General Disease Prevention

Malaria

Malaria is a serious and potentially life threatening illness contracted through mosquito bites. Fortunately there are medications travelers can take to decrease their likelihood of infection. It is important to discuss your risk of contracting malaria with your provider to determine if you should take a medicine to prevent malaria while traveling. Of course, the best prevention is to avoid mosquito bites altogether. Using bug spray with DEET, wearing long pants, long sleeved shirt, socks and shoes, and sleeping under mosquito nets can help. It is also important to try to avoid being outdoors at dawn and dusk when mosquitoes are more common. See the link below For More Information on your risk and preventing malaria while traveling.

For More Information:
www.cdc.gov/malaria/faq.htm

Travelers' Diarrhea

Travelers' Diarrhea is one of the most common ailments affecting people traveling abroad. Your risk will depend on where you travel, the precautions you take and your own immune system. Any food or water from an infected source can potentially cause travelers' diarrhea. The general rule is "cook it, boil it, peel it, or forget it!" Some travelers will become ill despite following these measures. Common pitfalls include ice in beverages, brushing your teeth with the tap water, eating raw vegetables or unpeeled fruit, and eating food from roadside stands. If diarrhea occurs, it is important to stay well hydrated by drinking plenty of safe fluids. Loperamide (Imodium-AD over the counter) may be taken for few days to stop the diarrhea. However it should be avoided if you have blood in your stool or a history of bowel problems. Your provider may prescribe antibiotics to take with you to treat travelers' diarrhea if your symptoms persist. See the link below for more detailed information on travelers' diarrhea.

For More Information:
www.cdc.gov/ncidod/dbmd/diseaseinfo/travelersdiarrhea_g.htm

High Altitude Travel

Travel to high altitude may result in altitude sickness which can take three forms: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS is the most common and most benign form of altitude sickness. Symptoms can include headache, fatigue, loss of appetite, and nausea usually not accompanied by vomiting. HACE is a more severe form of AMS. In addition to the symptoms of AMS, the traveler will also experience lethargy, confusion, and may have a staggering gait. If these signs are present, the traveler should immediately descend. HAPE impedes a person's ability to breathe and the hallmark is breathlessness without exertion. HAPE also requires immediate descent and medical treatment. Both HACE and HAPE are potentially fatal. There are numerous medications used to treat the various forms of altitude sickness, and it is important to discuss your travel plans with your provider to determine if you should carry any of these medications.

Sexual Health

Some travelers may become less inhibited when they travel and take risks they would not usually take. This may include making poor choices regarding their sexual health. Here are some important reminders:

  • Hepatitis B is a vaccine-preventable sexually transmitted disease (STD). Prevention requires 3 doses of vaccine over a minimum of 6 months. Hepatitis B vaccine is recommended by the CDC for travelers to almost all countries. Plan early so you can fit the entire series into your schedule before traveling.
  • Condoms are the only reliable method of decreasing the risk of infection with an STD. They DO NOT eliminate your risk. Condoms should be purchased at home prior to travel and should be kept available. Remember that heat can decrease the effectiveness of condoms. Abstinence is the only way to assure prevention of STD's.
  • The risk of infection with HIV can also be decreased with the use of condoms.
  • Human papilloma virus (HPV), herpes, genital warts and molluscum contagiosum are now vaccine-preventable. For more information on the HPV Vaccine see our information page (link). However, condoms should always be worn and may reduce your risk of contracting HPV if you or your partner are not vaccinated.
  • Females should know that emergency contraception can reduce your risk of pregnancy should unprotected intercourse occur or your condom breaks. It is not recommended as a primary form of birth control, and we recommend you take your usual birth control measures with you when you travel. However, should you need information regarding emergency contraception while traveling, you may find the following link helpful:

For More Information:
www.not-2-late.com

Typhoid Fever

Typhoid fever is a potentially life threatening illness that is characterized by high fevers, fatigue and muscle aches. Diarrhea may or may not occur. It is contracted by eating or drinking contaminated food and/or water. Travelers to Asia, Africa, parts of the Caribbean and Central and South America may be at risk, particularly if traveling to smaller cities or rural areas. While vaccination is recommended for many travelers, it is important to note that it is not 100% effective and is no substitute for eating and drinking only safe foods. If you have been vaccinated in the past you will need a booster if it has been longer than 2 years since your last vaccination.

For More Information:
www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=typhoid.htm&cssNav=browseoyb

Cholera

Cholera is an intestinal bacterial infection which causes an acute onset of profuse watery diarrhea, muscle cramping, and vomiting. In some people, sudden, severe fluid loss can be life-threatening. Cholera is usually caused by eating food or drinking water that has been contaminated by feces of a person infected with the bacteria. It is common after a disaster with inadequate treatment of sewage and drinking water. Cholera can be prevented by taking food and water precautions including: drink water that you have boiled or treated with chlorine or iodine, eat foods that have been thoroughly cooked and are still hot, eat fruit that you have peeled yourself, avoid raw or undercooked fish or shellfish, avoid raw vegetables, and do not eat food from street vendors. Currently, there are no licensed cholera vaccines in the United States.

For More Information:
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera_g.htm

Hepatitis A

Hepatitis A is a viral infection that infects the liver of susceptible people. The symptoms include loss of appetite, malaise, nausea, diarrhea, fever, and jaundice. Unlike Hepatitis B, there is no chronic infection from Hepatitis A virus. Once you have been infected with Hepatitis A, you cannot get the infection again, but some people will have prolonged or relapsing symptoms over a 6-9 month period. Most symptoms last 1- 3 weeks. Hepatitis A is spread from person to person by putting something in the mouth that has been contaminated with the feces of a person with Hepatitis A infection. Hepatitis A is the most common vaccine-preventable infection that is acquired by travelers. Washing your hands with soap and water after using the bathroom, changing diapers, and before preparing and eating food can help decrease the risk of infection. A vaccine is available to prevent Hepatitis A. If you have not been vaccinated against Hepatitis A, Hepatitis A immune globulin can be given before and within 2 weeks after coming in contact with the virus. Always contact a provider if you think that you may have been exposed to Hepatitis A.

For More Information:
http://www.cdc.gov/ncidod/diseases/hepatitis/a/index.htm

Hepatitis B

Hepatitis B is viral infection that infects the liver of susceptible people. The infection can cause cirrhosis of the liver, liver failure and death. It is spread when blood or body fluids from an infected person enters the body of a person who is not immune. Methods of transmission include blood transfusions, sex, sharing drugs and needles or other drug paraphernalia, needlestick or sharps exposure on the job, or from an infected mother to her baby during birth. Signs and symptoms include jaundice (yellowing skin/eyes), fatigue, loss of appetite, nausea, joint pain, vomiting, and abdominal pain. There is a vaccine available to prevent Hepatitis B.The best way to prevent Hepatitis B infection is to get vaccinated. Other preventive measures include decreasing the number of sexual partners. Use condoms, do not share personal items that might have blood on them, do not shoot drugs or share paraphernalia, do not get piercings or tattoos if health practices are questionable. Health care workers should get vaccinated and always follow routine barrier precautions and safely handle needles and other sharps.

For More Information:
http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm

Rabies

Rabies is a serious, almost always fatal viral infection of the central nervous system. It is transmitted to mammals by the bite of an infected animal. Signs and symptoms usually arise within 3 weeks of exposure. Early signs of rabies can be fever or headache and then can progress to confusion, sleepiness and agitated or violent behavior. A person rarely survives when symptoms arise. It is important to talk with your health care provider immediately after being bitten by an animal, especially a wild animal. A rabies pre- exposure vaccine is recommended for international travelers who will be in direct contact with animals in areas where rabies is common, including Asia, Africa, and Latin America. Injections of human-diploid-cell-strain vaccine are given to the victim if the biting animal is proven rabid.

For More Information:
http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=dis&obj=rabies.htm

Polio

Polio is an acute viral infection that is an acquired by fecal-oral or oral transmission. It involves the gastrointestinal system and occasionally the central nervous system. Symptoms are variable. Most of the people infected are asymptomatic, but symptoms can include acute flaccid paralysis, respiratory failure, and death. The risk of polio has significantly decreased since the development of polio vaccines. The last reported case of polio in the United States was in 1979. Travelers should verify completion of polio vaccinations at least 8 weeks prior to going to areas where poliomyelitis cases still occur. In 2004 polio remained prevalent in Afghanistan, India, Pakistan, Nigeria, Niger, and Egypt

For More Information:
http://www.cdc.gov/nip/publications/pink/polio.pdf

Tuberculosis (TB)

Tuberculosis is a bacterial infection that usually affects the lungs, but it can also affect bones, joints, spine, brain, and kidneys. It is spread from person to person in airborne droplets when a person infected with TB coughs sneezes, speaks, sings or laughs. It usually takes prolonged contact with someone with active TB before becoming infected. Most of the time people infected with TB do not have symptoms; this is called latent tuberculosis. The symptoms of an active infection or "active tuberculosis" include cough, fever, night sweats, loss of energy or appetite and weight loss. People can be tested for tuberculosis with a skin test. If a red welt develops within 48-72 hours after skin testing is done, this could be a positive test. The test must be read by a trained professional. A chest x-ray is done to identify an active infection. Both active and latent TB should be treated with an antibiotic. People who anticipate prolonged exposure through travel (those working in prisons or with the homeless, in hospitals/clinics, or living in group settings), should have a TB skin test before leaving the US. They should also repeat the test 12 weeks after returning from travel.

For More Information:
http://www.cdc.gov/travel/diseases/tb.htm

Severe Acute Respiratory Syndrome (SARS)

Severe Acute Respiratory Syndrome is a viral respiratory infection first diagnosed in Asia in 2003. This respiratory infection is in the same family of viruses that can cause the common cold. Symptoms usually occur two to ten days after exposure. Symptoms may include fevers higher than 100.4, headache, body aches, dry cough, and difficulty breathing. Severe breathing problems may lead to death. The virus is spread by close person-to-person contact. A cough or a sneeze can spread the virus to others. It can also be spread if you touch someone who is infected, then touch your eyes, nose, or mouth. The best prevention is avoiding travel to areas where the infection is present. Washing hands often, using alcohol-based wipes, and wearing a protective face mask can decrease infection. If you have been exposed to SARS, or you have recently been traveling and symptoms occur, contact a medical provider immediately and let them know about possible exposure prior to arriving to the medical facility.

For More Information:
http://www.cdc.gov/ncidod/sars/basics.htm

Japanese Encephalitis (JE)

Encephalitis means inflammation of the brain. Japanese Encephalitis is caused by a virus transmitted by mosquitoes. Acute JE can progress to paralysis, seizure, coma, and death. Most infections are very mild and are not always reported. Symptoms include headache, body aches, fatigue, and loss of appetite. JE primarily occurs in rural areas of Asia. The risk to travelers is low if they confine travel to urban settings. A vaccine is available for persons who plan to live in endemic or epidemic areas and those whose activities include trips into rural agricultural areas. Prevention also includes avoiding mosquito bites. Using insect repellent with DEET and protective clothing is helpful. Travelers should avoid being outdoors at dawn and dusk when mosquitoes are most active.

For More Information:
http://www.cdc.gov/ncidod/dvbid/jencephalitis/index.htm

Marburg or Ebola Hemorrhagic Fever

Marburg and Ebola are rare and poorly understood viruses. They infect humans and non-human primates, but the reservoirs for these viruses are not known. Both are animal-borne viruses. Marburg virus has been identified in parts of Uganda, western Kenya, Democratic Republic of Congo and Zimbabwe. Ebola cases have been reported in the Congo, Cote d'Ivoire, Democratic Republic of Congo, Cabon, Sudan and Uganda. Symptoms usually present 5-10 days after exposure and may include skin rashes, nausea, vomiting, fevers, chill, muscle aches, chest pain, sore throat, abdominal pain and diarrhea. Increased severity of symptoms can lead to multi-organ failure. The best prevention is avoiding contact with people who may be infected and in close contact with monkeys/primates. Travelers should consult with a health-care provider immediately if they become ill. If an infection is suspected, limit contact with others.

For More Information:
http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/marburg.htm

Avian Influenza (Bird Flu)

Bird flu is an infection caused by avian influenza viruses. These viruses typically infect wild birds, but do not cause illness in them. They can infect domesticated birds like turkeys, ducks, and chickens. These viruses can be found in bird saliva, nasal excretions, and feces. It is believed that most cases of bird flu infection in humans are a result of contact with infected poultry or contaminated surfaces. There have been reported cases of human infection since 1997. These cases are rare. Outbreaks have occurred in Cambodia, China, Indonesia, Japan, Laos, South Korea, Vietnam, and Thailand. Symptoms include fever, cough, sore throat, eye infections, pneumonia, and respiratory distress. Various subtypes of Avian Influenza have caused death in 50 percent of the people infected. Treatment may include antiviral medications as well as supportive measures for respiratory problems. You should seek medical consult if you have the symptoms of bird flu, you have traveled in areas where bird flu has been reported, and you have had contact with infected poultry. To help prevent the spread of the illness avoid contact with others as much as possible if you feel ill. The U.S embassy or consulate can provide names of local providers. Prevention includes increased hand washing, avoiding contact with live poultry, and cooking poultry and egg products thoroughly before eating.

For More Information:
http://www.cdc.gov/flu/avian/gen-info/

Dengue Fever

Dengue fever and dengue hemorrhagic fever (DHF) are viral diseases transmitted by Aedes mosquitoes. Dengue is a rapidly expanding disease in most tropical and subtropical areas of the world. Dengue fever is endemic in most tropical countries of the South Pacific, Asia, the Caribbean, the Americas, and Africa. The incidence of the severe disease, DHF, has increased dramatically in Southeast Asia, the South Pacific, and the American tropics in the past 25 years. The principal vector mosquito, Ae. aegypti, is most frequently found in or near human habitations and prefers to feed on humans during the daytime. It has two peak periods of biting activity: in the morning for several hours after daybreak and in the late afternoon for several hours before dark. The mosquito may feed at any time during the day, however, especially indoors, in shady areas, or when it is overcast. Cases of dengue are confirmed every year in travelers returning to the United States after visits to tropical and subtropical areas. Dengue fever is characterized by sudden onset of high fevers, severe frontal headache, and joint and muscle pain after an incubation period of 3-14 days. Many patients have nausea, vomiting, and rash. The rash appears 3-5 days after onset of fever and can spread from the torso to the arms, legs, and face. The disease is usually self-limited, although convalescence can be prolonged. Dengue can also present as a severe, sometimes fatal disease characterized by hemorrhagic manifestations and hypotension (DHF/ dengue shock syndrome). No vaccine or preventive medication is available. Since dengue is transmitted by mosquitoes, travelers can reduce their risk of acquiring dengue by remaining in well-screened or air-conditioned areas when possible, wearing clothing that adequately covers the arms and legs, and applying insect repellent to both skin and clothing. The most effective repellents are those containing N,N-diethylmetatoluamide (DEET).

Yellow Fever

Yellow fever is a viral disease that is transmitted to humans through the bite of infected mosquitoes. Illness ranges in severity from an influenza-like syndrome to severe liver infection and hemorrhagic fever. The disease occurs only in sub-Saharan Africa and tropical South America, where it is endemic and intermittently epidemic. A traveler's risk of acquiring yellow fever is determined by immunization status, location of travel, season, duration of exposure, occupational and recreational activities while traveling, and the local rate of yellow fever virus transmission at the time. Severe yellow fever typically evolves through 3 stages, from a nonspecific febrile illness with headache, weakness, nausea and vomiting; through a brief period of remission; to a hemorrhagic fever with jaundice, protein in the urine, lack of urine formation, and multiple organ dysfunction (liver, kidneys, cardiovascular system). 50% of cases are fatal. In addition to vaccination, travelers to areas with yellow fever transmission should take precautions against exposure to mosquitoes. Staying in air-conditioned or well-screened quarters and wearing long-sleeved shirts and long pants will help to prevent mosquito bites. Insect repellents containing DEET should be used on exposed skin. Permethrin-containing repellents should be applied to clothing. Yellow fever is preventable by a single dose of a relatively safe, effective vaccine. Yellow fever vaccine may be obtained at the DU Student Health and Counseling Center which is an authorized US yellow fever vaccine center.


This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, call the Student Health and Counseling Center or talk to your family doctor.