Travelling to the tropics?

Bring back memories, not an infection
Dr. Michael Libman discusses the infectious diseases and other medical problems prevalent in this traveller's vacation destination.

Packing sunscreen and changing money for foreign currency are just a few items on a tropical vacation “to do” list. Perhaps the most important “to do” item, however, is checking for potential health risks of a travel destination—yet, it is most often overlooked. Unfortunately, every year Canadians’ dream holidays turn unpleasant due to preventable illness.

“There are some people who think a safari to Kenya is the same as going to Disneyworld,” says Dr. Michael Libman, director of the Division of Infectious Diseases and Centre for Tropical Diseases at the McGill University Health Centre (MUHC). “Obviously, this is not true. My advice is to consult with someone who knows about infectious diseases and other medical problems prevalent in the travel destination rather than rely on a travel agent.”

The MUHC Clinic for Tropical Diseases sees about 1,200 people annually who have contracted diseases while on vacation. “People can come to see us with their vacation itinerary at our pre-travel clinic so we can assess the risks, or also go to official websites (see “Travel Resources for Disease Information”),” says Dr. Libman.

Dr. Momar Ndao holds a nematode, commonly known as round worm. This parasite, which infects human and carnivorous animal intestines, can reach up to 40 centimetres. It is commonly found in tropical and subtropical areas where sanitation is inadequate.

Travel Resources For Disease Information

According to Dr. Libman, preventative measures should be taken when heading to a tropical destination. This includes bringing insect repellent to prevent mosquito bites, and ensuring the food you eat is hot and cooked, and that all drinks, including water in tea and coffee, and especially cocktails and ice, should be from boiled or bottled sources. “A lot of people do not take precautions,” he says. “It’s probably one of the reasons why so many travellers get diarrhea when going to places like Cuba, Mexico or the Dominican Republic. ”

Diarrhea can be contracted from bacteria, parasites or viruses, and is by far the most common health problem travellers experience when heading south. “Around 25 per cent of travellers get diarrhea after one week in a place where there are sanitation and hygiene problems,” says Dr. Libman.

Travelling farther than Central America or the Caribbean requires taking additional precautionary measures. The tropical disease of greatest concern when travelling in the tropics is malaria, which is spread through the bite of infected mosquitoes. Areas at high-risk include Africa, South East Asia and Latin American. “We worry about this disease because it can rapidly become fatal,” says Dr. Momar Ndao, director of the National Reference Centre for Parasitology at the Research Institute of the MUHC. “It’s very important that preventative medication be taken if malaria is present.” Dr. Ndao cautions that proven medicine should always be taken, rather than homemade treatments, such as probiotics or plant remedies.

Recently, it has been reported that tropical and epidemic diseases like malaria, cholera and dengue are spreading due to global warming. “The Southern United States is becoming a tropical country,” says Dr. Libman. “Most recently, we had dengue moving into Florida and over the last few months there has been a big dengue outbreak in the Portuguese Islands. As I always maintain, the best way to travel is to be informed and think prevention, and the dream holiday can stay this way.”