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  • Writer's pictureLaura Peters

Healthy Travel

Updated: Mar 30, 2022

What I have learned about keeping healthy when traveling from -

  • drinking the local tap water on an upper floor of a home in England (don’t);

  • eating foods of questionable provenance in India (don’t);

  • swallowing tap water when brushing my teeth in Nepal and other Asian countries (mostly don’t);

  • not getting gastrointestinal distress when traveling in China and India (very doable!)

  • having a foot injury in India in 2019 (act quickly); and

  • preventing colds and illness when traveling in the winter in Northern Europe (it can be done!)

- won’t fill a book, but will certainly provide you, dear reader, with some useful tips.

Local Water

On my first trip to London in 1971, I stayed with friends. No one told me not to drink the water from the fourth floor tap. It never occurred to me that anything would be wrong with the water in a home in England, but unsafe drinking water from anywhere but the kitchen was common. Apparently, drinking tap water from any room other than the kitchen is a bad idea in many countries. According to Bathroom City the safest countries from which you can drink tap water are:

  1. Switzerland

  2. Norway

  3. Luxemburg

  4. France

  5. Austria

  6. Italy

  7. United Kingdom

  8. Sweden

  9. Germany

  10. New Zealand

Notice that the USA is not on the list. When traveling in the US check the state you are in for more information about its water quality before drinking from the hotel tap or bathroom tap.

Avoiding Tummy Trouble

In 1978, I went to India and Nepal on a six-week trip. I got gastrointestinal illness from water or food or both on day one and never really shook it off for the entire six weeks. Plus, I developed a persistent low grade fever that made me tired. I made a full recovery within a week after returning to California, but I thought that if I ever traveled to an Asian country again, I would pay more particular attention to the water and food I ingested.

I got the opportunity to put my resolve at not getting stomach sick to the test on a trip to China in 2017 and again on a trip to India in 2019. Luckily, I found an article by Jane Brody of the New York Times which offered several pieces of advice which I followed. The article, Staying Healthy While Traveling the Globe published February 22, 2016.

Here’s an excerpt from Jane Brody’s article with references to her family removed and a few comments I have added in red:

No. 1: Any water you drink or use to brush your teeth must come from a sealed bottle that you open. Ice should be prepared from bottled water. When you take a shower or swim in a pool, keep your mouth shut.

No. 2: Before every meal, chew one pink tablet of bismuth subsalicylate (sold as Pepto-Bismol and various store brands). This reduces the risk of diarrhea by 65 percent. Make sure you pack enough tablets for your entire party for the entire trip. Without a preventive, which is no guarantee against food-borne illness, stick to “safe food” that is cooked and served hot, and fruits and vegetables you have washed in bottled water and peeled yourself. Never eat undercooked foods — eggs, meat, fish or poultry — or any food sold by street vendors. (*My caveat to this below)

Reduce your exposure to germs by washing your hands often, and always before eating. A hand sanitizer with at least 60 percent alcohol can be used if soap and water are unavailable.

Carry an emergency supply of Lomotil (for digestive problems) and azithromycin (Zithromax Z-pak, for infections) just in case.

No. 3: Be up-to-date on routine vaccines — measles-mumps-rubella, varicella (chickenpox), diphtheria-tetanus-pertussis, polio and an annual flu shot. Check with the Centers for Disease Control and Prevention for recommendations to any area of any country to which you plan to travel. You may need shots for hepatitis, Japanese encephalitis, rabies or cholera vaccinations. You can review recommendations for other destinations on the C.D.C. website. Fill a prescriptions for generic Malarone (atovaquone proguanil) to prevent malaria, in countries where malaria is endemic. Now, of course, you will want to be fully vaccinated against Covid as well. Also, please note thatThe U.S. may be lax about vaccinating, other countries are not. Some countries will not let you in if you do not have proof of certain vaccinations. For instance, you cannot fly from a country at high risk of Yellow Fever to India without proof of a vaccination against Yellow Fever.

If you plan travel to Europe, you can pick up sunscreen, insect repellent and other staples at any pharmacy, but if you’re headed into the bush or equatorial regions take an ample supply of sunscreen, insect repellent with 20 percent or more of DEET, and a first-aid kit of hydrocortisone cream, antibiotic ointment and a variety of bandages. If you have motion sickness, some meclizine might be of use.

Note that some supplements that are over-the-counter in the U.S. are by prescription only in Europe, or at least in Germany, where, for instance, you can’t buy Melatonin without a prescription.

To reduce the risk of blood clots when flying long distances, book an aisle seat so you get up every hour or so and walk around for a minute. It also helps to move your legs and flex your ankles frequently. You might also wear graduated compression stockings on very long trips. Similar precautions apply to long car or train trips. Flying business or first class with most airlines you can put your feet up and lie flat which helps prevent blood clots. smiley face. Learn more about blood clot risk from the C.D.C.

Consider carrying a card that lists your blood type, any chronic illnesses or serious allergies and the generic names of prescription medicines you take. Bring some (plenty of!) extra doses in case of travel delays. This is really an essential item.

Other worthy precautions: To avoid nasty parasitic diseases like schistosomiasis, do not swim or wade in fresh water in developing countries or wherever the sanitation is poor. Pools should be chlorinated. However adorable an animal (domestic or wild) may be, keep your distance. Do not touch or feed any animal you don’t know. Some carry rabies. Should you get bitten or scratched by an animal, wash the wound immediately with soap and clean water and, if at all possible, get to a doctor quickly.

Staying Safe at High Altitude

If you expect to be at a high altitude (8,000 feet or higher), consult your doctor about medicine to prevent altitude sickness, which can take more than the starch out of a person. The recommended preventive is acetazolamide (generic version of Diamox). Challenging altitudes are no joke and Diamox works wonders. I can attest. My 2019 trip included a visit to Leh, Ladakh in Northern India at an altitude of 11,483 feet. As directed, I started taking Diamox a day or two before we flew to Leh and continued for the prescribed amount of time. When that time was over, I stopped taking it and quickly found that breathing was difficult. The hotel gave me oxygen and recommended that I continue taking Diamox as long as I was going to be there. They didn’t have to ask me twice! Diamox saved that leg of my trip and all the beautiful experiences that followed.

Thank you, Jane Brody! *The only thing that I found contrary to Jane’s advice when traveling in China, India, Thailand and Indonesia, is that there are plenty of hotels, restaurants and street food vendors who understand the Western Digestive System and offer safe water and foods. These places are well vetted online, just do some research so you don’t miss out on wonderful cuisine for fear of getting sick. When in doubt though, only eat cooked food and hot tea.

Treating Injury

When I was in India with my daughter, Rebecca, in 2019, it was hot and humid. Very hot and humid. So, we naturally wore sandals and light clothing. Unfortunately, while standing in some grass in my sandals, something, an insect probably, bit my right ankle. By the end of the day my foot was swollen and red, and clearly heading into blood poisoning. We had a walking tour planned in Varanasi the next morning, but when we showed my foot and ankle to our guide, he shook his head saying, “This is very bad.” He walked us to a local clinic where I was quickly seen and given a prescription for ten days of antibiotic pills as well as topical antibiotics. I firmly believe that this saved not just my foot and leg, but my life.

Keeping Healthy

I secretly kind of love wearing a mask against Covid because I haven’t had so much as a cold since the pandemic began. Pre-mask, I drank Zinc tea to prevent getting ill when I felt that first tickle in my throat. A tea I get in Germany is pictured. I also gargle frequently with warm salt water. Over the many times I have traveled, I’ve only had a cold once that I recall.

Of course, masks were required in China and India pre-Covid because the air quality was so horrendously bad. When traveling to bad air countries, always carry 3M masks.

Medical Insurance

Jane Brody also mentions in her article purchasing medical evacuation and travel health insurance. In the past, I have not purchased this kind of insurance. I did go to an emergency room in Germany once for a health issue I have that flared up unexpectedly, and had to pay the bill in cash for four hours in the ER and a lot of tests. Luckily, the charge equaled $500, rather than $5,000 the same emergency costs in the U.S.

With Coronavirus lurking in the wings and a few health issues that could require additional insurance, I anticipate turning to a user-friendly website called Squaremouth to find suitable travel insurance in the future. If it’s just emergency medical I want to insure for, I’ll look at EA+. It covers emergency medical expenses and transportation/repatriation costs for any medical event incurred more than a certain number of miles from your home. This affordably priced option offers very good concierge service working with you to find doctors, coordinate coverage and arrange care, including custom Medivac with medical attendants.

Always be sure to find out if the insurance you seek covers pre-existing conditions you may have.

Get out there and travel. Stay healthy, but if you don’t, know you have options that will help.


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