USA Staying Healthy

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

Environmental Hazards

Heat exhaustion and dehydration: Heat exhaustion leads to nausea, heavy sweating, 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 always wearing sunscreen. Continuous heat stress can eventually lead to heatstroke, characterized by a rising temperature, severe headache, delirium and cessation of sweating. Cool off victims with wet towels and take them to a doctor. The southern US is particularly prone to heat waves, though travelers in all areas should be cautious in summer and bring plenty of water on hiking or camping trips.
High Altitude: The Rocky, Sierra Nevada, and Cascades mountains in the western US are at particularly high altitudes. When visiting these locations, 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.
Hypothermia and frostbite: Travelers to the US during the winter months should be aware of the dangers of cold exposure. A rapid drop in body temperature is the clearest sign of overexposure to cold. Victims may shiver, feel exhausted, have poor coordination or slurred speech, hallucinate, or experience mental lethargy. Do not let hypothermia victims fall asleep. To avoid hypothermia, keep dry, wear warm, moisture-wicking layers (polyester, wool, silk), limit alcohol and caffeine intake, drink a lot of water, and eat plenty of carbohydrates. When the temperature is below freezing, watch out for frostbite, especially on ears, nose, hands, and feet. If skin turns white or purple, waxy, and cold, come out of the cold immediately and call for medical assistance. Do not rub the area. Drink warm, non-alcoholic, non-caffeinated fluids, and avoid gradually thawing the area until medical help arrives. To prevent frostbite, dress warmly, stay out of the wind, and apply skin moisturizer to any exposed body part.
Sunburn: Always wear sunscreen (SPF 30 or higher) when spending excessive amounts of time outdoors. If you are planning on spending time near water, in the desert, or in the snow, you are at higher risk of getting burned, even through clouds. 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 affects the entire body, causing fever, fatigue, and a blistering skin rash. Sun poisoning should always be treated by a doctor.

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, carriers of diseases including malaria, dengue fever, and yellow fever, can be particularly dangerous in wet, swampy, or wooded areas such as the southeastern US. Ticks, carriers of Lyme and other diseases, can be particularly dangerous in rural and forested regions, particularly the northeast, central north, and Pacific coast.

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 disease can cause chronic joint pain, heart irregularities, and problems with the nervous system. If you find a tick attached to your skin, grasp its body with fine-tipped tweezers and steadily pull away from the skin. Do not try to remove ticks with petroleum jelly, nail polish remover, or a hot match. Cleanse the area with antiseptic. Removing a tick within 24hr. greatly reduces the chance of Lyme disease transmission. Tick bites usually occur in moist, shaded environments and wooded areas of the northeastern, central northern, and Pacific coastal regions and are most common during the late spring and summer months. If you are going to be hiking in these areas, wear long clothes and use DEET.
West Nile Virus: The West Nile Virus has been detected in all 48 continental states and is transmitted through the bite of an infected mosquito. Most victims do not have any symptoms, but some develop mild flu-like symptoms; less than 1% develop more severe symptoms including meningitis or encephalitis. Those at highest risk are the elderly and those with lowered immune systems, but people of all ages can develop a serious illness. To minimize the risk of infection, limit outdoor activity when mosquitoes are most active (dawn, dusk, and early evening), wear long clothes, and use DEET.

Food- And Water-Borne Diseases

In the US, city and suburban tap water is treated to be safe for drinking, though travelers should still exercise caution in remote rural areas or areas with untreated well water. Raw shellfish, unpasteurized milk, or dishes containing raw eggs may still present health risks. Watch out for food from markets or street vendors that may have been cooked in unhygienic conditions.

Backcountry hikers may purify their own water by bringing it to a rolling boil or treating it with iodine tablets; note, however, that some parasites such as giardia have exteriors that resist iodine treatment, so boiling is a more reliable treatment. Always wash your hands before eating or bring a quick-drying purifying liquid hand cleaner.

Gastroenteritis/Stomach Flu: Caused by a class of viruses called Noroviruses; spreads via contact with the body fluids of infected people, including exposure to contaminated foods or touching contaminated objects, and direct contact with infected persons. Symptoms appear within 48hr. of infection and include vomiting, nausea, chills, diarrhea, and abdominal cramping. Though the symptoms usually pass within a few days, the disease can be contagious for several weeks and a doctor should be consulted if any of these symptoms develop.
Giardiasis: Transmitted through parasites (microbes, tapeworms, etc. in contaminated water and food) and acquired by drinking untreated water from streams or lakes. Symptoms include diarrhea, abdominal cramps, bloating, fatigue, weight loss, and nausea. If untreated it can lead to severe dehydration. Giardiasis occurs worldwide.

Other Infectious Diseases

Rabies: Transmitted through the saliva of infected animals; fatal if untreated. By the time symptoms (thirst and muscle spasms) appear, the disease is in its terminal stage. If you are bitten, wash the wound thoroughly, seek immediate medical care, and try to have the animal located. A rabies vaccine, which consists of 3 shots given over a 21-day period, is available and recommended for developing world travel, but is only semi-effective. Rabies is found all over the world, and is often transmitted through dogs, but travelers to backcountry and wooded areas should be wary of all wild animals.
HIV and AIDS: For detailed information on Acquired Immune Deficiency Syndrome (AIDS) in the US, call the US Centers for Disease Control’s 24hr. hotline at ☎770-488-7100, or contact the Joint United Nations Programme on HIV/AIDS (UNAIDS), 20 ave. Appia, CH-1211 Geneva 27, Switzerland (☎+41 22 791 3666; fax 22 791 4187).
Sexually Transmitted Infections (STIs): Gonorrhea, chlamydia, genital warts, syphilis, herpes, and other STIs are easier to catch than HIV and can be just as deadly. Hepatitis B and C can also be transmitted sexually. 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

Medical care in the US is among the best in the world. In case of medical emergency, dial ☎911 from any phone and an operator will send out paramedics, a fire brigade, or the police as needed. Emergency care is available at any emergency room on a walk-in basis. If you do not have insurance, you will have to pay for medical care. Appointments are required for non-emergency medical services. If you are concerned about obtaining medical assistance while traveling, you may wish to employ special support services. The MedPass from GlobalCare, Inc., 6875 Shiloh Rd. East, Alpharetta, GA 30005 (☎800-860-1111; www.globalcare.net), provides 24hr. international medical assistance, support, and medical evacuation resources. 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 (first year $35, annually thereafter $20), which includes a stainless steel ID tag, among other benefits, like a 24hr. collect-call number. Contact the MedicAlert Foundation, 2323 Colorado Ave., Turlock, CA 95382, USA (☎888-633-4298, outside US ☎209-668-3333; www.medicalert.org).

Women’S Health

Women traveling in the backcountry are vulnerable to urinary tract (including bladder and kidney) infections. Over-the-counter medicines can sometimes alleviate symptoms, but if they persist, see a doctor. Vaginal yeast infections may flare up in hot and humid climates. Wearing loosely fitting trousers or a skirt and cotton underwear will help, as will over-the-counter remedies like Monostat or Gynelotrimin. Tampons, pads, and contraceptive devices are widely available in the US, but your favorite brand may not be stocked—bring extras of anything you can’t live without. Abortion is legal in the US; for more information contact Planned Parenthood (☎800-230-7526; www.plannedparenthood.org).