INTERNATIONAL TRAVEL: Traveling with kids; The pregnant traveler; After your return.

What you need to know: Travel to destinations beyond North America and Europe is common; so are serious health risks- especially where sanitation and medical conditions are poor. Diseases such as tetanus, diphtheria, polio, typhoid, hepatitis, yellow fever, rabies, measles, malaria, and travelers' diarrhea pose threats to the unprotected traveler.

Most immunizations or health precautions aren't required for entry to foreign countries, but they do provide valuable protection for people who wish to travel in good health.

USE COMMON SENSE: Traveling to tropical climates may be a big adjustment for body and mind. You will enjoy your trip more if you take precautions to stay healthy.

DETERMINE YOUR RISK: Each traveler is unique. Your risk of exposure to disease and developing an illness while traveling is determined by several factors: Your current health, length of time before departure, geographical destinations, itinerary, purpose of travel, length of stay, type of accommodation, food and water sources.

ASK ABOUT IMMUNIZATION: Appropriate immunizations to maximize your health protection can take up to eight week, so make your appointment as soon as you start planning your trip.

RECOGNIZE AND REDUCE YOUR RISKS: You can further safe-guard your health by understanding how diseases are transmitted and by taking personal precautions to reduce your risks.

--------------------------------------------------------------------------------

Food and water precautions: Consuming contaminated food and water is one of the most common ways travelers to develop illnesses. Ensure your water is properly purified and food is either well-cooked or washed and peeled.

Insects: In most developing and third world countries, insects can be a threat to your health. Wear protective clothing. Always use an effective insect repellent.

Contaminated soil: Throughout the world, soil can be contaminated with bacteria that can enter broken skin and cause tetanus. Certain parasites are capable of entering unbroken skin. Always wear protective footwear. Try to avoid direct contact with sand and soil that may be contaminated with animal feces.

Person to Person: Along with the common cold, diseases such as influenza, diphtheria, meningococcal meningitis, and tuberculosis are transmitted from person to person through coughing or sneezing. Diseases transmitted by sexual activities, body piercing, contaminated needles or syringes or blood include Hepatitis C, B, and AIDS.

--------------------------------------------------------------------------------

TRAVELING KIDS

Preparing kids for international travel should start no later than 8 weeks before the start of your trip. Schedule a visit to your travel medicine specialist or pediatrician. Your doctor will also help you get the latest information on the immunization requirements of your destination and on any recent disease outbreaks that you should know about.

Keep to a schedule: Children respond well to routines. Planning travel that coincides with children's normal sleeping time causes less disruption, and keeps them from feeling "cooped up".

Confirm air travel arrangements: Specific seating requests can make your flight more comfortable.

Bring along the necessities: When traveling with an infant, always bring the bottles and nipples he or she is familiar with. Disposable diapers: pack a good supply in the crevices of your luggage, and keep one easily available.

Ear pain: When traveling by plane, children often experience ear pain as the pressure inside their inner ears equalizes during take-off and landing. Nasal congestion makes the problem worse. There are things you can do to help relieve the pain and to comfort your child.

Disease carriers may pose special risks to kids: an organism (a virus, bacteria, or parasite) and a carrier (an insect) cause vector-borne diseases. The two most common such diseases in travelers are malaria and schistosomiasis. Other diseases, such as dengue fever, yellow fever, sleeping sickness, are also increasing.

--------------------------------------------------------------------------------

THE PREGNANT TRAVELER

Although pregnancy does not mean a woman cannot travel, traveling internationally while pregnant presents unique problems. There are no restrictions on air travel for pregnant women, but the second trimester is considered the safest. While flying, pregnant women should avoid cramped positions and sitting for long periods. Moving your legs and toes helps to improve circulation on long trips.

The most important things for the pregnant traveler to know are:

--------------------------------------------------------------------------------

AFTER YOU RETURN

Some illnesses can emerge weeks or even months after you return home. For example, hepatitis B symptoms typically appear 3 to 4 months after infection. Keep this time lag in mind, especially in case of intestinal illness. If an illness is severe or does not improve after 3 or 4 days, call us. We will ask you your itinerary, what you did, how long you stayed, what you ate and drank, and if you recall being bitten by any insects while traveling.