Travel health can be a dicey subject, and not just because the subject matter itself might be unpleasant. Travel health can also be seen as a factor of the level of development in many countries, and can reflect some larger social issues that are out of an individual traveler’s control.
With that said, few people know as much about travel health as Dr. Mark Wise. The Toronto-based, London-educated physician is the author of two books on travel health – The Travel Doctor and Travel Health Guide – and covers a wide range of travel-health topics in interviews and on his blog (which includes a fantastic discussion between Dr. Wise and the world’s most famous traveling foodie, Anthony Bourdain).
We sat down with Dr. Wise and talked travel health, with a busy season of travel (and bugs) just ahead. You can hear the full interview on the next “BHTP Connections” podcast, coming later this month. In the meantime, here are his answers to some of the most frequently-asked travel-health questions.
BHTP: So why is it so hard for people to stay healthy when they’re traveling?
Dr. Wise: In fact, most people stay okay. That’s No. 1. Number 2, keep in mind that people get sick even when they’re not traveling; they get coughs and colds and fall and hurt themselves. Then, maybe they’re going to places where there are different risks they don’t encounter at home. They may be related to the weather, the environment – like the altitude – they may be related to poverty and food and water, or they may be related to greater dangers from traffic or personal violence. I think sometimes we see our vacations as a time when we can sort of act out of character and take risks that we don’t normally take. So if you go to Cuba, God willing, and you sit in the sun drinking piña coladas all day and having unsafe sex at night, and then you’re getting on a motorbike, you’re going to get hurt.
BHTP: So what about some of the individual risks people encounter when they’re traveling? How dangerous really are some of these? Let’s start with the air in an airplane cabin.
Dr. Wise: I think that’s low-risk and probably overblown. An airplane cabin is similar to a movie theater, which is similar to a lineup at Customs. You’re going to be around people who are sneezing and have colds and coughing. As far as getting more serious things like tuberculosis and SARS and MERS, these things are pretty unlikely just from being in a plane. I don’t think the risks are all that great, and I think the air is circulated a little bit better than what the general public thinks.
BHTP: How about strange food?
Dr. Wise: When you go to a strange country – and by strange, we often mean tropical, and by tropical, we often mean poorer or lesser developed – you’re going to have a poorer level of hygiene and sanitation. That means [there might be issues with] the quality of the water washing the food we’re going to eat, the hygiene of the people might be less – I’m generalizing; it’s not always true – and the storage of the food might not always be great because the electricity might go off a couple of times during the day. So there’s all those infectious concerns about the food, and then I think there’s the strange food itself. You suddenly go to India and eat spicy food for seven days and you’re surprised that you got heartburn, or greasy food in China for a week and you’ve got diarrhea. So it’s not just the infectious food or the poor hygiene and sanitation. I think if you eat differently for a week or two you’re going to have some problems.
BHTP: So how about things in a hotel room, like the bedspread or the rugs?
Dr. Wise: I think the first thing you should actually look for is what to do in case of an emergency, which is much more important than the bedbugs and stuff. If you’re in a squalorous hotel or an overrun youth hostel, you might get bedbugs. You’re unlikely to get these things in most four-, five-, six-star hotels. So you’re welcome to look around, and you might find a dead bug or a dead cockroach or a hair, but I don’t think that creates a great health risk.
BHTP: Are there any other particularly toxic things people might encounter when they’re traveling that they might need to be aware of?
Dr. Wise: If you use the word “toxic” to mean anything bad, there are lots of infections abroad in the tropics, and maybe not always in the tropics, that people need to know about and might be exposed to. So if you’re going to Wisconsin you’re not going to get malaria or dengue fever or traveler’s diarrhea, but if you’re going to India or the Amazon or Africa you might get all of these things. So there are a lot of infections, and there are a lot of factors like mosquitoes and ticks that can transmit infections. Sometimes the air is toxic, as it is in Beijing. And then it’s really up to people to know what’s a risk.
So how sick is sick enough for you to say, “You know, I really need to see a medical professional”?
Dr. Wise: If you’re very sick, meaning, in the case of diarrhea, you’ve got lots of diarrhea, and every time you stand up you’re a little bit woozy and lightheaded, you might be getting dehydrated, and you might need to see a doctor. If you’ve got a fever in a malarious country or a dengue-endemic country, you might want to see a doctor. If you’ve been assaulted or exposed to a sexually transmitted infection, you might want to see a doctor. And if you’ve had something you think you can deal with and in fact it’s not getting better, whether it’s a bad cold or a bad rash or anything, whether it’s here or there, it makes sense to see a doctor. Having said all that, I think common sense is the most important thing for people to take.
BHTP: And common sense in the sense of what?
Dr. Wise: [In the sense of] I’d better not do too many stupid things, like getting on a motorbike and then having a tattoo in Bangkok and then having unprotected sex, and then lying in the sun all day, and then eating dirty sushi on the street.
Editor’s Note: As Dr. Wise noted, every traveler has their own definition of a “risk worth taking.” Berkshire Hathaway Travel Protection has coverage for all the risks worth taking in travel. Get it here.