BNL Occupational Medicine Clinic

Traveler's Risks and How to Avoid Them

+-------------------------------+--------------------------------------+
| # Food and Waterborne Illness | Frequent hand-washing. Avoid         |
|                               | high-risk foods (e.g., dairy         |
|                               | products, undercooked foods). Use    |
|                               | bottled, sealed water if possible.   |
|                               | Select foods with peels/skins. Avoid |
|                               | foods cleaned with tap water; avoid  |
|                               | ice in drinks. Use caution using tap |
|                               | water for brushing teeth.            |
+-------------------------------+--------------------------------------+
| **Motor vehicle accidents/    | Observe local ordinances and         |
| adventure travel**            | regulations. Use public              |
|                               | transportation whenever possible.    |
|                               | Participate only in                  |
|                               | activities/sports/swimming/driving   |
|                               | compatible with personal skill       |
|                               | level. Use of seat belts/ helmets.   |
+-------------------------------+--------------------------------------+
| # Fish-                       | Avoid raw freshwater fish.           |
| related toxins and infections |                                      |
+-------------------------------+--------------------------------------+
| **Malaria** (rural travel     | Avoid mosquitoes by taking           |
| risk\>\>urban.) See CDC       | protective measures;                 |
| recommendations for intended  |                                      |
| destination(s).               | Use protective clothing and DEET     |
|                               | repellant; Prophylactic medications  |
|                               | when indicated.                      |
+-------------------------------+--------------------------------------+
| **Tuberculosis**              | Check PPD 3 to 6 months after return |
| (particularly multi-drug      | if history of prior negative PPD and |
| resistant)                    | long stay (\>3 months)               |
|                               |                                      |
|                               | Awareness of TB symptoms and         |
|                               | avoidance.                           |
+-------------------------------+--------------------------------------+
| **Blood and body fluid for    | Avoid high risk behaviors including  |
| sexually transmitted          | tattoos, piercing, dental work,      |
| diseases**                    | sexual encounters.                   |
|                               |                                      |
|                               | Purchase condoms prior to travel.    |
+-------------------------------+--------------------------------------+
| **Toxin ingestion** (e.g.,    | Anticipate and purchase medications  |
| medication adverse events,    | prior to travel. Avoid local         |
| heavy metal ingestion)        | traditional medications and          |
|                               | high-risk items (e.g., large reef    |
|                               | fish- i.e. ciguatera poisoning).     |
+-------------------------------+--------------------------------------+
| # Respiratory problems        | Avoid close exposures to fires,      |
|                               | smoking, pollution. Prepare for      |
|                               | asthma exacerbations by considering  |
|                               | stand-by steroids.                   |
+-------------------------------+--------------------------------------+
| **Zoonotic diseases** (animal | Avoid animals. Wash hands. Wear      |
| sources) (e.g., rickettsial,  | protective clothing and DEET         |
| leptospirosis, viral fevers,  | preparations. Perform daily tick     |
| anthrax). leishmaniasis (from | checks. Avoid sleeping at floor      |
| sand flies) rural risk &      | level. Avoid thatched roofs, mud     |
| nighttime exposure\> urban &  | walls in Latin America, freshwater   |
| daytime; See CDC for specific | sports or flooded areas.             |
| locales.                      |                                      |
+-------------------------------+--------------------------------------+
| **Schistosomiasis** and       | Avoid freshwater exposure            |
| **helminthes** (parasitic     | (bathing/wading); Use groundcover,   |
| worms). See CDC for specific  | protective footwear. Discourage      |
| destination(s).               | child from playing in dirt. Consider |
|                               | liposomal DEET (LipoDEET)            |
|                               | preparation with freshwater          |
|                               | exposures.                           |
+-------------------------------+--------------------------------------+
| **Envenomations** (e.g.,      | Avoid sleeping at floor level. Use   |
| snakes, spiders, scorpions)   | footwear out-of-doors at night.      |
+-------------------------------+--------------------------------------+
| **Yellow fever** and          | Avoid mosquitoes by taking           |
| **Japanese encephalitis** See | protective measures and receiving    |
| CDC for specific              | vaccination when appropriate.        |
| destination(s). (Rural        |                                      |
| risk\>\>urban)                |                                      |
+-------------------------------+--------------------------------------+
| **Dengue fever** See CDC for  | Avoid mosquitoes by taking           |
| locales.                      | protective measures.                 |
+-------------------------------+--------------------------------------+

Adapted from: JAMA, June 16, 2004, Vol. 291, No. 23, p 2859. Contact OMC
x3670 for questions.

For further information: *<http://www.cdc.gov/travel>
<http://www.who.int/ith> [http://www.istm.org](http://www.istm.org/)
[http://www.iamat.org](http://www.iamat.org/)
<http://www.cdc.gov/travel/yb/toc.htm>*