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SAFETI Online Newsletter

Volume 1, Number 2, Spring - Summer 2000

United States Centers for Disease Control and Prevention (CDC): Important Resources for Students

Background

The Centers for Disease Control and Prevention (CDC), located in Atlanta, Georgia, USA, is an agency of the Department of Health and Human Services. The CDC Mission emphasizes promoting health and quality of life by preventing and controlling disease, injury, and disability. The CDC focuses its travel issues on disease risk and prevention as well as resources for treatment of illness. The following information comes directly from the CDC Traveler’s Health Website to assist in introducing some of the useful resources that are available through the CDC.

Advice

There are health and safety challenges in the US and around the world. It is important for students to take the time to educate themselves about the particular health risks for their trip abroad. This should include a physical by your personal physician or at your student health center, confirming that your inoculations are up-to-date for the US and determining what special vaccines you need for the specific countries you are traveling to (a good resource is the CDC Travelers' Health Vaccination Site. Select the "Destination" menu which will provide information appropriate for your itinerary. It is also important to have any dental treatment prior to your trip, and consider obtaining cross-cultural orientation and personal counseling to support positive personal mental health. Educating yourself before your trip about cross-cultural issues you may encounter abroad can better help you prepare, anticipate and adjust to what can be a dramatic change in lifestyle and behaviors expected of you in the country of your visit. It is important that students prepare for travel abroad and take an active role in their health and safety.

According to Rosamond Dewart, Chief, Travelers' Health Section of the US Centers for Disease Control and Prevention (CDC):

Arming yourself with the information tools necessary for your overseas experience is probably the most important aspect for ensuring a safe trip. This includes learning as much as you can about the health risks that may occur where you are going. Another important part of preparing for your trip is allowing sufficient time for your vaccinations to take effect before your travel. Gathering your health records together and consulting with a medical provider that is familiar with travel medicine issues is important especially when traveling to less developed countries. As a general rule, the longer duration of your time abroad, the more vaccines you may need and the longer the lead-time to get them completed before you travel. Some require several shots weeks to months apart. Assessing your risk of disease is what you and your healthcare provider should be doing as you provide the healthcare provider the information on your itinerary, your activity, your purpose, your lodging, etc., It is important to understand that many primary care providers do not see many travel patients and may choose to refer you to someone else who has more specialized experience. Setting up these appointments can take time so planning well in advance of your departure date is important.

CDC Resources for Students

Most of the resources that will be particularly useful for college and university students traveling abroad will be found in the CDC Traveler's Health Web Site and the CDC biennial publication Health Information for International Travel (The Yellow Book) which can be downloaded off the World Wide Web at http://www.cdc.gov/travel/yellowbk99.pdf. It may also be purchased. Information on how to purchase the 200 page book is on the following web site http://www.cdc.gov/travel/ybint.htm.

Region-Specific Information

From the CDC Travelers’ home page at http://www.cdc.gov/travel select the region of your travel from the Destination pop-up menu. If you are not sure, a map is provided to aid you and underneath the world map are the names of all the regions and the countries within them. By choosing the appropriate region of your travel, you can obtain all the vaccine requirements and recommendations, malaria risk and prevention information and any other important prevention behaviors you should follow. For more detailed information on the vaccines recommended, you can choose the vaccination menu and get details for each vaccine.

The world is divided into the following regions on this web site:

  • Australia and the South Pacific
  • Caribbean
  • Central Africa
  • East Africa
  • East Asia
  • Eastern Europe
  • Indian Region
  • Mexico and Central America
  • Middle East
  • North Africa
  • North America
  • Southern Africa
  • South East Asia
  • Tropical South America
  • Temperate South America
  • West Africa
  • Western Europe

Common Health Advice From the CDC Travelers’ Health Regional Information site:

All travelers should take the following precautions, no matter the destination:

  • Wash hands often with soap and water.
  • Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively.
  • Avoid travel at night if possible and always use seat belts.
  • Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.
  • Don't eat or drink dairy products unless you know they have been pasteurized.
  • Don't share needles with anyone.
  • Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it - Never eat undercooked ground beef and poultry, raw eggs, and unpasteurized dairy products. Raw shellfish is particularly dangerous to persons who have liver disease or compromised immune systems.

Health Advice for Students Traveling to Undeveloped Areas:

To Stay Healthy, Do:

  • Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes.
  • If this is not possible, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.
  • If you visit an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
  • Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at >4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
  • To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.

To Avoid Getting Sick:

What You Need To Bring with You:

  • Long-sleeved shirt and long pants to wear whenever possible to prevent illnesses carried by insects (e.g., malaria, dengue, and leishmaniasis).
  • Insect repellent containing DEET (diethylmethyltoluamide), in 30%-35% strength for adults and 6%-10% for children. If you are not staying in air-conditioned or well-screened housing, you should purchase a bed net impregnated with the insecticide permethrin. (Bed nets can be purchased in camping or military supply stores).
  • Over-the-counter anti-diarrheal medicine to take if you have diarrhea.
  • Iodine tablets and portable water filters to purify water if bottled water is not available. See above for more detailed information about water filters.
  • Sun block, sunglasses, hat.
  • Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).

After You Return Home:

  • If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area.
  • If you become ill - even as long as a year after your return-tell your doctor where you have traveled.

Injuries: The Making Travel Safe Website includes information about preventing and preparing to respond to injury abroad:

Injuries, especially those from motor vehicle crashes, pose the greatest risk of serious disability or loss of life to international travelers. The risk of motor vehicle-related death is generally many times higher in developing countries than in the United States. Motor vehicle crashes result from a variety of factors, including inadequate roadway design, hazardous conditions, lack of appropriate vehicles and vehicle maintenance, unskilled or inexperienced drivers, inattention to pedestrians and cyclists, or impairment due to alcohol or drug use; all these factors are preventable or can be abated. Defensive driving is an important preventive measure. When driving or riding, request a vehicle equipped with safety belts, and, where available, use them. Cars and trucks should be carefully inspected to assure that tires, windshield wipers, and brakes are in good condition and that all lights are in good working order. Where available, also request a vehicle equipped with air bags. As a high proportion of crashes occur at night when drivers are returning from "social events," avoid nonessential night driving, alcohol, and riding with persons who are under the influence of alcohol or drugs. This risk of death in a motor vehicle crash is greater for persons sitting in the front seat than for those in the rear seat. Where possible, travelers should ride in the rear seats of motor vehicles. Pedestrian, bicycle, and motorcycle travel are often dangerous, and helmet use is imperative for bicycle and motorcycle travel. In developing countries, helmets will likely not be available, so bring your own with you if you plan to ride bicycles or motorcycles. For travel with young children, you should bring your own child safety seat.

Fire injuries are also a significant cause of injuries and death. Do not smoke in bed, and inquire about whether hotels have smoke detectors and sprinkler systems. Travelers may wish to bring their own smoke detectors with them. Always look for a primary and alternate escape route from rooms in which you are meeting or staying. Look for improperly vented heating devices which may cause carbon monoxide poisoning. Remember to escape a fire by crawling low under smoke.

Other major causes of injury trauma include drowning (see the Swimming Precautions and injuries to water skiers and divers due to boat propellers. Boats equipped with propeller guards should be used whenever possible. Wear a personal flotation device (PFD) whenever you ride on a boat.

Travelers should also be aware of the potential for violence-related injuries. Risk for assault or terrorist attack varies from country to country; heed advice from residents and tour guides about areas to be avoided, going out at night, and going out alone. Do not fight attackers. If confronted, give up your valuables. For more information, contact the U.S. Department of State, Overseas Citizens Emergency Center at (202) 647-5225, or visit their web site for specific country Travel Warnings and Consular Information Sheets.

Diseases: The CDC Web site provides background on the following travel-related diseases on the Travelers' Health Web site at http://www.cdc.gov/travel/diseases.htm:

  • African sleeping sickness (African trypanosomiasis)
  • AIDS/HIV
  • Amebiasis
  • BSE ("mad cow disease") and nvCJD
  • Campylobacter infections
  • Chagas disease (American trypanosomiasis)
  • Cholera
  • Coccidioidomycosis
  • Cryptosporidiosis
  • Cyclosporiasis (Cyclospora infection)
  • Dengue fever
  • Diarrhea
  • Diphtheria, tetanus, and pertussis
  • E. coli (Escherichia coli)
  • Encephalitis
  • Filariasis
  • Giardiasis
  • Hantavirus
  • Head lice (pediculosis)
  • Hepatitis
  • Histoplasmosis
  • Influenza (flu)
  • Leishmaniasis
  • Leptospirosis
  • Lyme disease
  • Malaria
  • Measles, mumps, and rubella (MMR)
  • Meningitis
  • Onchocerciasis (river blindness)
  • Plague
  • Poliomyelitis
  • Rabies
  • Rotavirus
  • Salmonella infections
  • Scabies
  • Schistosomiasis
  • Sexually Transmitted Diseases (STDs)
  • Shigellosis
  • Smallpox
  • Tuberculosis (TB)
  • Typhoid fever
  • Typhus fever
  • Vibrioparahaemolyticus
  • Viral hemorrhagic fevers (e.g., Ebola, Lassa, Marburg, Rift Valley)
  • Yellow fever

Conclusion

It is important for students to take their health and safety seriously and prepare for study and travel abroad. Consultations with medical experts in the US and abroad are important. The US Centers for Disease Control and Prevention (CDC) and their Travelers' Health web site provide extensive health information for the student traveler. Providing information to students about accessing this information well in advance of their trip will help them to be prepared and better able to respond to a variety of health and safety issues that may arise while abroad.