Italy Staying Healthy

Common sense is the simplest prescription for good health while you travel. Drink lots of fluids to prevent dehydration, and wear sturdy, broken-in shoes.

Environmental Hazards

Arid summer weather in the south creates prime conditions for heat exhaustion and dehydration. Be especially careful at Pompeii; there may no longer be a threat of volcanic eruption, but a lack of water fountains and shade create new dangers. Trekking at high altitudes in the Dolomites, the Alps, and on Mt. Vesuvius and Mt. Etna should not be done too hastily; be especially careful in winter to protect yourself against hypothermia and frostbite.

Heat exhaustion and dehydration: Heat exhaustion leads to nausea, excessive thirst, headaches, and dizziness. Avoid it by drinking plenty of fluids, eating salty foods (e.g., crackers), abstaining from dehydrating beverages (e.g., alcohol and caffeinated beverages), and wearing sunscreen. Continuous heat stress can eventually lead to heatstroke, characterized by a rising temperature, severe headache, delirium, and cessation of sweating. Victims should be cooled off with wet towels and taken to a doctor.
Sunburn: Always wear sunscreen (SPF 30 or higher) when spending time outdoors. If you get sunburned, drink more fluids than usual and apply an aloe-based lotion. Severe sunburns can lead to sun poisoning, a condition that can cause fever, chills, nausea, and vomiting. Sun poisoning should always be treated by a doctor.
Hypothermia and frostbite: A rapid drop in body temperature is the clearest sign of overexposure to cold. Victims may also shiver, feel exhausted, have poor coordination or slurred speech, hallucinate, or suffer amnesia. Do not let hypothermia victims fall asleep. To avoid hypothermia, keep dry, wear layers, and stay out of the wind. When the temperature is below freezing, watch out for frostbite. If skin turns white or blue, waxy, and cold, do not rub the area. Drink warm beverages, stay dry, and slowly warm the area with dry fabric or steady body contact until a doctor can be found.
High Altitude: Allow your body a couple of days to adjust to less oxygen before exerting yourself. Note that alcohol is more potent and UV rays are stronger at high elevations.

Insect-Borne Diseases

Many diseases are transmitted by insects—mainly mosquitoes, fleas, ticks, and lice. Be aware of insects in wet or forested areas, especially while hiking and camping. Wear long pants and long sleeves, tuck your pants into your socks, and use a mosquito net. Use insect repellents such as DEET and soak or spray your gear with permethrin (licensed in the US only for use on clothing). Mosquitoes —responsible for malaria, dengue fever, and yellow fever—can be particularly abundant in wet, swampy, or wooded areas like those found in Liguria and Trentino-Alto Adige. Ticks —which can carry Lyme and other diseases—can be particularly dangerous in rural and forested regions, especially in Friuli-Venezia Giulia, the Veneto, and Trentino-Alto Adige.

Lyme disease: A bacterial infection carried by ticks and marked by a circular bull’s-eye rash of 2 in. or more. Later symptoms include fever, headache, fatigue, and aches and pains. Antibiotics are effective if administered early. Left untreated, Lyme can cause problems in joints, the heart, and the nervous system. If you find a tick attached to your skin, grasp the head with tweezers as close to your skin as possible and apply slow, steady traction. Removing a tick within 24hr. greatly reduces the risk of infection. Do not try to remove ticks with petroleum jelly, nail polish remover, or a hot match. Ticks usually inhabit moist, shaded environments and heavily wooded areas. If you are going to be hiking in these areas, wear long clothes and insect repellent.

Food- And Water-Borne Diseases

Prevention is the best cure: be sure that your food is properly cooked and the water you drink is clean. Watch out for food from markets or street vendors that may have been cooked in unhygienic conditions. Other culprits are raw shellfish, unpasteurized milk, and sauces containing raw eggs. Buy bottled water or purify your own water by bringing it to a rolling boil or treating it with iodine tablets; note, however, that boiling is more reliable. While Italy’s water is relatively clean (the ancient Roman aqueduct water still provides Rome with a reliable water source), it is important to be wary in places like some campgrounds and trains where water is not clean. The sign “acqua non potabile” means the water is not drinkable; the sign “acqua potabile” means the water is sanitary. Even as a developed nation, Italy experienced an outbreak of stomach flu due to contaminated drinking water in Taranto in 2006.

Traveler’s diarrhea: Results from drinking fecally contaminated water or eating uncooked and contaminated foods. Symptoms include nausea, bloating, and urgency. Try quick-energy, non-sugary foods with protein and carbohydrates to keep your strength up. Over-the-counter anti-diarrheals (e.g., Imodium®) may counteract the problem. The most dangerous side effect is dehydration; drink 8 oz. of water with ½ tsp. of sugar or honey and a pinch of salt, try uncaffeinated soft drinks, or eat salted crackers. If you develop a fever or your symptoms don’t go away after 4-5 days, consult a doctor. Consult a doctor immediately for treatment of diarrhea in children.
Giardiasis: Transmitted through parasites and acquired by drinking untreated water from streams or lakes. Symptoms include diarrhea, cramps, bloating, fatigue, weight loss, and nausea. If untreated, it can lead to severe dehydration.

Other Infectious Diseases

The following diseases exist all over the world. Travelers should know how to recognize them and what to do if they suspect they have been infected.

AIDS and HIV: For detailed info on Acquired Immune Deficiency Syndrome (AIDS) in Italy, call the 24hr. National AIDS Hotline at ☎+1-800-342-2437. Note that Italy screens incoming travelers for AIDS, primarily those planning extended visits for work or study, and denies entrance to those who test HIV-positive. Contact the consulate of Italy for info.
Hepatitis B: A viral infection of the liver transmitted via blood or other bodily fluids. Symptoms include jaundice, appetite loss, fever, and joint pain. It is transmitted through unprotected sex and unclean needles. A 3-shot vaccination sequence is recommended for sexually active travelers and anyone planning to seek medical treatment abroad; it must begin 6 months before your trip to Italy.
Hepatitis C: Like Hepatitis B, but the mode of transmission differs. IV drug users, those with occupational exposure to blood, and recipients of blood transfusions are at the highest risk, but the disease can also be spread through sexual contact or sharing items like razors and toothbrushes that may have traces of blood on them. No symptoms are usually exhibited. If untreated, Hepatitis C can lead to liver failure.
Sexually transmitted infections (STIs): Gonorrhea, chlamydia, genital warts, syphilis, herpes, HPV, and other STIs are easier to catch than HIV and can be just as serious. Though condoms may protect you from some STIs, oral or even tactile contact can lead to transmission. If you think you may have contracted an STI, see a doctor immediately.

Other Health Concerns

Medical Care On The Road

Although quality of care varies by region, Italy overall conforms to standards of modern health care. Medical facilities tend to be better in the north and in private hospitals and clinics. Doctors speak English in most large cities; if they don’t, they may be able to arrange for a translator. Let’s Go lists info on how to access medical help in the Practical Information sections of most cities.

Those concerned about obtaining medical assistance abroad may wish to employ special support services. The MedPass from GlobalCare, Inc., 6875 Shiloh Rd. East, Alpharetta, GA 30005, USA (☎+1-800-860-1111; www.globalcare.net), provides 24hr. international medical assistance, support, and evacuation resources. The International Association for Medical Assistance to Travelers ( IAMAT; US ☎+1-716-754-4883, Canada +1-519-836-0102; www.iamat.org) lists English-speaking doctors worldwide, and offers detailed info on immunization requirements and sanitation. If your regular insurance policy does not cover travel abroad, you may wish to purchase additional coverage .

Those with medical conditions (such as diabetes, allergies to antibiotics, epilepsy, or heart conditions) may want to obtain a MedicAlert membership (US$40 per year), which includes among other things a stainless-steel ID tag and a 24hr. collect-call number. Contact the MedicAlert Foundation International, 2323 Colorado Ave., Turlock, CA 95382, USA (☎+1-888-633-4298, outside US 209-668-3333; www.medicalert.org).

Women’S Health

Women traveling in unsanitary conditions are vulnerable to urinary tract (including bladder and kidney) infections. Bring supplies from home if you are prone to infection, as they may be difficult to find on the road. Tampons, pads, and contraceptive devices are widely available, though your preferred brand may not be stocked—bring extras of anything you can’t live without. Abortion ( aborto or interruzione volontaria di gravidanza ) is legal and may be performed in the first 90 days of pregnancy for free in a public hospital or for a fee in an authorized private facility. Except in urgent cases, a week-long reflection period is required. Women under 18 must obtain parental permission or a judge’s decision. Availability may be limited in some areas, especially in the south, due to a “conscience clause” that allows physicians who oppose abortion to opt out of performing the procedure. The election of Pope Benedict XVI has sparked controversy over abortion, but no immediate policy changes are expected.