Virtually everything that we humans do for pleasure could place us at risk for illness, or even death. In recent years, a growing variety of medical conditions has been reported among travelers. The ‘top-ten’ from this list follow:
- Diarrhea – Not the most serious, but certainly the most common. Roughly 40% of travelers to less-developed countries will develop diarrhea within 48 hours of arrival. Much of the next few days of touring will be seriously damaged by searching for a clean bathroom … or even toilet paper. In recent years, scores of ocean voyages have been cut short by mass outbreaks of vomiting and diarrhea – related to Norovirus infection.
- Skin disorders due to sun, heat, humidity and insect bites. Like diarrhea, not life threatening – but no fun while touring.
- Insect-borne fevers. Dengue and Chikungunya are becoming increasingly common and are no longer limited to “local natives.” Both diseases are characterized by headache, high fever, muscle and joint pain. The incubation periods are short – meaning that the traveler is likely to still be on the road, with no chance for continued tourism and the risk of exposure to sub-standard health care.
- Malaria. Like Dengue and Chikungunya, malaria is an insect-borne fever; however, the disease carries a real risk of severe complications, and even death. Unlike dengue and Chikungunya, malaria can be easily prevented and treated by specific medications.
- Although not “diseases,” physical injuries represent a major medical risk to travelers. Accidents – airplane, boating, automobile, climbing, diving – may threaten life, often in situations where proper medical care is non-existent or carries risks for AIDS, hepatitis, wound infection, etc. Increasingly, this category will also include political violence, kidnapping and simply “being in the wrong place…” when terrorist acts are carried out.
- Sexually-transmitted diseases are very common among tourists, and none can be prevented by drugs or vaccines. Tourists engage in a variety of reckless activities in foreign countries – which they would never dream of at home.
- Intestinal and other parasites are often acquired through exposure to exotic, unhygienic or under-cooked food. Signs and symptoms may be subtle, and illness may progress for years following return from an exotic country – a situation compounded by the fact that physicians in the traveler’s home country are unfamiliar and ill-equipped to recognize these diseases.
- Disorders associated with air travel: jet-lag, ear disorders associated with cabin pressure changes, thrombophlebitis (blood clots in the legs) associated with prolonged sitting in cramped conditions, exposure to infected passengers (measles, influenza, tuberculosis).
- An increasing list of rare, exotic infections which are becoming common among travelers: Lassa fever, Schistosomiasis, African tick-bite fever, Trypanosomiasis, Yellow fever, Japanese encephalitis. In some cases, travel to the United States has become hazardous for tourists from overseas: Coccidioidomycosis, West Nile fever, Rocky Mountain spotted fever, Lyme disease
- Legionnaire’s disease has been intimately associated with travel, since the first outbreak (1976) was reported among American Legion veterans who had traveled to a convention in Philadelphia. Travelers exposed to central air conditioning systems in hotels continue to account for a large proportion of victims of this disease.
Of course, there is also an infinite variety of “universal diseases” which may just happen to occur during travel. Not all diseases acquired in the developing world are “exotic.” Many of the returning travelers who consult me after returning home are found to have mundane conditions such as urinary tract infection, “strep throat” ear aches, bronchitis, allergies, arthritis, conjunctivitis, neuroses, etc .. all of which can still ruin a trip overseas.