Before you pop on over the border

WE Angelenos can skip across the border to Mexico almost as easily as we can drive from L.A. to Orange County. After all, when the traffic gods are smiling, you get to the border in three hours or so for the chance to bargain for silver jewelry in Tijuana, relax at a Baja resort or stretch out on the shoreline sands.

But even though Mexico is our next-door playground, we have plenty of health hazards to consider when traveling there. For instance, you face a higher risk of contracting hepatitis A, malaria, rabies, typhoid fever and, now, a re-emerging brain disorder caused by a parasitic tapeworm found in pork.

The most common cause of neurocysticercosis, or adult-onset seizures, in Mexico is the taenia solium tapeworm, says Casey Barton, an epidemiologist for the state of Texas, who conducted a study in 2004 at the University of Texas Health Science Center in Houston.

“In Mexico, it’s also known as solitaria,” she says. “This tapeworm lives in a human intestine, and that normally isn’t much of a problem for the person carrying it.”

But trouble starts when the person sheds the tapeworm’s eggs in feces and hygiene standards are poor. If food preparers have eggs on their hands, they can infect the food, in turn infecting those who eat the food, who then get the eggs in their digestive tracts. When the eggs hatch and migrate to other parts of the body, they bring on seizures, Barton says.

“It’s considered to be a re-emerging disease,” she says. When she studied 200 households from August to December 2004 along the Texas-Mexico border region of El Paso and Ciudad Juarez, Mexico, she found 3% of those who gave her samples had the disease caused by the intestinal parasite.

“The best tip to prevent this tapeworm is not to eat undercooked pork,” she says. “Get it well done, no matter what type of meat, but especially pork. If you see pork that looks like it has blisters on it or through it -- even one -- don’t eat it. It means the pork is infected with the larval stage of the tapeworm.”

But just avoiding undercooked pork isn’t enough. Travelers also must avoid food prepared by people who may have come into contact with the tapeworm eggs, says Dr. Joshua Fierer, an infectious disease specialist and the Michael and Marci Oxman Professor of Medicine at UC San Diego.

“Don’t eat fresh salads in Mexico, and when eating fruits, make sure they are washed and peeled,” he says.

Other health risks for travelers to Mexico:

Hepatitis: A viral infection of the liver, hepatitis A is spread by contaminated food and drink. Get a hepatitis A vaccine, unless you are already immune, Fierer says.

Hepatitis B is on the federal Centers for Disease Control and Prevention’s list of vaccines to be considered before travel to Mexico. In general, it’s needed for leisure travelers to Mexico only if you share drugs and needles, get a blood transfusion or have unprotected sex with infected partners while there, Fierer says. But the CDC recommends the vaccine for all infants and children who have not been vaccinated.

Malaria: Malaria cases have decreased in Mexico in the last two decades, but it is still a threat in some places, although not generally in major urban tourist resorts. According to the CDC, chloroquine is the recommended drug for tourists to take to prevent malaria, which is spread by the bite of infected mosquitoes.

Typhoid fever: The bacterial disease, contracted through contaminated drinking water or food, is a risk in Mexico, the CDC says. Besides food and drink precautions, vaccines are available but not required.

Rabies: The viral disease transmitted by a rabid animal strikes the central nervous system and can be fatal. “Don’t mess with any stray dogs,” Fierer says.

Traveler’s diarrhea: “The most common problem is Montezuma’s revenge or traveler’s diarrhea,” Fierer says. It can strike whether you’re staying in a budget hotel or a posh resort. “It’s not the resort or how fancy it is, it’s the people handling the food.”

Exercising a little restraint might save hours of misery. Use only bottled water for drinking and brushing your teeth. “Don’t put ice in your drinks,” Fierer says. Your best prevention? Bottled water that’s carbonated. If you see the bubbles, you can be pretty sure it was bottled and sealed, not tap water put in reused bottles, Fierer says.

Some travelers take Pepto-Bismol preventively, two tablets four times a day, he says. Or you can wait until you are ill and take the same dose, he says. It can turn your tongue black temporarily.

If you get ill, Fierer also recommends Imodium (loperamide) or Lomotril (diphenoxylate atropine), both available over the counter. Or ask your doctor about taking antibiotics to treat yourself once the diarrhea strikes, he says.

If you have blood in the stool, see a doctor immediately, Fierer says, to rule out dysentery, a condition spread by contaminated water in which the lining of the large intestine is inflamed. If your fever doesn’t improve within 24 hours, you also need to see a doctor, he says.

Prescription drugs: Because prices of medications are often lower than in the U.S., and many medicines that require a prescription in the U.S. are available over the counter in Mexico, it may seem like a good place to stock up for cost-conscious consumers.

Bad idea, says Marvin Shepherd, director of the Center for Pharmacoeconomic Studies at the University of Texas at Austin who has researched counterfeit drugs. “About 20% to 30% of drugs bought in Mexico are counterfeit,” he says.

Those involved in counterfeiting make the drugs look legitimate, “right down to the trademark,” Shepherd says. The medications may be the same color and look like U.S.-made drugs, he says, and sometimes you’ll discover they are fake only after you take them and notice you don’t get the same relief as with medication bought in the U.S.

Medical quality aside, there are legal issues to be wary of. Generally, interstate shipment, including importation of new drugs and those that have not been approved by the Food and Drug Administration, is prohibited in the U.S. That includes foreign-made versions of drugs approved here.

But FDA officials can use their discretion to decide if small supplies of medications, usually three months’ worth or less, that are not controlled substances, can be allowed in the U.S.

“Customs asks the FDA what to do when they encounter medications coming into the U.S. since FDA has jurisdiction of prescription drugs,” says Rae Jones, an FDA spokeswoman. “Even though it is illegal to bring medications into the U.S., the current practice has been for [the] FDA to use its enforcement discretion, by allowing small amounts of medications to come into the U.S., while keeping out potentially harmful drugs.

“There is no list of allowed or disallowed drugs available,” she says.

The U.S. Drug Enforcement Administration has jurisdiction over controlled substances, including tranquilizers and some painkillers, and the agency may allow you to bring in a personal supply of such a drug as long as you have a prescription written by a U.S. physician, says Lauren Alder, a DEA spokeswoman.

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Kathleen Doheny can be reached at kathleendoheny@earthlink.net.