Traveling is always exciting, planning the trip, where we will eat, booking hotels, seeing maps, museums to visit, walks to take, etc., but without fear of being wrong, the health or the care that we must have when traveling or visiting some areas of the world They don’t go through our heads. Do not worry, here I mention some points to take into account to preserve the health of the traveler.
The World Tourism Organization (UNWTO) estimates that 700 million tourists traveled internationally between January and September 2022, more than double (+133%) the number registered in the same period of 2021, which is equivalent to 63% of 2019 levels and places the sector on track to reach 65% of its pre-pandemic levels this year.
This means that there is an estimate that only in the third quarter of 2022, 340 million international arrivals were registered, almost 50% of the total for the 9 months. Thus, it is observed that the number is increasing, for which I will give you some advice to take care of yourself when you travel.
It is convenient to clarify that there is no such thing as a specialty of travel medicine; many can “specialize”: infectologists, epidemiologists, health professionals, general practitioners or pediatricians, but the main thing is to have knowledge about vaccines, travel health alerts and tropical medicine, which can be learned in a master’s degree, a diploma, etc.
But the important thing is to know what risks you have when traveling. There are those that range from illnesses to falls, altitude sickness, burns, heat stroke and dehydration, but what is interesting is what we could prevent, either with vaccines or with certain prophylaxis, as in vector-borne pathologies, such as denguemalaria, yellow fever, zikachikungunya and Japanese encephalitis, among others, and diseases acquired by contaminated water or food, such as typhoid, cholera, hepatitis A and schistosomiasis, to name a few.
Among the vaccines available in Mexico to prevent diseases are those that you probably remember being given when you were a child and some booster as an adult, such as measles, rubella, poliomyelitis, tetanus, hepatitis A and B, pneumococcus and influenza, among other. It is convenient that before traveling you review your vaccination schedule. We also have specific vaccines for travelers, such as yellow fever, a disease that is transmitted by the bite of a mosquito, preventable with a vaccine and whose certificate is required to travel to many African countries, where in some there are only recommendations, but in others it is mandatory to have this.
Some countries that require it are the Republic of Niger, Mali and Uganda; in others, the requirement is to be vaccinated if you come from a country that is endemic for yellow fever (that is, the disease circulates normally in the country). On this side of the world, Brazil has been experiencing an outbreak for years and although vaccination is not a requirement to enter the country, it is a recommendation. If you go to Colombia from Angola, for example, they will ask you for your vaccination certificate; in the Americas this is recommended when visiting some areas of the Amazon and Brazil, so it is always better to go with an expert on the subject.
Another very important disease to mention is malaria (malaria), a “tropical” disease that is spread by the bite of a mosquito, for which we do not have a vaccine, but it can be prevented and cured. The prevention of malaria and any other disease acquired through the bite of a mosquito consists of using a repellent that contains N-diethyl-meta-toluamide, long-sleeved clothing and making sure to use a mosquito net, as well as prophylaxis in the case of malaria, that is, taking a drug before, during and some time after the trip. Who should take it? Anyone who goes to a place where there is malaria, but it is the doctor who should prescribe the drug, since it depends on the area (there are very resistant parasites), as well as the medical and physical condition. How is it taken? Depending on the drug prescribed, but it starts 1 or 2 days before the trip and during it, without forgetting any dose and continues for another week or 28 days. According to the data of the World Malaria Report 2021 According to the World Health Organization (WHO), there were 41 million cases of malaria and 627,000 deaths, hence the importance of prevention.
We cannot ignore dengue, a mosquito-borne disease present in various parts of our country, but also in the rest of America and Africa. The good news is that there are 2 approved vaccines in the world, the bad news is that they are not yet available in Mexico, so we must use repellent, applied every 4 hours in humid and tropical environments; the most important thing is that the repellent contains N,N-diethyl-meta-toluamide; there are four dengue serotypes scattered throughout the world (in Mexico we have all 4), therefore, the importance of protecting yourself, not only when traveling, but also when living in areas where dengue is part of daily life.
Among the diseases acquired by contaminated water, in Mexico we have a vaccine against typhoid fever and hepatitis A, but another way to prevent diseases associated with contaminated water or food are hygiene measures, such as hand washing, avoiding eating food in the street and always drink bottled water checking that the seals are not violated, among other things.
Travel medicine is a dynamic field because conditions around the world are subject to rapid change and are highly variable in relation to available medical resources. Undoubtedly, following these steps helps as a basic guide and a final recommendation would be to see a specialist in travel medicine before leaving home, whether for leisure, work or study reasons, since having updated information on health, drugs and vaccinations helps ensure a safe, healthy and pleasant trip.
Dr. Sonia López Álvarez is a specialist in Preventive Medicine and Public Health. She is currently the general director of the Panam Research Clinic Cuernavaca and a professor of Public Health at the Faculty of Health Sciences at the Autonomous University of Tlaxcala.
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2023-05-30 05:02:01
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