Tips for staying well while traveling the world

Many a well-planned trip has been ruined by traveler’s diarrhea, airborne illness and vaccination procrastination. Paul Sehdev, M.D., an infectious diseases and internal medicine physician at Providence St. Vincent Traveler’s Clinic, answers common questions about staying well while traveling the world.

How can I make sure my next trip isn’t ruined by traveler’s diarrhea?

Traveler’s diarrhea is probably the most common health problem that travelers encounter. Depending on where you go, the risk of contracting it may be as high as 50 percent. To protect yourself, pay close attention to what you eat and drink, and perform good hand hygiene. In many countries, tap water should be considered off limits. Don’t even brush your teeth or rinse your mouth with tap water – it doesn’t take many bacteria to make you sick. Drink only bottled or boiled water. Avoid ice cubes, unless you’ve made them yourself from purified water – freezing does not kill all the bacteria. Cook or peel all fruits and vegetables before eating. And wash your hands thoroughly and often with soap and hot water (tap water is fine for washing and bathing). Read more about water and food safety, as well as malaria and other issues, in these International Travel FAQs.

If you do develop traveler’s diarrhea, over-the-counter Imodium can offer some relief. When patients at Providence St. Vincent Traveler’s Clinic tell us that they are planning to visit a country where we know the risk of traveler’s diarrhea is high, we also may write a prescription for antibiotics, which they can fill here and take with them. If problems arise during their travels, they can take the medication, which will speed recovery from three or four miserable days to a vacation-saving 12 to 24 hours.

It never fails - someone on the plane has a cold, and a few days into my trip, I have it, too. What’s the best way to prevent this?

The most important thing is to focus on your own hand hygiene. What I do, and what I recommend to others, is to take some alcohol-based hand sanitizer with you and to use it fairly frequently. This is your best line of defense. If you’re seriously concerned, wearing a face mask can offer protection from airborne viruses, as well.

I take medications for a chronic condition - will I have any trouble getting them through customs?

As long as your medicine is in its original bottle, with your name on it and the doctor’s name on it, you won’t have any problem. In some countries, travelers are sometimes hassled for bringing in narcotic medications. But according to international law, if it’s in the original bottle with your name on it and you need it for your health, you have a legal right to take it with you into another country.

What other types of medicines are useful to pack for trips out of the country?

In a basic first-aid kit for travel, the following items might be useful:

  • A pain reliever, such as acetaminophen or ibuprofen
  • An antihistamine in case you develop allergy symptoms
  • Imodium, which I mentioned, as an antidiarrheal
  • A decongestant in case of a cold
  • Bandages, which help cushion blisters if you do a lot of walking
  • Insect repellant containing 30 percent DEET, if you are going to a country where insect-borne diseases like malaria and dengue fever are prevalent

Beyond that, unless you are going way off the beaten path, you can usually buy what you need at a local pharmacy, wherever your destination.

I am traveling to (fill in the blank). What shots do I need?

As a specialist in travel medicine, this is the question I hear most often. To investigate on your own, probably the most user-friendly online resource for this type of information is the Centers for Disease Control and Prevention, which offers a Travelers’ Health website at This site provides some good general guidelines about the immunization recommendations and requirements of different countries. However, it’s important to understand that when you travel outside of your own country, it’s more than just shots that you need to consider. To get more detailed health-risk information, tailored to your health and destination, it’s best to be evaluated in person at a clinic that specializes in travel health.

At Providence St. Vincent Traveler’s Clinic, we meet with you before you travel, do a full risk assessment of your itinerary, and provide you with not only the necessary shots, but also strategies and advice to help you reduce or eliminate a broad spectrum of travel-related health risks. And just in case you do fall ill in another country, we can equip our patients with contact information for English-speaking, Western-trained physicians in almost any country on the planet.

How far in advance do I need to get my shots?

The further in advance, the better. Six weeks is ideal, because certain vaccines, such as Japanese encephalitis, take a month to complete the series, plus two additional weeks to build full immunity. That said, if you’re reading this two weeks before your trip, it’s still worth coming in to the clinic. In some countries, certain vaccines are legally required before entering. The yellow fever vaccine, for example, must be given 10 days before you arrive in some countries, according to international law.

I’ve lived in the United States for 20 years, but I grew up in Nigeria, and I’m planning a trip back. Am I still naturally immune to malaria, or do I need to get immunized before I go?

You need to be immunized. Many people believe, incorrectly, that living in a country builds permanent immunity to that country’s most common infectious diseases. It doesn’t. In my experience, the people who are most likely to get ill while traveling are those who bypass vaccinations in the mistaken belief that they are already immune.

Any other advice?

The last word on vaccinations: it’s just as important for adults as it is for kids to stay up to date on routine vaccinations. Keeping current on immunizations against tetanus, diphtheria and pertussis (which are all included in one shot now), pneumonia, shingles, the flu and other common illnesses are an important part of routine care, whether or not you travel. If you haven’t updated these routine vaccinations in a while, review them with your primary care doctor.

The last word on vacations: Don’t risk an illness ruining the trip of a lifetime. If you want to see the world, first see a travel clinic. Safe travels!