Most disease risks lurk well below the exotic-illness headlines

In the not-so-olden days, travelers worried about catching exotic diseases such as malaria or yellow fever, developing-world hazards largely foreign to many Americans. These days, Americans also worry about a host of new travel-related health problems.

Even veteran travelers are more concerned about the health risks of international travel, says Dr. Brian Terry, a travel medicine specialist in Pasadena. “SARS did it,” he says. “Travelers are paying more attention. Now they realize ‘I may not just get sick [on a trip]. I may get quarantined in Taiwan for three weeks.’ ”

But travelers don’t always put the health risks in perspective, experts say. Most of us worry too much about health risks that can be minimized with simple precautions and don’t worry enough about more probable health risks.

“The first thing that always comes to mind [for travelers] is respiratory illness,” says Dr. Phyllis Kozarsky, chief of travelers health for the federal Centers for Disease Control and Prevention. And the respiratory illness most travelers think of first is SARS -- severe acute respiratory syndrome. It first struck in Asia in February and spread over the next few months to more than two dozen countries, afflicting 8,000 people worldwide and killing 774 before it was contained.

Worrying about it for 2004 travel may prove groundless, Kozarsky says, although some experts expect a resurgence.

In mid-December, public health officials in Taiwan reported a single case of SARS, in a scientist who was working with the virus in the lab.

The CDC urges all travelers to be aware of the symptoms (fever above 100.4 degrees, body aches, discomfort) and to seek medical help as soon as possible if SARS is suspected.

A traveler is statistically more likely to contract a respiratory illness such as influenza. And although airplanes have gotten a reputation as germ-spreading machines, “we run the same risk in any small, confined space -- that is, a classroom or the mall,” Kozarsky says. “Many environments are just as germy as an airplane.”

To reduce the risk of respiratory illness, Kozarsky tells travelers to get a flu shot before departure, wash their hands often and pack hand wipes or sanitizing gel for those times when water isn’t available.

Also pay attention to what Kozarsky calls “respiratory infection etiquette.” Cover your mouth when you cough, sneeze into a tissue and avoid public places if possible.

Travelers also underestimate the health risks associated with mosquitoes, Kozarsky says. The insects can transmit malaria, dengue fever and West Nile virus. Insect repellent containing 35% DEET is recommended.

Few travelers think about sexually transmitted diseases (STDs) as a travel risk, but they should, Terry and Kozarsky say.

“We see an increasing number of people who travel and who have casual, unprotected sex,” Kozarsky says. “They are having these casual relations with people they deem are from the same educational or social background. And statistics show frequent travelers may have higher rates of STDs than the general population.”

Kozarsky says that business or leisure travelers from the United States who might not consider having sex with commercial sex workers overseas often do not think twice about having sex with someone they encounter at a meeting; they consider the potential partner low risk because he or she has a similar professional background.

Acupuncture and tattooing also can be health hazards abroad. The potential for infection from dirty needles is real.

Terry also suggests a dental checkup before you travel abroad.

Kozarsky suggests seeing a travel medicine doctor before you go. Check the website of the International Society of Travel Medicine, www.istm.org, for a list of travel clinics and doctors with experience in travel medicine, and study the CDC traveler’s health Web page (www.cdc.gov/travel) for updates on current health risks.

Healthy Traveler appears every other week. Kathleen Doheny can be reached at kathleendoheny@earthlink.net.