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(2022 - Fall/Winter Issue)


The COVID-19 pandemic has made travellers more aware of the need to mitigate preventable risks, travel health professionals say.

With Canadian airports and passport renewal offices struggling to keep up with an unprecedented surge in global travel following the lifting of pandemic restrictions, travel health clinics across the country are expe-riencing what may be an even greater uptick in demand.

At the Medcan clinic in downtown Toronto, for instance, travel medicine director Dr. Aisha Khatib says patient visits began surpassing pre-COVID levels in early July. While this surge is partially due to international vacations being put on hold for more than two years, the nature of Canadians’ travel health concerns has also changed. “People are more worried about underlying medical conditions, and whether they predispose them to being at higher risk while travelling,” Khatib says.

After COVID-19 exposed the fragility of healthcare systems around the world, travellers have also become more aware of the importance of mitigating preventable health-related risks, says Ajit Johal, director of the TravelRx Clinic in Vancouver. “There is limited healthcare capacity, especially in developing countries, and we should take measures to reduce our chances of needing hospital care in those destinations. For example, if we can reduce our chances of having severe traveller’s diarrhea, then it is less likely that we will require hospitalization and IV fluids. Every travel itinerary is unique, and it brings unique health risks that could be prevented with vaccination or education.”

With developing countries such as Mexico, Cuba, and the Dominican Republic being among the most popular winter travel destinations for Canadians, both Khatib and Johal are adamant about sharing the following tips, all of which are essential to staying healthy while visiting many sun and sand destinations. 

Watch Your Water Intake

One of the most common post-trip complaints heard by both Khatib and Johal involves traveller’s diarrhea, which is typically contracted by drinking or ingesting water containing unsafe levels of E. coli bacteria.

“A general rule of thumb is that hot food is good, and cold food, such as salads, is bad,” Johal says, adding that drinking bottled water, and ensuring that ice is made with safe drinking water, are essential on trips to developing countries.

Because dehydration can be a dangerous complication of traveller’s diarrhea, especially for young children, Johal recommends packing oral rehydration salts such as Hydralyte or Pedialyte.

Taking an oral cholera and LT-ETEC diarrhea vaccine two to three weeks before a trip can help to mitigate the risk of diarrhea during travel. “While travellers may want to avoid the out-of-pocket costs of travel health consultations and vaccinations, a health-related event that could have been prevented through vaccination or education can significantly impact their travel experience,” Johal says. “Such an impact has a large cost financially, and also on the opportunity to enjoy travel to its fullest.”

Watch Your Water Play

While waterfront beach resorts are both convenient and picturesque, travellers should also be aware of the risks associated with frolicking in the waves, Khatib says. “Swim where there are well-marked areas and lifeguards, and heed local advisories,” she recommends. “Monitor your surroundings and weather changes, never swim alone, take frequent breaks, and do not swim if there is thunder or lightning.”

It is also important to wear life jackets, avoid drinking alcohol while using watercraft, and to wear reef shoes to avoid foot injuries.

Mosquitoes Be Gone!

According to Johal, climate change is also changing mosquito breeding patterns, making the transmission of diseases such as yellow fever, Japanese encephalitis and malaria more unpredictable than ever. “With these unpredictable risks, mosquito precautions, medications and related vaccinations are more important than ever,” he says, adding that store-bought mosquito repellent should be applied two to three times each day, and at least 10 minutes after sunscreen so as to ensure that the latter has been fully absorbed.

Mind Your “Immunization Gaps”

“Most Canadian adults are not up to date with respect to their age- and risk-based vaccinations,” Johal says. “These immunization gaps increase the chance of contracting diseases like measles and diphtheria abroad, and coming home and spreading these communicable diseases to others. Travellers should always be up to date on their routine immunizations, especially when exposing themselves to increased risk abroad.”

See a Travel Health Provider

Johal recommends that travellers see a travel health provider four to six weeks prior to departure to ensure enough time for vaccinations and prophylactic medications to take effect. Khatib, for her part, pegs the lead time at six to eight weeks.

Should a healthcare concern arise during a vacation, those that sought advice and expertise from a travel health professional are “better prepared to deal with an illness, know how to avoid getting sick, and are able to seek out appropriate medical advice,” Khatib says.

Post-travel symptoms such as fever, diarrhea or rash, especially in travellers returning from a malaria endemic region, require immediate medical attention, Johal adds. “Hopefully with lessons learned from the COVID-19 pandemic, more travellers will realize the importance of mitigating risk from communicable diseases, and will take the necessary steps to obtain pre-travel advice and vaccinations.”

There’s an App for That

Launched in 2018, a web-based app from TravelRx determines the extent of travel-related health risks ranging from communicable diseases to food and water precautions. Based on the countries, regions and cities visited, as well as planned activities in a given destination, the app generates a customized risk report that can be downloaded and shared with others. app.travelrx.ca

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