pills (prophylaxis).
Recommended Medical Kit for Travelers
This list was given to us by a doctor who specializes in international travel, and it is oriented towards sub-Saharan Africa. This medical kit is more applicable to people who will be going outside of Gaborone, Botswana.
Sterile Dressing:
- 4x4 gauze pads/band-aids
- adhesive tape/elastic bandage roll
- disinfectant (Betadine, Ethanol 70%)
Insect repellent:
- Containing up to 30% deet (Deet Plus, Skedaddle)
Insecticide spray for clothes and mosquito nets:
- Permethrin (Permanone)
Sunscreen:
- With wide spectrum UVA-UVB block, SPF 15, good adherence and resistance to water (eg, Photoplex, Age Block Daytime Skin Defense Cream, Shade Uvaguard)
Drugs:
- Malaria prophylaxis: for stays in endemic areas
- Skin: 0.5% hydrocortisone cream topical; oral antihistamine such as diphenhydramine (Benadryl), loratadine (Claritin) or fexofenadine (Allegra)
- Diarrhea: watery diarrhea without fever: loperamide (lmodium), bismouth subsalicylate (Peptobismol)
- Severe diarrhea with mucus and/or blood in stool and/or fever: an antibiotic such as ciprofloxacin (Cipro) of trimetoprim-sulfamethoxazole (Bactrim, Septra)
- Fever and pain: aspirin, acetaminophen (e.g. Tylenol), ibuprofen (Motrin, Advil)
- Nausea and travel sickness: Dimenhydrinate (Dramamine), meclizine (Bonine)
- Minor cuts and bruises: Antibiotic ointment (1% bacitracin, Betadine Antibiotics)
- High-altitude sickness: Acetazolamide (Diamox)
- Water Purification: Iodine-containing water purification tablets (Globaline)
Traveler's Diarrhea
Principal Precautions:
- drink only from known-brand sealed bottles, or freshly prepared coffee or tea
- eat only fruits washed and peeled by yourself
- avoid uncooked vegetables, meat and fish
- avoid creams, dairy products, pastries, ice creams, and ice cubes
- eat preferably recently cooked and hot-served food
- wash hands before eating and do not dry them with towels used by others
- if bottled water is unavailable, filter water (Katadyn, Pur filters), disinfect it (one tab of Globaline or one of Coghlan’s Germicidal Tablets per liter) or boil it (most reliable).
Early control of dehydration:
- tea or mineral water with sugar (3 tablespoons/liter ) and/or orange juice, salt (1 teaspoon/liter) or salted food, soup, or an oral rehydration solution, such as WHO Oral Rehydration Salts (ORS) solution.
- Solutions prepared with packets of rehydration salts, especially for children and the elderly, are available at stores or pharmacies throughout the developing world. ORS packets are available in the U.S. from Jianas Brothers Packaging Company, Kansas City, MO, tel: 816-421-2880 or from Cera Products, Jessup, MD, 888-237-2598.
- Oral Rehydration Solution (ORS), according to WHO, whould contain: sodium chloride 3.5 g, trisodium citrate dihydrate 2.9 g, porassium chloride 1.5 g, and glucose 20 g or sucrose 40 g dissolved in 1 liter of drinking water. Drink within 12 hours at room temperature or 24 hours if refrigerated: <6 kg: 200to 400 ml; 6-9 kg: 400 to 600 ml; 9-13 kg: 600 to 800 ml;; 13-20 kg: 800 to 1000 ml; 20-43 kg; 1000 to 2000 ml; >43 kg: 2000 to 4000 ml.
Treatment of invasive diarrhea (fever, blood, mucus):
- Adults: ciprofloxacin (Cipro) 500 mg b.i.d., levofloxacin (Levaquin) 500 mg once/daily, norfloxacin (Noroxin) 400 mg b.i.d. or ofloxacin (floxin) 300 mg b.i.d. * 3 days.
- Children: trimethoprim-sulfamethoxazole (Bactrim, Septra), 4/20 mg/kg b.i.d. * 3 days.
- Control of diarrhea:
Adults: loperamide (lmodium, and others), a 4-mg loading dose, then 2 mg orally after each loose stool, to a maximum of 16 mg/day.
Insect Repellents
In general, travelers should avoid perfumes, soaps, lotions and hair products containing floral fragrances, which can act as mosquito attractants.
The most effective topical insect repellent known is N, N-diethyl-m-toluamide, commonly called “deet.” Deet repels a variety or mosquitoes, ticks, fleas and biting flies. Although concentrations of deet have ranged form less than 10% to 100% in different products, those with 10-35% are considered effective for adults. The American Academy of Pediatrics recommends that repellents for children should contain no more than 10% deet. Higher concentrations prolong duration of action but do not improve efficacy. Deet may decrease the effectiveness of sunscreens; when they are used together, a sunscreen with a higher SPF factor should be used. Deet-containing repellents can damage plastics such as eyeglass fames and watch crystals, as well as rayon fabrics, spandex and leather. They are safe on cotton, nylon or wool.
Permethrin, actually a pesticide rather than a repellent, is marketed as a clothing spray for protection against both mosquitoes and ticks.
Wearing protective clothing treated with permethrin in addition to using deet on exposed skin provides the greatest degree of protection for both adults and children against mosquito and tick bites..
Tropical corticosteroids can decrease the erythema, pruritus and induration of mosquito bites. Oral antihistamines have been shown to reduce the symptoms cause by mosquito bites. Travelers who are highly sensitized to mosquito bites may benefit form taking and oral non-sedating antihistamine prophylactically.
Recommended Products:
- Sawyer Controlled Release Deet Formula
- Deet Plus Composite Repellent
- Sawyer 30
- Deep Woods Off! For Sportsmen
- Cutter Outdoorsman
- Skedaddle! For Children
- Duranon (Coulston)
- Repel Permanone (Wisconsin Pharmacal)
Copyright © 2004
Ann M. Mathison.