Listen Up or Pay With Your Health

doctorIt was love at first bite.

Proving that under the skin we’re all the same, actor George Clooney revealed in January that he had been stricken with malaria on a recent trip to Sudan ? and that it was his second time to get it.

He made light of the disease when interviewed on television, laughing off his illness: “I guess the mosquito in Juba looked at me and thought I was the bar,” he told CNN. He also was quoted by his publicist saying that proper medication can turn “the most lethal condition in Africa” into “a bad 10 days instead of a death sentence.”

But malaria is no joke.

Despite international efforts to eradicate it, malaria kills 890,000 people every year, mostly children in Africa. It makes 250 million people sick each year. Common in Africa, southern Asia, South America and parts of the Caribbean, malaria is caused by a parasite spread by night-biting mosquitoes.

And yes, it does affect travelers ? about 30,000 a year, according to the World Health Organization.

While mild cases resolve with shaking, chills, fever, vomiting and jaundice, untreated malaria can develop into seizures, coma, kidney failure and death. It also can “hide” when travelers come back, striking weeks or up to a year later, showing up as a mysterious unexplained fever.

But that is not the only ailment unprepared travelers can contract.

A new study published in the Journal of Travel Medicine in December found that 44 percent of international travelers don’t seek any health advice before their trips. Only 36 percent carry medication against travelers’ diarrhea. Just 20 percent of people traveling to countries with malaria risk take medication to prevent it.

The reason people behave with such apathy? “I just think it is ignorance,” says Dr. Bruce Kane, medical director of Passport Health, which has six locations in Michigan.

“I don’t think travel agents even mention the thought of protection. And it is only if the travelers wonder themselves and seek out their physician who refers them to us that they would know,” he says.

Of 508 confirmed cases where U.S. civilian travelers contracted malaria abroad in 2008, the CDC found that 70 percent had not taken medication to prevent it.

While it’s unclear whether Clooney was taking malaria preventive meds, his plight points out the cavalier attitude many travelers have in general about travel health.

The most common health risks to travelers, of course, come not from malaria but from accidental injuries, aggravating a pre-existing health problem, or picking up travelers’ diarrhea, respiratory infection or a stomach bug.

Those are bad enough.

“It wrecks your vacation because you can’t eat, you have diarrhea and are throwing up at the same time,” says Yvonne Boike of Berkley, Mich.,who contracted the Norovirus stomach bug on a Mediterranean cruise ? the only time in 15 cruises that she has gotten sick. “It lasts for a couple of days.”

But if you peruse a catalog of hideous illnesses you can get while traveling to the world’s exotic locales, it’s enough to make you hide under the bed. The Plague. River blindness. Rift Valley fever. Yellow fever. Crimean-Congo?hemorrhagic fever. Q fever. Sandfly fever. Typhoid. Cholera. Tuberculosis. Meningitis. Polio. Measles. Hepatitis. AIDS. Encephalitis. And on and on.

Luckily, most travelers never come in contact with such a scary fate. And not every traveler needs to be immunized against everything.

“I spend more time talking people out of vaccinations than into them,” says Dr. Jeffrey Band, director of infectious diseases and international medicine at Beaumont Hospital in Royal Oak, Mich. He said while yellow fever, a fatal disease, has a well-tolerated immunization profile and malaria prevention is common sense, something like Japanese encephalitis is so rare as to make the immunization advisable for only certain travelers.

The CDC has a traveler’s page ( on which you can check real-time health alerts and suggested immunizations for individual countries . For instance, Sudan, where Clooney traveled, shows that travelers should take steps to protect against malaria, yellow fever, typhoid, hepatitis, polio and rabies.

Ironically, those least prepared for health risks when traveling abroad include travelers who are visiting friends or family, those on vacation or who are traveling less than 14 days ? in other words, casual travelers, according to the recent study in the Journal of Travel Medicine.

“Those visiting family or friends have been one of our biggest problems” when it comes to malaria prevention, Band says.

But mosquitoes don’t care if you’re family, a friend or even George Clooney. They just want your blood.


Most travelers come home from their trips perfectly healthy. However, an ounce of prevention is worth a pound of cure, so take reasonable protections against these illnesses:

?Travelers’ diarrhea: The most common travel illness, this comes when you eat food or drink water that contain bacteria unfamiliar to your system. Treat with Imodium or Pepto-Bismol, or antibiotics if it is persistent. An estimated 10 percent-20 percent of all international travelers complain of this ailment.

?Malaria: Parasitic disease spread by mosquitoes, causing fever, chills and other complications; untreated it can be fatal. Prevention is not absolute, but if you take medication, use DEET lotions and avoid mosquitoes when traveling, you will cut your risk.

?Yellow fever: Potentially fatal viral fever spread by mosquitoes. Proof of vaccination is mandatory for visiting certain countries. Vaccination will protect you for 10 years.

?Typhoid: Bacterial infection, potentially fatal, spread by contaminated food and water. An oral immunization protects for 5 years.

?Hepatitis A and B: The A virus is spread by contaminated food and water; B is from blood or bodily fluids. A series of three immunizations (Twinrix) protects you.

?Polio: You might think polio was wiped out, but it’s not true. A polio booster protects travelers previously immunized.

?Meningitis: Inflammation of brain and spinal cord fluid caused by infection; the bacterial kind can kill you. An immunization protects you.

?Measles, mumps, TB: These still exist around the world. Make sure your regular immunizations are up to date.

?H1N1 flu: The pandemic is over and the amount of flu is back to normal this year in the world, according to the World Health Organization.

?Dengue fever, West Nile virus, Rift Valley fever, hemorrhagic fever, Chikungunya: These viruses are mostly spread by mosquitoes or ticks at various spots around the world. N o immunizations are available, so take precautions to avoid mosquito bites.

?Japanese encephalitis: Serious brain inflammation disease, transmitted by mosquitoes. An immunization exists.

Source: McClatchy-Tribune Information Services.