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HOUSE CALL WITH DR. SANJAY GUPTA

Stay Healthy While Traveling

Aired June 5, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BETTY NGUYEN, ANCHOR: A man with two rifles has been found dead in the steel armored cab of his bulldozer in Granby, Colorado. Police believe he died of a self-inflicted gunshot wound. Authorities blasted their way into the cab after the bulldozer destroyed or damaged several buildings in the town.
Air Force One is arriving in Paris on a flight from Rome where President Bush met this morning with Italy's prime minister. Next is a meeting with French President Jacques Chirac. Then Mr. Bush heads for the Normandy coast and ceremonies marking the 60th anniversary of D-Day.

Smarty Jones runs for the Triple Crown later today. They favorite is trying to become the first horse in 26 years to win the Kentucky Derby, the Preakness and today's Belmont Stakes.

But first it is time for HOUSE CALL with Dr. Sanjay Gupta.

DR. SANJAY GUPTA, HOST: Good morning and welcome to HOUSE CALL.

Well, it's that time of year: Americans are on the move.

Whether you've been planning a vacation for months or taking a spur of the moment trip, your bags are packed and you're ready to go. But it may not all be fun in the sun.

From sunburn and the cold to Montezuma's Revenge, many of us get sick, either on vacation or when we get home.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Millions of Americans are heading on vacation this summer, some taking road trips and others heading to the beach and amusement parks. Still others are venturing further from home and heading overseas, but they'd better be prepared.

DR. PHYLISS KOZANSKY, CDC TRAVEL SPECIALIST: Thirty million from the United States alone. About 50 percent will become ill at some point during a two-week travel period.

GUPTA: The most common ailments, traveler's sickness, otherwise known as Montezuma's revenge of Delhi belly (ph), and the common cold.

However, developing countries or tropical areas can bring more serious risks as well. KOZANSKY: Agents such as hepatitis A or typhoid fever. Then there's a whole group of illnesses that are transmitted by mosquitoes, for example, or other what we call vectors or insects, and malaria and dengue fever are big ones.

GUPTA: Some common sense can help you stay healthy.

No. 1, go see your doctor at least six weeks before taking your trip. Your doctor may recommend getting a vaccination or bringing along medication for certain ailments, especially if you have any chronic disorders.

Also, check your health insurance to find out what your plan covers when traveling.

If you're taking a regular prescription, make sure to bring a little extra and pack it on your carry on, just in case your luggage takes a side trip.

(END VIDEOTAPE)

GUPTA: We're going to be talking about all your travel health issues today, from jet lag to protection against mosquitoes and getting sick on vacation, which is no fun.

Experts say as many as 40 percent of Americans who travel to Mexico end up with traveler's diarrhea or traveler's sickness. For those who tend to suffer from this illness, more help is on the way.

There's a new antibiotic, Rilaximin, just approved last month by the FDA. The drug seems to have few side effects and can be taken before you actually get sick.

Here to talk with us today about staying healthy on vacation is Dr. Bradley Connor. He's founder and medical director of the New York Center for Travel and Tropical Medicine. He's also the president of the International Society of Travel Medicine.

Welcome, Doctor.

DR. BRADLEY CONNOR, MEDICAL DIRECTOR, NEW YORK CENTER FOR TRAVEL AND TROPICAL MEDICINE: Thank you.

GUPTA: Listen, this is what you do. You see a lot of different vacationers who get sick. What sort of illnesses do you see the most at your travel clinic?

CONNOR: Well, you know, it's been shown that up to 50 percent of travelers will report some health issue when they travel. And we see everything from the mundane sunburn and jet lag and issues like that to some of the more serious ailments: malaria, hepatitis a, dengue fever.

So there's a wide array of illnesses out there and what we do in travel medicine is try to discuss prevention. That's really our main thrust. GUPTA: And a lot of people do try and prevent this from happening in the first place. That's been the topic of a lot of our e-mail questions.

First one coming in. This one is from Betsy in California, who asks, "I am going to Mexico but no matter how careful I am, I still get sick. Are there any new products on the market to try and help?"

CONNOR: Well, the first line of defense is knowing good food and water precautions. We always tell people, of course, don't drink the water but avoid foods that are washed in water. Eat foods that are freshly cooked and served piping hot.

And now the good news is there is a new medication that we're all very excited about. It's an antibiotic called refaxamin. It goes under the brand name of Xifaxan, which is a non-absorbable antibiotic. That is, it's not absorbed into the blood stream, so it acts in the intestine to both treat or prevent traveler's diarrhea.

GUPTA: People -- That's interesting, taking an antibiotic without having actually an infection. Isn't there concerns about antibiotic resistance and things like that when you do that?

CONNOR: Well, that is a paradigm shift. Usually we reserve antibiotics for documented infections.

In this case, we feel pretty comfortable with this new antibiotic because it's non-absorbable. That is, it's not -- it's not absorbed into the blood stream. So we think that it will be well tolerated and virtually free of the sort of side effects you see with other antibiotics.

GUPTA: It just works in the intestines, so to speak.

Lots more questions coming in. We've got questions coming in from around the world, as it turns out.

Emil from Latvia wants to know, "Where is it safe to drink the water when on vacation? Are only Western countries safe? Also, what about ice cubes in your drinks?"

And Doc, I mentioned to you, I just went to Italy. I think this is an interesting question because you never know exactly when it's OK to drink the water. Any rules of thumb there?

CONNOR: Well, this is a question I hear all the time. And you know, unfortunately, most of the world's water supply is contaminated.

And when you leave areas -- the U.S. and Canada, Western Europe, Australia, New Zealand, Japan -- you have to at least consider the fact that the water may be contaminated.

And we recommend bottled beverages or especially bottled carbonated beverages that imply that the beverage is bottled at a bottling plant. Or if it's a sealed beverage, that's fine.

But I think when in doubt; it pays not to take a chance.

GUPTA: All right. Really, really good advice. Better be safe than sorry, certainly.

And as Dr. Connor pointed out, fevers and colds are very common in travelers.

We've got a question from Debbie in California to that extent: "My husband and I recently traveled to Italy. On the third day in Rome, I came down with a terrible chest cold which almost ruined our vacation. What are some ways to stay healthy while traveling abroad? Is there something that can be done prior to leaving?"

What can you tell someone like Debbie, Doctor? Is there something that you can do? Is it different in Italy than it is at home or is it just sort of luck of the draw for her?

CONNOR: Well, I mean, you can get a cold anywhere, obviously. But it's really -- it's unfortunate to be sick when you're traveling in a foreign country on your vacation.

And some of this may relate to the fact that before a trip, travelers are often very stressed with a lot of last minute things, and they may not be getting proper sleep or sort of burning the candle at both ends. If there's any way to sort of take easy before you leave, that may help.

You know, you're exposed to a lot of people who are incubating viruses, and there may be a higher risk of contracting colds when you travel.

Take along a travel health kit. Have over the counter medications, a decongestant, something for colds, something that might make you feel more comfortable.

And of course, if you're someone who suffers from any chronic medical condition, you may want to avail yourself of the name of a physician at your destination. Those of us in travel medicine often provide that for our travelers.

GUPTA: That's all good advice. And we'll certainly talk about that in more detail coming up.

Also, if you have a long car trip or flight coming up this summer, stay tuned for ways you can avoid a potentially deadly problem.

ANNOUNCER: Coming up on HOUSE CALL, what you can do to prevent getting blood clots while traveling.

Plus, is jet lag bringing you down? We'll have some tips to help you hit the ground running on your next trip.

First take today's "Daily Dose" quiz: "How long before a trip should you visit your doctor? A, one to two weeks; b, four to six weeks; or c, six to eight weeks." The answer when we come back. (COMMERCIAL BREAK)

ANNOUNCER: "The Daily Dose" quiz. We asked how long before a trip should you visit your doctor?

The answer? Four to six weeks. According to the CDC, this allows time for any vaccines to take effect.

GUPTA: Sometimes you need those vaccines.

Four million Americans will be traveling by plane this summer, and according to AAA, travel packages to Europe are already selling fast.

What that means is packed planes and concerns about those long haul flights, especially about something known as DVT, or deep vein thrombosis. That's a condition which affects about two million people in the United States every year.

Now, if you develop DVT, that means you've got a blood clot, usually in your legs. That clot could travel to your heart or lungs and be potentially deadly. The disorder is caused by sitting for too long periods of time with little movement.

We're talking with Dr. Bradley Connor. He's president of the International Society of Travel Medicine.

Doctor, we sent our roving camera out to get some questions on this particular topic. Let's take a listen.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Is there anything you should do before a flight to prepare your body? You know, to avoid those blood clots?

(END VIDEO CLIP)

GUPTA: So doctor, how common are these blood clots? Is there any way for someone to prevent them?

CONNOR: Well, you know, the good news is they're not terribly common. But there are certain conditions which predispose the blood clots, pregnancy, recent surgery, certain medications, birth control pills perhaps. And there are certain people who are genetically predisposed to -- to getting blood clots. Most of these people don't know who they are.

So what we tell people is on board an airplane or any closed conveyance, whether it's a train or a bus, to try to, if you can, get up and move around. I know on airplanes that's difficult to do now, but use the -- do the in-seat exercises.

If you have a risk condition for blood clots and you've had a previous problem with blood clots, certainly see your doctor and be put on medication before a long haul flight.

GUPTA: And try and stay really well hydrated, as well.

CONNOR: Exactly.

GUPTA: People remember that this is the thing that actually Vice President Gore had during the campaign several years ago. So it can happen to just about anybody.

CONNOR: That's right.

GUPTA: Another common question, as well, kids and travel. Mary in Denmark writing, "We'll be traveling to California from Europe with my 1-year-old granddaughter this summer. Any tips to make her trip easier. I've heard of some drops to put in their ears to keep pressure pain away."

Toddlers on planes, Doctor. I mean, that can be a real hassle for everybody, passengers and parents alike. Any tips for her?

CONNOR: Well, that's a tough one, really. And there are a lot of things here.

The ear pain, of course, is something that -- that you're alluding to, very common in younger children. Certainly during ascent and descent, make sure the child is taking the bottle or an older child should be chewing gum or some such thing.

There are a few things here in terms of travel with children.

I like to have, again, the name of a doctor or a medical referral at the destination. You know, what if the child develops a fever in the middle of the night? It's good to plan these things ahead of time.

Part of what we do in travel medicine is preparedness, is thinking ahead and extending the safety net that we've come to experience at home to foreign travel. So there's a lot you can do, but I think thinking about these things beforehand is a good idea.

GUPTA: I think I know the answer to this next question. But do you ever advocate any kind of sleeping aid for children or toddlers?

CONNOR: As a rule of thumb for children we don't. You know, jet lag is an issue and long flights are an issue, and, you know, sometimes the pediatrician might say something like Benadryl, which might make the child drowsy in addition to having other antihistamine effects, might be OK.

But as a rule of thumb, I don't think it's a good idea to medicate children for long flights.

GUPTA: All right. Well, we've got another question now coming in from our camera at the airport. Take a listen.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: When we get to Spain after an eight-hour flight and we're exhausted and hopefully we've gotten some sleep, how do we get our body clocks back to normal again?

(END VIDEO CLIP)

GUPTA: So jet lag. I mean, it affects just about everybody at some point or another. Any tips for her?

CONNOR: Jet lag does affect everybody to varying degrees. And some people are more susceptible to it than others.

And what we like to do is utilize some of the natural cues, the light cues if you arrive early in the morning, if you can. Use the light to allow you to stay awake, perhaps going to sleep earlier than usual.

It's a tough one, because it's not just your level of alertness. It's also your body's digestive system which is lagging behind. And try to eat light. Don't eat fatty meals. Avoid caffeine. Avoid alcohol, and stay well hydrated.

GUPTA: We're talking to Dr. Bradley Connor. Really good advice on traveling and how to stay healthy.

When HOUSE CALL continues, we'll tell you what not to leave home without. Stay tuned.

ANNOUNCER: Coming up, we'll give you tips on what to pack, plus some easy to follow advice to help you stay healthy on your vacation.

But first, here's a tip from our health conscious Bod Squad.

(BEGIN VIDEO CLIP)

HOLLY FIRFER, CNN CORRESPONDENT (voice-over): Summer is just around the corner and as we all know, it's the season to bare those body parts you've kept covered for months. And if you haven't been diligent with your workouts, you can still get trouble areas toned up in time to enjoy the warm weather.

You just have to make it through boot camp with celebrity trainer David Kirsch.

DAVID KIRSCH, FITNESS TRAINER: Hold it there. Makes it very tough.

The boot camp is a 45-minute to 60-minute workout. I think you need to be doing that at least three or four times a week and eating properly all the time.

FIRFER: With moves taken from his new "One on One" training series, Kirsch has created six simple, effective, and challenging exercises targeted to tone and sculpt problem areas of the body.

KIRSCH: You're going to sweat. You're going to feel challenged. You're going to feel empowered and you're going to see results.

FIRFER: And because the physical is just part of the successful equation for fitness guru Kirsch, every challenging workout concludes by refueling with healthy food choices.

Holly Firfer, CNN, Atlanta.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. We're talking about having an illness free vacation this summer, something everybody wants.

The experts all agree that planning ahead is the key.

Don't put off getting a checkup or getting those cavities filled. You want to avoid tooth pain, as well. Do it before you go to avoid running into problems while on vacation.

Also, make sure to pack more of your prescription than you need, and don't forget the sunscreen, SPF 15 or higher. This helps prevent a possible sunburn and possibly skin cancer later in life.

We're talking with Dr. Bradley Connor. He's medical director of the New York Center for Travel and Tropical Medicine.

Doctor, you mentioned earlier, and most travel experts recommend packing a first aid trip when you travel, even if it's just a road trip. And we've got a great question on that particular topic.

Kent from Canada wanting to know, "How do you make up a good portable first aid kit when you travel lightly? What if you are traveling by plane?"

So Doctor, talk us through sort of the basics of a first aid kit. What are the things that are mandatory to put in there?

CONNOR: I look at it as looking at over the counter medications and first aid as one travel health kit. And looking at, you know, bandages and a thermometer and the types of antibiotic ointments, small packages of those.

Looking at something like antacid, decongestant, certainly sunblock, the basic items that, if you didn't have them, would be a nuisance on a trip.

Go through the shelves of the pharmacy and go through your own medicine cabinet and see what would take with you to make yourself more comfortable or something that you'd need even -- even in a trip across the United States.

It's very easy to have a medical kit with you rather than having to go out to the pharmacy at, you know, midnight if you happen to develop a symptom.

If you're somebody who's normally healthy, think about what health issues come up. Perhaps it's urinary tract infection or a hemorrhoid flare up or a skin rash or something that would be a problem, certainly, at home, but even more so on a trip. GUPTA: And you know, you mentioned that otherwise healthy people, but besides packing extra prescription medication, are there precautions for someone with a chronic illness that they should take when traveling?

CONNOR: Well, people with chronic illnesses should make sure their medical condition is stable before they travel. You know, have a visit to the doctor. Make sure the condition is -- is compensated or stable.

Take along more than enough medication, as you mentioned. Pack it in your carry-on bag, not in your checked luggage.

And also, I would recommend looking into medical evacuation insurance. I can't tell you how many times in my practice I've heard of somebody who got sick and had to be evacuated at great expense to themselves. That could have been avoided and expedited, had they looked into medical evacuation insurance.

GUPTA: Who do you get that through? Through your medical insurance?

CONNOR: You don't. There are certain companies that will write policies for evacuation. There's one called International SOS. There are a few others that do a reasonably good job.

A very reasonable, cost effective way of insuring against the sort of catastrophic condition that occurs that might need evacuation.

CONNOR: OK. Good advice.

Let's keep going with the e-mails here. We've got another one coming in now.

Ida in New York writing, "My two teenage sons will be traveling for 10 days to Australia this summer. What medical supplies should I pack for them? They will be in Sydney mostly, but are planning to visit some of the outback, as well."

So Doctor, Australia is considered sort of a Western country, but there are still precautions to take and supplies to bring. Correct?

CONNOR: Correct. The main thing is sun protection. As you know, Australia has some of the highest rates of sun-related medical problems. So more than enough sun protection, you know, wide brimmed hats, et cetera.

You know, think about insect repellents and some of the more -- if these are teenagers, some of the more adventure travel type of issues.

Again, the name of a physician or a medical facility ahead of time would be a good idea, as well.

GUPTA: Good advice and certainly being prepared, just like in the Boy Scouts, being the key here. Coming up on HOUSE CALL, more kids are getting skin cancer than ever before. We're going to bring you the details. Stay tuned.

ANNOUNCER: If you're staying closer to home this summer, we'll give you tips for staying safe on the roads and avoiding those pesky mosquitoes.

Also, grab a pen. When we come back, we'll show you how to find travel clinics in your area.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

FIRFER (voice-over): Cancer experts say they are beginning to see an alarming trend: skin cancer in kids and teens.

A report from the American Cancer Society found fewer than one in three teens used any type of sun protection, while three in four got a sunburn during the summer.

And the Centers for Disease Control and Prevention says that only one in four parents with children under the age of 12 made sure that their child was protected against the sun's rays.

And a study in the Journal of the National Cancer Institute found pipe smokers have five times the risk of death from lung cancer and nearly four times the risk of death from throat cancer as people who never smoked. These risks, however, were generally smaller than those associated with cigarette smoking.

Holly Firfer, CNN.

(END VIDEOTAPE)

GUPTA: Thanks, Holly.

Welcome back to HOUSE CALL.

Millions of Americans are planning road trips this summer. This may seem like the safest way to travel. Yet, even overseas, car accidents are the leading cause of death to travelers.

We have some tips to help keep you safe if you're hitting the highways.

Make sure you get your car checked out before you leave, and plan out your route ahead of time.

Also, don't forget to tell a friend when you're leaving and what your route is going to be.

Also, bring your cell phone along and, if possible, sign up for a roadside service in case your car can't make the trip.

Lastly, don't drive while you're tired. That can be deadly. We're talking with Dr. Bradley Connor. He's medical director of the New York Center for Travel and Tropical Medicine.

Lots of questions coming in, Doctor. For those staying closer to home or heading to many parts of the United States, mosquitoes can cause problems. We've got time for one last question on this.

Jon in London writing, "We are planning to travel to the United States in August. With all that we have heard about West Nile being transmitted through mosquitoes, I'm getting confused about what is best for my children. Is deet safe for them or should we take our chances?"

Lots of people asking about this, Doctor.

CONNOR: It's funny. We deal with insect repellants when we talk about malaria, which is a major risk for travelers. But for someone coming over here, the risk of West Nile is obviously on their mind.

The deet based insect repellants are safe. And, despite some concern about toxicity with absorption, there have been millions of applications of deet and perhaps only four or five case reports in the literature of any sort of problems. So use good deet-based insect repellants, and there's usually not a problem using them in children, as well.

GUPTA: Probably going to be safe for children, as well.

Well, if you're heading on vacation and want to get more health information, go to the CDC's web site. That's at www.cdc.gov/travel. You can look up the area you're traveling to and find tips on keeping healthy while you travel.

Also, click on to www.istm.org. That's the International Society of Travel Medicine. Click on "travel clinic directory" to find clinics in your area.

We're out of time for today. Dr. Bradley Connor, I want to thank you so much for answering all of our questions and thanks to everyone at home, as well, for your e-mail. Hope you all have safe travels this summer.

Tune in next weekend when we go behind the mystery and controversy surrounding organ donation. That's at 8:30 Eastern here on CNN.

Remember, this is the place to ask the experts your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com


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