Doctor Bob folded up his stethoscope and put it in his pocket.
“Is there anything else I should know, Ken?” He stood at the counter, entering his findings of the yearly physical for this retiree.
“No, don’t think so.” Ken buttoned his shirt. “Marie’s home packing. We’re going to the Caribbean for two weeks.” Ken smiled at the thought. “Some friends are arranging the trip. Marie likes to pack early.”
“Oh?” Doctor Bob looked up, suddenly interested. “Do you know where you are going?”
“The itinerary’s not totally arranged yet,” Ken said absently, adjusting his belt.
“And what have you and Marie done about your health on this trip? What preparations have you made?”
“What do you mean?” Ken looked up quizzically. “We’re just going to the Caribbean.”
Doctor Bob sat back down on his stool. “The United States has for the most part eliminated many health risks in our environment – water, food, infectious diseases. Other countries have not been so fortunate. About 8% of people return from a trip outside the United States with an illness that they picked up in a foreign country, especially a third world country. You need to be prepared.”
“Prepared? In what way?”
“Be aware,” Doctor Bob said firmly. “Be aware of what diseases are endemic in the country you are visiting. Be aware of what vaccinations you need. You don’t know for sure yet where you are going?” Ken shook his head. “Some countries require yellow fever shots. Some need Hepatitis B or Dengue or Typhoid. Dengue is much more common than we once thought.”
Doctor Bob was thoughtful for a moment, organizing his thoughts. “Be aware of the potential health risks you face – in the water, in the food, insect bites, sunburn potential, just the emotional stress of being in a foreign country. You might want to put together a travel health kit – sun screen, insect repellant, hand wash. If you’re going hiking, I might even suggest a water filter. Are you going to be out in the bush, out in the jungles?”
“Don’t know yet.” Ken looked worried.
“When you know, have Marie call the office. If you’ll be eating outside of big cities, you should have Hepatitis A gamma globulin. Also, I’ll have a prescription for anti-malaria meds, if you’re going to be exposed at all. And a small supply of antibiotics, in case you get into a bad diarrhea situation. Usually taking along some over-the-counter antidiarrheal medicine is enough – sometimes not.
“Oh, and be careful on the beaches, in the sand. There’s a parasite that lives in the sand – an animal hookworm. Nasty little guy that can make little tunnels under your skin. Itches like the devil.”
“I had no idea. Do you suppose we shouldn’t go?”
“Of course, you should go,” Doctor Bob said reassuringly. “Just be aware, be prepared. If you have more questions, go on-line to the CDC website and look at the Yellowbook. It’s on the menu list on the left. The first three chapters are good on awareness and there’s specific information about specific countries. You and Marie can look at it when you know where you are going.
“It’s the old saying, Ken,” Doctor Bob arose to go. “An ounce of prevention.”
