Lincoln-Lancaster County Health Department
Health Data & Evaluation
Summer travel season is on, which means more travel both domestically and internationally. School vacations and holidays influence domestic travel while international travel may be more influenced by other reasons such as traveling for business, people traveling abroad to visit family and friends or traveling for mission work or as a religious pilgrimage (e.g., to visit Israel or attend the Hajj) or to attend sporting events such as the World Cup or Olympics; or perhaps it's retirees just wanting to see the world. International travelers need to be aware of diseases that may not be common in Lincoln, but diseases they are at risk of contracting during their travels.
While many people worry about eating foods or drinking water that could lead to a gastrointestinal illness such as norovirus that might ruin a cruise or tropical vacation there are other more troublesome health worries. National news reports have recently covered the case of travelers who contracted MERS-CoV Middle Eastern Severe Respiratory Syndrome-corona virus) from working or traveling in the Middle East. Also in the news are U.S. cases of measles and mumps (diseases that we don't often see in the U.S. anymore thanks to vaccinations) brought to the states by persons traveling abroad who then infected family and friends who had not been vaccinated against measles or mumps. Recently, there have also been an increasing number (153 cases in 2014 as of July 8) of cases of U.S. citizens being diagnosed with Chikungunya (a virus spread by mosquitoes causing fever and joint pain), an emerging disease that hasn't been commonly seen in the U.S. before. All cases so far were contracted by travelers to the Caribbean or Africa.
As these cases point out, it is wise to be prepared for international travel and to get vaccinations in plenty of time to develop immunity against diseases (e.g., Yellow fever, typhoid, Hepatitis A or even influenza) that might be circulating in the destination country. If you are visiting a country where malaria might be a risk, you need to get a prescription for drugs to prevent contracting the disease. To prevent contracting Chikungunya or other arbovirus diseases for which there is no vaccine it's important to avoid being bitten by mosquitoes by using a repellent such as DEET, wearing long sleeves and avoiding activity when mosquitoes are most active. In the case of MERS-CoV, if traveling to Saudi Arabia it may be best to stay away from camels; or if going to China, avoid open-air markets selling and butchering chickens to lessen the risk of contracting H7N9 (avian flu).
As you plan your trip, we recommend checking the CDC website to become aware of diseases that may be present in a county you are planning to visit, and to then seek out the recommended vaccines before traveling to those countries, especially to South America, Africa, the Middle East or the Far East. Visit CDC Traveler's Health to learn more about any diseases that you might be at risk for and for recommendations for vaccinations or medicine to pick up before traveling. Then, be sure to visit with your physician (ideally 4 to 6 weeks before your trip) to get the vaccinations needed in plenty of time, often 10 days to two weeks, for the vaccines to provide immunity. It's also a good idea to check on other diseases that are circulating in countries you may traveling to for which there's no vaccine to prevent infection and to learn of measures you can take to avoid contracting those diseases. There's also a free app available from the CDC (Can I Eat This?) to tell you about foods to avoid in foreign countries.
Even after your return, if you develop a sudden onset of fever or become ill it's best to see a doctor as some diseases, such as malaria, might not show symptoms until you've gotten home.