Why Your Family Needs a Travel Health Exam Before Going Abroad

It looks as though many Americans are gearing up for lots of travel in 2023, and beyond, as they play catch up from not traveling as often during the COVID-19 pandemic. Before one packs their bags, it’s important to prepare oneself so that they can stay healthy while on vacation.

At Nebraska Home Pediatrics, we offer a Travel Health clinic for children and adults. It’s recommended that you make an appointment at least a month before you are scheduled to leave so that the provider has time to review your vaccination record and where you plan to travel. The medical provider can then recommend any vaccines and/or medications needed, such as antibiotics for traveler’s diarrhea or medication to prevent malaria.

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Recommended Vaccinations

Routine vaccines, such as tetanus, diphtheria, pertussis, chicken pox, polio, MMR, hepatitis B, hepatitis A, annual influenza and COVID-19 are recommended for any place of travel. Depending on where you are traveling, you may also need one or more of the following vaccinations:

Rabies – A variety of rabid animals, such as dogs and bats, can sometimes be found when traveling abroad. You may not have easy access to modern medical clinics and rabies treatment, so it is important to get vaccinated before leaving if you are at risk for rabies exposure. We encourage travelers to get their rabies vaccination if they will be participating in outdoor activities or coming into contact with local wildlife in countries that have high incidence of rabid animals.

Typhoid – Typhoid is a bacterial infection caused by Salmonella Typhi bacteria. It is commonly spread from person to person when an infected person does not wash their hands after using the bathroom. This bacteria can also be found in the water of countries with poor sanitation. When the local water is used to rinse and prepare food or beverages, the water could be contaminated with these bacteria. Travelers who then eat the contaminated foods or drink the contaminated beverages can get sick.

Yellow Fever – Most people infected with the yellow fever virus do not get sick or have only mild symptoms. Unfortunately, approximately 12% of people who have symptoms go on to develop serious illness including jaundice, bleeding, shock, organ failure, and sometimes even death. Yellow Fever may be required for those traveling from a country with risk of yellow fever virus transmission and ≥1 year of age. This includes those who spend 12 hours or more in an airport located in a country with risk of yellow fever virus transmission. Yellow fever virus, and the mosquitoes that spread the virus, are found in certain parts of South America and Africa.

Traveler’s Diarrhea

Travelers’ diarrhea is the most common travel-related illness. Although travelers can get it anywhere, the destinations with the highest risk include Mexico, Central and South American, Africa, the Middle East and Asia. In otherwise healthy children and adults, diarrhea is rarely serious or life-threatening, but it can quickly routine your family trip.
At Nebraska Home Pediatrics, we can prescribe the appropriate antibiotics needed to treat traveler’s diarrhea specific to your destination. The antibiotics can help decrease the severity and length of symptoms. We recommend only taking these antibiotics if you begin to have moderate to severe diarrhea symptoms. If your diarrhea doesn’t go away with the antibiotics, sometimes we will ask to collect a stool sample and test it in order to hopefully identify the organism causing your symptoms.

Malaria Prevention

Malaria in humans is caused by protozoan parasites and it is typically transmitted through a bite of an infective female Anopheles mosquito. Symptoms from malaria infection include fever and influenza-like symptoms, such as chills, headache, body aches, and fatigue, which may occur intermittently. In severe illness, seizures, mental confusion, kidney failure, respiratory distress, coma, and even death may occur. Malaria can develop as early as seven days after being bitten by an infectious mosquito and as late as several months after exposure.

All recommended primary prevention regimens involve taking medicine before, during, and after travel to an endemic area with malaria. Some of the malaria preventative medications include Malarone, Plaquenil, and doxycycline. The medical provider will thoroughly review your medical history and your place of travel to determine which medication is best.

Motion Sickness

We can recommend and prescribe medications that can be used to prevent or treat motion sickness, although many of them cause drowsiness. Commonly used medicines are Benadryl, Dramamine, and scopolamine.

Motion sickness is more common in children ages 2 to 12 years old. Some medicines used to prevent or treat motion sickness are not recommended for children, so be sure to talk to your medical provider before giving them any medications. Although motion sickness medicines can make some people sleepy, they can have the opposite effect for some children and cause them to be very active.

Safety Tips When Traveling with Children

In addition to the preventative measures listed above, other tips to help you stay safe when traveling with children include:

Identify where to get healthcare, if needed, when traveling
Pack a travel health kit (https://wwwnc.cdc.gov/travel/page/pack-smart)
Purchasing travel insurance
Enroll in the Smart Traveler Enrollment Program (https://step.state.gov/step/)
Create a family safe code word
Consider family ID bracelets
Make a separation plan
Research car seat guidelines for the country you are traveling
Supervise children closely during water activities

Contact Nebraska Home Pediatrics after you return home if you or your child becomes ill while traveling.