SARS, West Nile, Bird Flu…oh my! If you are a worrier, the last few years have really given travelers something to worry about. Or have they? What do you really need to be concerned about and what is all just hype? Should you take that exotic trip of a lifetime or should you unpack and settle for a vacation in your own backyard? We have answered those questions for you. “Most of these things are a greater sensational interest compared to actual risk,” Douglas J. Zieger, M.D. said. Dr. Zieger is an infectious disease doctor and a specialist in travel medicine at NYU Medical Center and the Hospital for Joint Diseases. “These conditions have a small number of cases and a small amount of morbidity and the sensationalism far outweighs the true risk to any traveler.” SARS
Severe acute respiratory syndrome, or SARS, was recognized as a global threat in 2003, after making an appearance in 2002. In 2004, there were cases of SARS reported, but to date, there are no additional reports of outbreaks. Symptoms of SARS include a high fever, headache, body aches, mild respiratory symptoms, diarrhea and a dry cough. After several days the illness might lead to pneumonia. It is important to be aware especially if you are traveling to or from a SARS-affected area, that symptoms of this syndrome mimic the flu. “Anytime you’re in Southeast Asia where these viruses and germs originate for the most part, you should be very cognizant of animals and animal viruses that can transfer to humans and that’s the danger for these kinds of diseases,” Walter Koppel, M.D., medical director of MedEx with Mercy Medical Center, said. “We were very lucky with SARS; it was contained and there is not a lot of concern for the immediate future.” According to Jerome Levine, M.D., division chief of infectious diseases and a member of the Travelcare program at Hackensack University Medical Center in Hackensack, New Jersey, even a potential outbreak should not be too alarming thanks to improved global alert systems. “Whether it is through the CDC, World Health Organization or the travel community, there is a tremendous communication reporting system as a consequence to those first cases that appeared,” Dr. Levine said. “We will know about anything when it happens and we’ll alert travelers.”
What should you be concerned about instead? Because there are no current outbreaks of SARS, Dr. Koppel said you should worry more about how much sunshine you are getting as skin cancer poses a greater threat right now. Using sunscreen is extremely important. Mosquito Bites
In the United States, mosquitoes were known only as blood sucking nuisances that left itchy welts behind, but that changed a few years ago when a number of horses and birds were fatally infected with West Nile Virus or WNV, which causes encephalitis (brain swelling) and sometimes death. Soon after, the first cases of human WNV in the United States were reported. According to a recent CDC report, there were almost 3,000 human cases of WNV reported in 2005, but this is less than the 4,156 cases reported in 2002. Although the statistics seem alarming, it is not easy to contract WNV. “There isn’t much you can really do about it,” Dr. Levine said. “You will end up with a flu-like illness, but those who are elderly, sick or otherwise immunocompromised could be more at risk.” What should you be concerned about instead? “You should be more concerned about general insect bite protection,” Dr. Levine said. If you are traveling to tropical climates such as Mexico or Central and South America, mosquito bites can also lead to malaria and dengue fever. Tick bites can lead to Lyme disease. There are several things you should do to prevent bug bites, including using a DEET-containing insect repellent on your skin, wearing light-colored clothing with long pants and long sleeves, and using an insecticide such a permethrin on your clothes, avoid perfumes, soaps, lotions or hair products that contain floral fragrance, and use an insecticide-impregnated mosquito netting around your bed. Bird Flu
Avian influence or “bird flu” is this year’s biggest concern. Avian influenza, which is spread through poultry and other birds, has been found in humans in several countries. The CDC reports, “The avian influenza A (H5N1) epizootic (animal outbreak) in Asia and parts of Europe is not expected to diminish significantly in the short term. It is likely that H5N1 infection among birds has become endemic in certain areas and that human infections resulting from direct contact with infected poultry will continue to occur. So far, the spread of H5N1 virus from person-to-person has been rare and has not continued beyond one person. No evidence for genetic reassortment between human and avian influenza A virus genes has been found; however, the epizootic in Asia continues to pose an important public health threat.” Gil Smolin, M.D., and a professor at the University of California Medical Center in San Francisco, actually wrote a suspenseful novel about the worst-case scenario pandemic, entitled “Reign of the Rat,” but the uncertainties in the real world still remain.
“No one knows whether it is going to mutate into human form,” Dr. Smolin said. “If it ends up like the usual flu, people can fly and may get sick, but it is not going to be deadly. But nobody knows yet what’s going to happen.”
Levine agrees that the information is conflicting. “Some experts say it is doom and gloom, but others say it is not clear. There are concerns it may happen and hospitals are planning for a possible outbreak.” In the meantime, what should a traveler do? “Don’t panic,” Dr. Levine said. “You can become self-educated by going to the CDC Web site (www.cdc.gov) for the most up-to-date information and avoid the areas where there are outbreaks, but it would be crazy to cancel a trip.” What should you be concerned about? Because the spread of H5N1 virus from person-to-person has been rare and has not continued beyond one person, Dr. Zieger said you should be more concerned about common things like illness spread through contaminated water. If you travel to any areas that put you at a high risk for water contamination, make certain to drink beverages only in sealed cans or bottles, avoid salads, and only eat fruit that you have peeled personally.
The bottom line is that traveling can bring a whole host of maladies, but these should be your least concern. So go ahead and pack, make certain to see your doctor for medical clearance and any immunizations or special instructions you need. Make sure you educate yourself on special health precautions to take depending on your destination and keep yourself educated on today’s hottest topic so you know what is happening and where it is happening. Lisa Iannucci is the co-author of Healthy Travel: Don’t Travel Without It, by Basic Health Publications, 2005.
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