I’m not a doctor! Why? It may be that I wasn’t thrilled about 12 semesters of chemistry, calculus, biology, anatomy and the like—and I never had a penchant for memorizing multi-syllable Latin words. However, as I cut my teeth in the realm of overland travel, weekend treks in the local backcountry morphed into extended adventures outside U.S. borders. With this came the famous little yellow card, my International Certificate of Vaccination. It’s just an ordinary piece of craft paper, run through a printer and smeared with doctors’ signatures, initials and Latin mumbo jumbo. But this crumpled, folded and worn document is my ticket to accessing many foreign countries. Without it, I’d likely have experienced extended visits with certain immigration officers. And it might even save my life, if it hasn’t already.?>
In 1998 I experienced my first dose of what I call “The Traveler’s Blues” in Bolivia while traveling with the crew from Jeepers Jamboree. I have a habit, maybe a bad habit, of mixing it up with street food vendors and sampling the local cuisine—it is part of the travel experience for me. In this case, though, the uninvited bug came on board in a sandwich from a grungy roadside café (probably the mayonnaise). I had a funny feeling when they handed it to me. I lifted the bread to inspect what I was about to put in my body . . . I was hungry and ate it anyway. My punishment was two days of gut-wrenching vomiting and simultaneous diarrhea. I’ve become much more cautious over the years, but the bottom line is: Listen to your gut.
Visit The Doc First: As I write this month’s column, I’m preparing for a trip to Argentina and needed to make sure my travel vaccinations were up to date. Unlike travelers of centuries past, there is an incredible amount of information available for almost any destination. I sat with a travel nurse, listening to a long dissertation about typhoid, malaria, yellow fever, hepatitis, STDs, rabies, scabies and the like. I would have heard “Blah, blah, blah,” but I know this is serious business. She then stuck a couple of needles in my arm. I smiled and said thank you.
The Centers for Disease Control, or CDC: (www.cdc.gov) is a wealth of information for doing your own research ahead of time, and there are some basic points of concern regardless of where we travel. When you cross the border, especially to the south, or touch down on another continent, there are health risks to consider—the type that may not only affect your trip but can cause long-term annoyances or disabilities. Mexico is probably the most common locale frequented by Americans, so I’ll start there.
Water-Borne Bugs and Montezuma: Caused by pathogenic microorganisms in much of the world’s water supplies, Traveler’s diarrhea is the most common waterborne concern; Giardia (Giardia lamblia) is the second. The best way to stay healthy is to drink only bottled water, wash or peel all fruits and vegetables, and avoid watery delicacies like shrimp cocktail. I love a good margarita, but unless I’m confident that it is made with purified ice (aqua purificata in Spanish), I’ll pass. Also, don’t forget to wipe clean any coldies that are pulled from a swirling cooler of sea slime.
As a kid backpacking in the Sierra Nevada with my family, we’d drink directly from most creeks without issue. Today, treating water is essential. The two most common methods are using ultraviolet light—the Steripen UV purifier for example—or filter it with a high-quality unit such as a PUR ceramic job. Ultraviolet light will kill bacteria and viruses—they’re still in your water, but dead. Filters do just that (filtering out most of the bad guys), though it is argued that some viruses may slip through. I’ve used both methods successfully in South America and Africa, but lean towards the UV method. Why worry about a little extra protein, right? Finally, the old-school method is iodine tablets. I carry iodine but have only used it once as an experiment. Most variants leave an undesirable aftertaste but do the job. The failsafe method of boiling kills almost everything, but experts say that certain bacteria view 212-degree water as a soothing hot tub.
Handshakes and Bad Food: A greeting handshake, handling money, or grabbing a doorknob can deposit a fair number of unwanted guests in your palm. Carrying a bottle of hand sanitizer and using it regularly is one of the best ways to avoid what I call “hand-to-mouth” bugs. Hepatitis A (picornavirus) and typhoid fever (caused by a strain of salmonella and responsible for 200,000 global deaths annually) are most common, and transmitted primarily by the fecal-oral method (hand to mouth) or the consumption of contaminated food or water. Fortunately, the risk of both is greatly reduced with a few additional needles in your arm from the travel nurse.
Vector Borne Diseases: These are transmitted via mosquitoes, ticks, rats, etc. Though most are transmitted from human to human via mosquitoes (Spanish for “little fly”), primarily in Africa, Asia, and the tropics, we do have a few here in the States to be aware of. While vaccinations are available for some, preventive measures are the only safeguard for the majority. As with most diseases, awareness of symptoms and early diagnosis and treatment are key. If after being in the backcountry you develop severe fever, chills, rash, fatigue, headaches, stiff neck and achy joints, nausea or diarrhea, make sure your physician is aware of where you’ve been and what you were doing. If you are in the field, locate a doctor ASAP!
Ticks, Rats and Mice: Lyme disease (B. burgdorferi) is a nasty critter that is spread by ticks, and causes dermatologic, rheumatologic and other pain-in-the-tologic abnormalities. Most common is a ring-type rash, fatigue and fever within 30 days. Untreated, it can cause long-term neurological and cardiac conditions. Transmission to you from the carrier is said to require 72 hours, so check closely for ticks each day. Using repellant on clothing and exposed skin also reduces risk. Don’t forget to inspect your pets, especially if they dive into your sleeping bag to stay warm at night.
Hantavirus: This rare but deadly disease is transmitted through contact with the urine or fecal matter of rodents, and there is no known treatment. In short, use caution when rummaging through old mines, ghost towns and other places rodents reside.
Mosquito Threats (U.S. and abroad): West Nile Virus, which can be fatal, is a recent concern in the States. Though 80 percent of people show no symptoms, about five percent of those that do may perish or experience long-term effects.
Malaria is the most common mosquito-transmitted disease and is credited for millions of deaths annually worldwide. Important to remember is that symptoms—fever, chills and flu-like conditions—might not show up for a year. Fortunately, there are effective anti-malaria drugs available, and the disease is treatable. Though some experience short-term side effects, the drug mefloquine (taken orally each week), has worked well for me.
Yellow Fever is common in much of the world. Fortunately, a vaccination is available and is on the short-list of needles your travel nurse will poke you with.
Dengue Fever: The origin for this emerging wonder is monkeys. Mosquito bites infect monkey, then the bug bites you, and you’re infected. Though only two percent of cases are fatal, early diagnosis is crucial and treatment is similar to that of a severe fever. Sorry, no cure-all needles for this one.
Though we can take medications and receive immunizations for vector-borne diseases such as malaria, yellow fever and Lyme disease, be sure to slop on the bug spray. I’ve used a number of products from Backwoods Off (28-percent Deet) to Repel (100-percent Deet). The reality is that in some environs such as the tropics, flying and biting arthropods eat this stuff for breakfast. It is advised to wear long pants, long-sleeve shirts and a hat that covers the back of your neck, and sleep under a mosquito net when in high-risk areas.
Pack Smart: No one likes to get sick. When it happens on the road, it can really be a bummer. Antidiarrheal meds, such as Ammonium AD and doctor-prescribed Ciprofloxacin (antibiotic), should keep your trek in forward motion. Decongestants, motion-sickness pills, Ibuprofen, a laxative and an antacid are also part of my meds kit. Important! Prescriptions should be in original pharmacy-labeled containers. Detainment and extensive questioning may be the result if a handful of loose pills is discovered during a search of your gear.
About Chris Collard
A southern California native, photojournalist Chris Collard has been wheeling in the dirt since age five (dirt bike). A certified SCUBA instructor who also holds a private pilot’s license, he has trekked across more than 40 countries on five continents, and his work has been published in National Geographic Adventure, Car & Driver, Cigar Aficionado and numerous other publications. When not hacking his way through equatorial rain forests, he makes his home near Sacramento, California.