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[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC - safer, healthier people.

[Susanna Haynes] As a student, I've always wanted to study abroad. It's been a dream of mine ever since grade school, because I really want to experience different countries and cultures first hand. Well, today's a great day for me! I just found out I'm going to Southeast Asia this summer through the study abroad program at my school. This is such an opportunity to broaden my horizons and expand my knowledge and understanding of international, political, and economic issues. And who knew? The U.S. Senate has even declared two thousand six "The Year of Study Abroad" to encourage students to have an international study experience.

I'm really excited, but I know that there's a lot I have to do before I'm ready to go. Because the culture and environment are so different from home, I might be more likely to get sick or injured, especially since I'm traveling to developing regions of the world for longer than 2 weeks.

I've gotten some tips from my friends, but I really don't want to get sick or have an accident, so I thought I'd contact a medical expert my school told me about - Dr. Christie Reed at the CDC. Boy do I have some questions for her!

Hi, Dr. Reed. This is Susanna Haynes. Thanks for talking to me.

[Dr. Reed] Hi, Susanna, I've heard you have some great news about studying abroad. How are you feeling about your upcoming trip?

[Susanna Haynes] I'm really excited, but Dr. Reed, I need to ask you some questions so I don't get sick or hurt when I travel. What's the first thing I need to do before I leave the country?

[Dr. Reed] Be sure to check with a health care provider to make sure you're up to date with all routine vaccinations. For someone your age, these would be: measles, mumps, rubella, tetanus, diphtheria, pertussis, hepatitis A and B, meningitis, and polio

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[Susanna Haynes] OK. Now, when should I do this?

[Dr. Reed] Well, ideally, you'd want to do it 4-6 weeks before you travel. This will give you time to get any additional vaccinations, medications, or information you may need to stay healthy. If it's less than 4 weeks before you're scheduled to travel, you should still see your health care provider, because there may be some vaccinations, medications, or preventive information that could be helpful to you. To find a travel medicine specialist, visit our website at www.cdc.gov/travel, and click on the link "Travel Medicine Clinics." It's especially important for students who travel to rural areas of developing countries or who have medical problems that need to be managed while abroad to consult a health care provider who specializes in travel medicine.

[Susanna Haynes] Is there a website I can go to if I want to learn more about disease risks and preventive measures for the countries that I'm going to be traveling to?

[Dr. Reed] Yes! You can visit CDC's travel health website at www.cdc.gov/travel. In addition to links to travel medicine clinics, the site has detailed information about common diseases of travel, outbreaks, vaccines, and other helpful information. And let me emphasize again Susanna, that students visiting developing countries are at a greater risk for illness or injuries than those who travel to developed countries like Canada, Australia, New Zealand, Japan, and Western Europe, where the health risks are comparable to those found in the United States. But remember, even vaccine preventable diseases such as measles and mumps are common in many parts of the world, including developed countries.

[Susanna Haynes] OK, Dr. Reed. Aside from my personal items, is there anything else I should take on my trip to stay healthy or in case I get sick?

[Dr. Reed] Yes. You should definitely put together a travel health kit that includes:

• an adequate supply of any prescription medications you may take, and remember to carry them in their original containers;
• an over-the-counter antidiarrheal medication;
• an alcohol-based hand gel that contains at least 60% alcohol;
• an antibiotic for self-treatment of many causes of acute bacterial diarrhea;
• a thermometer;
• insect repellent containing at least 30% DEET if you plan to study in or visit a tropical or a subtropical area;
• the name and telephone number of your primary health care provider; and
• a copy of your vaccination record.

Also, you should familiarize yourself with basic first aid so you can self-treat minor injuries. If you plan on participating in any water activities, you should also learn how to swim if you don't already know how.

[Susanna Haynes] So what about health insurance? Do I need any special insurance?

[Dr. Reed] Check to see if your insurance plan provides care while abroad. If it doesn't include this service, it's a good idea to consider additional insurance that covers medical evacuation in case you become sick or injured while abroad. You can find more information about travel insurance and medical evacuation services on the U.S. Department of State website at www.travel.state.gov. Go to the section on international travel for U.S. citizens. It includes information about questions like this. You should also identify in-country health care resources in advance of your trip, in case of a medical emergency. This is especially important if you have any pre-existing medical conditions. The U.S. Department of State website also has a list of doctors and hospitals abroad. The U.S. Embassy or the consulate at your travel destination may also be able to help you find these resources. There are even several private travel medicine organizations that provide assistance in finding medical care abroad. All of this is covered on the Travelers' Health website at www.cdc.gov/travel. On that website, select the "Yellow Book", which is the on-line CDC textbook of travel medicine. Then select the section called "Seeking Health Care Abroad". The Yellow Book, which is formally titled Health Information for International Travel, is also available in hard copy at bookstores.

[Susanna Haynes] Since I'll be living in a foreign country, how would I be notified in case there's an emergency, such as a severe storm or civil unrest?

[Dr. Reed] You can register on-line with the U.S. State Department at www.travel.state.gov. Look under the "Registration with Embassies" link. This way, the U.S. Embassy or consulate in the country you'll be visiting will know your whereabouts in case of an emergency that makes it necessary for a consular officer to contact you. This registration is especially important if you plan to stay abroad for longer than one month, or you'll be visiting a country that has an unstable political climate or is at risk for a natural disaster, such as an earthquake or hurricane.

[Susanna Haynes] Dr. Reed, while I'm in Southeast Asia this summer, what are some ways I can reduce my risk of getting sick?

[Dr. Reed] Drink only bottled water or carbonated drinks from cans or bottles with intact seals. You can also boil your water. Don't drink tap water or fountain drinks or add ice to beverages. Avoid eating unpasteurized dairy products, fruits you can't peel yourself, and uncooked food that may have been washed in local water, such as salads and raw vegetables.

Eat only food that has been fully cooked and is served to you hot; avoid food from street vendors. If you will be living with a host family, discuss any food allergies or dietary preferences in advance.

To avoid bites and serious diseases such as rabies, don't touch animals, including domestic pets, and especially monkeys, dogs, and cats. If you are bitten or scratched by any animal, get medical attention right away, and clean the wound well with a lot of soap and water and a topical antiseptic, such as Betadine®, if it's available.

Wash your hands often with soap and water, especially before meals and after going to the bathroom. If soap and water aren't available, and your hands aren't visibly dirty, use an alcohol-based hand gel that contains at least 60% alcohol to clean your hands. Cleaning your hands often with soap and water removes potentially infectious material from your skin and helps prevent disease transmission.

[Susanna Haynes] What about areas where there is a risk of contracting malaria?

[Dr. Reed] Be sure to take your malaria prevention medication as directed, before, during, and after your trip. Use insect repellent and a mosquito net while sleeping, and wear long sleeved shirts and long pants outdoors between dusk and dawn when the mosquitoes that transmit malaria are active.

[Susanna Haynes] So, Bird flu. What should I do to reduce my risk of getting bird flu?

[Dr. Reed] If you are in areas with avian flu or bird flu, make sure any poultry products are fully cooked before eating them, just as you would to avoid a variety of foodborne illnesses. Avoid direct contact with birds, even if they don't appear sick. It's best if you could avoid poultry farms, bird markets, and other places where poultry is raised or kept.

For more information, see the outbreak notice about avian influenza on our website titled: "Guidelines and Recommendations: Interim Guidance about Avian Influenza A (H5N1) for U.S. Citizens Living Abroad." Again, our website is www.cdc.gov/travel.

[Susanna Haynes] Dr. Reed, can you tell me some of the most common infections a student might be at risk for, and exactly what can I do to avoid them?

[Dr. Reed] Sexually transmitted diseases or STDs, including HIV and AIDS, are among the most common infections worldwide. The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual activity or to be in a long-term, mutually monogamous relationship with a partner who has been tested and you know is uninfected. Also, the proper, consistent use of latex or polyurethane condoms when engaging in sexual activity can greatly reduce your risk of getting or transmitting sexually transmitted diseases, including HIV.

[Susanna Haynes] OK. Now, is there anything else I need to know to stay safe while I'm away from home?

[Dr. Reed] Susanna, did you know that automobile accidents are the leading cause of preventable deaths in travelers? The most important risk factor for road traffic injuries is the presence of alcohol in the blood of a driver or pedestrian who is injured, so please, don't drink alcoholic beverages and drive. Wear your safety belt, follow the local customs and laws regarding pedestrian safety and vehicle speed, and use a helmet when riding bicycles and motorcycles. It's also important to be aware of the cultural impact of being involved in or causing an accident that includes injury to the local population. In unfamiliar or foreign environments, it's best to use a local driver. It's also important to find out the legal age for driving, because it varies by country.

Remember to swim in well-maintained, chlorinated pools, and only if you are an experienced swimmer. Drowning is also a leading cause of death in travelers.

If you're visiting an area which has a high risk of water-borne infections like schistosomiasis, don't swim in lakes, streams, or other fresh bodies of water.

To prevent infections such as HIV and Hepatitis B, avoid getting tattoos, body piercings, or injections.

[Susanna Haynes] OK, Dr. Reed, I'm going to follow your advice, but one more thing, what should I do if I get home and don't feel well or have been hurt?

[Dr. Reed] Well Susanna, the first thing you should do is get medical attention, including psychological support and counseling, if necessary. Be sure to tell the health care provider everywhere you traveled.

It's especially important for you to get health care if you have a fever, rash, cough, or difficulty breathing, or any other unusual symptoms.

If you're returning from a malaria-risk area and become sick with a fever or flu-like illness, for up to a year after your return, get immediate medical attention and be sure to tell the doctor or health care provider your travel history.

[Susanna Haynes] Dr. Reed, I can't thank you enough for all the information you've given me. I feel better prepared for my trip and even more excited about meeting new people and learning new things. Thank you so much.

[Announcer] To access the most accurate and relevant health information that affects you, your family, and your community, please visit www.cdc.gov.