Health Precautions for Travelers

By Jean Nelson-Erichsen and Heino R. Erichsen

Your adoption trip will be one of the peak experiences in your life. It's definitely not the time to get sick. Taking some simple precautions listed below should minimize your risk of becoming ill while overseas.

Travelers to developing countries must be extremely careful about what they eat and drink if they want to avoid spending a substantial portion of their trip in search of a bathroom. Rule number one is to eat only in first-class restaurants or to dine in the homes of the upper-class nationals. However, this is not always guaranteed safe or even possible. Even then, do not eat raw salads. And, don't eat raw vegetables or fruits unless you disinfect them with iodine before peeling them yourself. The tried and true mantra “Boil it, peel it, wash it, or forget it,” still holds true.

Do not eat raw meat or raw fish. Don't eat or drink milk products unless you know they are pasteurized. And avoid foods, including condiments, that have been sitting around at room temperature for long periods of time.

So what do you do if you are far from an AAA-rated restaurant and hungry? Find a bakery and buy some just-out-of-the-oven rolls or the equivalent staff of life for that country, such as steaming hot rice or boiled or roasted potatoes. Hot noodle soup or hot tea or coffee should also be safe. Clean your hands before you eat with the packaged pre-moistened towelettes you brought from home. Or, stash some U.S. breakfast bars or other high protein bars in your pockets.

What should you drink? Bottled mineral water, with seal intact, with or without carbonation, or other carbonated beverages, preferably drunk from the bottle through a straw. You should purify water for hygienic use. The easiest method is to purchase a pint-sized water purifier from a camping outfitter to take along. Otherwise, you can purify water by boiling it for twenty minutes. (Take a hot pot and, if necessary, an electrical current adapter, if you plan to boil water.) If boiling is not possible, treat water with Halazone tablets or mix in 10 drops of 2% tincture of iodine to one quart of water and let stand for 30 minutes. (Keep in mind that Halazone only treats bacterial agents, not viruses. Use this method only as a last resort.) If the water is cloudy, filter it through a cotton cloth.

In Latin American countries, U.S. adoptive parents who stay in better hotels will have little to worry about regarding food and water. Luxury hotels post notices in each room explaining the purity of the water supply. However, if you stay in lower rate hotels, bottled water can be ordered. Check to make certain that the seal isn’t broken. For all of the former Soviet Union, Eastern Europe, and all of Asia, except Japan, you must use bottled water at all times. This includes water for rinsing your toothbrush as well as for brushing. With the frequency of international travel, most hotels will provide boiled and filtered water.

Should you be unlucky enough to ingest contaminated food or water, the vomiting and/or diarrhea are more of a threat to your health than the particular pathogen, whether it be a virus, bacterium, or parasite. Mild diarrhea in adults can be managed with Imodium (available over-the-counter) or Lomotil (available by prescription). However, diarrhea drains salts and fluids from the body, causing the dehydration that accounts for the deaths of babies worldwide. While an adult's diarrhea is not usually life threatening, grown-ups should replace the salts and fluids they are losing with almost any fluid. If diarrhea is severe (more than one stool every two hours), adults should use an oral rehydration solution (ORS) such as Pedialyte. An ORS powder to be mixed with boiled water is available over the counter at pharmacies around the world.

Should you or your child feel ill the first year after your trip, alert your doctor as to which country you visited. The doctor will then order the appropriate series of stool examination kits. Most diarrhea-producing parasites such as Crypotosporidium or Giardia are transmitted by contaminated water. Even if the diarrhea abates, you may still be harboring the parasite. Get rechecked at home if you are not completely back to normal.

Other parasites, such as tapeworms and flukes, are transmitted by contaminated foods and, occasionally, by water. Some, like hookworms and schistosomes, which cause schistosomiasis, are acquired through the skin by walking barefoot outside or swimming in contaminated water. Most of these parasites require an intermediate animal host and are not contagious from person to person. These parasites typically do not give diarrhea and may be detected only months or years after travel.

Since most parasites are transmitted in a food-fecal chain, consider each diaper a transmitter. Make certain that all members of your family keep up a scrupulous hand-washing ritual. All orphans and their new parents with symptoms should be tested for parasites after their arrival home. Some worms and parasites have dormant periods and will not show up in every stool sample. You or your child should be rechecked if symptoms persist. (Chapter 13 provides a more detailed overview of the potential health problems of children from developing countries.)

Most bacterial pathogens, such as Salmonella and Shigella resolve on their own. There is no need to recheck after arrival unless symptoms persist or new problems develop. A few viral pathogens may be spread by travelers after arrival home, especially Hepatitis A and Hepatitis B. Of course, strict hand washing should be practiced even after arrival back home. An ill person should not prepare food for the family, nor share food or utensils with anyone.

See the Health and Medical Advice for International Travel section for more information.

Book review | Author interview | Purchase 'How to Adopt Internationally'

Jean Nelson-Erichsen and Heino R. Erichsen