TRAVEL

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There are innumerable reasons to travel locally and internationally and the process can be a rewarding experience when all goes well. There are inherent potential  risks when deviating from your beaten path so here is my 2 cents on potential risks and how to mitigate them (below). 

Primary care physicians without specialized training may be helpful for some preliminary counselling but NOT EXPERTS in travel medicine. Consider seeing a TRAVEL CLINIC - it would not be covered by OHIP but has specialists who can give you up-to-date information, may be able to source necessary difficult-to-find vaccines, or special licensing to be able to prescribe certain vaccines.  In general, the earlier travel planning and vaccination takes place the better as some vaccine series may require several months before they are effective after initially given. 

* CRIME & POLITICAL SITUATION: be aware and plan accordingly

* WEATHER: be aware and plan accordingly including adequate sun protection equipment , proper footwear and adequately cooling or warm clothing depending on your destination. 

* WATER SAFETY: research age-specific products and where necessary, carry water safety devices with you.

* BABY PROOFING: examine rooms for hazards and unsecured furniture, carrying some baby-proofing items might be helpful (outlet covers/ cabinet closers)

* TRANSPORTATION: adhere to same (or increased) precautions when it comes to travel; age/size appropriate car seats or boosters.

@ INSECT BORNE DISEASES: 

* insect repellant  (note that DEET can only be used safely from 6 months onwards) other natural options exist; please refer to https://www.caringforkids.cps.ca/handouts/kidssafe-index

* DEET from 6 months onwards available/ recommended < 10% DEET with frequent reapplications

* limit exposure: avoid being exposed during twilight (certain species of mosquitoes are more abundant then)

* wear long clothing outdoors, mosquito netting for beds/ windows

 @ FOOD-BORNE ILLNESSES: 

* in certain places, one may want to drink only bottled or treated water

* beware communal fresh/uncooked fruits/vegetables and we recommend re-washing or sticking to items you can peel

* don’t get ice cubes (usually not same standard for water quality)

You can get a sense of region-dependent illnesses/ recommendations from reviewing:

 # the public health sites for the regions to be visited  AND 

 # Health Canada (https://travel.gc.ca/travelling/health-safety) 

I would recommend (at a minimum) below:

 # Routine vaccinations: to ensure up-to-date (including MMR at > 6 months old)

 # Hepatitis A: to be considered for > 6 months old (not OHIP -covered)

 # Hepatitis B: anytime from birth (not OHIP-covered except for at-risk groups or in grade 7/8)

 [NOTE: combined Hepatitis A+B vaccine (TwinRix Jr) can be given if > 12 months old]

 # Diarrheal illnesses:

@ Typhoid > 2 years old (oral available for >6 years old) given > 2 weeks before travelling

@ Dukoral > 2 years old  given > 2 weeks before travelling

Zoonoses (organism-transmitted diseases): 

# mosquito borne pathogens e.g. Malaria, Yellow fever, Japaneses encephalitis...

# Mammal borne pathogens e.g. Rabies, .. 

 * don't travel without some

* ensure you have adequate travel insurance and be aware of the limitations/ coverage

* Please carry regular essential or likely ‘as-needed medications (e.g. puffers/ ointments) in duplicate and separately stored

* some medications may require accompanying details or letters in order to be carried over borders; ensure to clarify this well in advance to prevent frustrations at borders