Take a page from their adventure script -- use caution

A TV crew headed to Africa worried that it might be injured while filming elephants and other dangerous wildlife. Dr. Bradley Connor, a medical consultant for some members of the production, quickly put the risks into perspective.

The biggest enemy, he says, is much smaller than an elephant: “Mosquitoes cause 3 million deaths a year from malaria,” says Connor, a N.Y. physician and president of the International Society of Travel Medicine.

Connor and other doctors who specialize in travel medicine have been called on to provide preproduction medical care to the cast and crew of such TV shows as “Survivor” and “Eco-Challenge” as well as documentaries and feature films set in remote destinations.

What these doctors have learned about cast and crew — how they respond to the risks and the mistakes they make in preparing for life on the road — also can help leisure travelers stay healthy.

“People are always looking for more unusual places to go,” says Dr. Brian Terry, a Pasadena physician who has cared for crews of adventure shows and documentaries. “They see a show and say, ‘I should go there.’ ”

How can you avoid the mistakes of cast and crew?

• Be careful of Hollywood’s penchant for “natural” remedies, says Dr. Terri Rock, a Santa Monica physician specializing in travel medicine. She cared for one actress who got a hepatitis-A shot before traveling to an area with potentially contaminated food. “Then her assistant said, ‘Shots are bad for you,’ and she didn’t get the other ones she needed,” Rock says. The assistant discouraged the actress from getting a typhoid fever vaccine and suggested an herbal cleansing tea in the event of illness, although there is no evidence the latter works, Rock says.

• Put risk in proper perspective. “People look at the obscure risks and then don’t consider the familiar ones,” Terry says. “They don’t take mosquito repellents, and they don’t consider putting on a safety belt in a taxi.”

• Decide how adventurous you’re going to be and protect yourself accordingly. Rock says that in a fit of spontaneity, one cast member of a TV adventure show grabbed a live nonvenomous snake, clamped its fangs on his skin and, as was local custom, applied tattoo dye and dirt. “He came back with a skin infection, although he had had every shot known to man,” Rock says.

• Don’t ignore the obvious. Get rest and eat well. It’s tempting for cast and crew to cram hours of fun on top of a grueling work schedule, similar to the way some leisure travelers try to fit a month’s worth of adventure into a weeklong vacation. Production people put in long days. “They are exhausted, and their immune system is down,” Rock says. “And then they party like there is no tomorrow.” She adds that some get lax about the kind of local food and drink they consume and then get sick.

• Unsafe sex is another problem, says Judy Shipley, registered nurse and clinical coordinator for Connor’s New York Center for Travel and Tropical Medicine. She cautions crews about HIV and other sexually transmitted diseases.

• Dress practically. Rock, Shipley and Terry have had patients planning to wear flip-flops or sandals to remote, rugged destinations. Puncture wounds are common. Plus, Rock says, walking barefoot can increase the risk of cutaneous larva migrans: Tiny worms picked up from animal feces penetrate the skin of the foot and cause itching and other discomfort. Topical or oral medicine usually is effective. But the precaution — closed shoes — is simpler.