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Making Travel Safe
Injuries
Injuries,
especially those from motor vehicle crashes, pose the
greatest risk of serious disability or loss of life to
international travelers. The risk of motor vehicle-related
death is generally many times higher in developing countries
than in the United States. Motor vehicle crashes result from
a variety of factors, including inadequate roadway design,
hazardous conditions, lack of appropriate vehicles and
vehicle maintenance, unskilled or inexperienced drivers,
inattention to pedestrians and cyclists, or impairment due
to alcohol or drug use; all these factors are preventable or
can be abated. Defensive driving is an important preventive
measure. When driving or riding, request a vehicle equipped
with safety belts, and, where available, use them. Cars and
trucks should be carefully inspected to assure that tires,
windshield wipers, and brakes are in good condition and that
all lights are in good working order. Where available, also
request a vehicle equipped with air bags. As a high
proportion of crashes occur at night when drivers are
returning from "social events," avoid nonessential
night driving, alcohol, and riding with persons who are
under the influence of alcohol or drugs. This risk of death
in a motor vehicle crash is greater for persons sitting in
the front seat than for those in the rear seat. Where
possible, travelers should ride in the rear seats of motor
vehicles. Pedestrian, bicycle, and motorcycle travel are
often dangerous, and helmet use is imperative for bicycle
and motorcycle travel. In developing countries, helmets will
likely not be available, so bring your own with you if you
plan to ride bicycles or motorcycles. For travel with young
children, you should bring your own child safety seat.
Fire injuries are also a
significant cause of injuries and death. Do not smoke in
bed, and inquire about whether hotels have smoke detectors
and sprinkler systems. Travelers may wish to bring their own
smoke detectors with them. Always look for a primary and
alternate escape route from rooms in which you are meeting
or staying. Look for improperly vented heating devices which
may cause carbon monoxide poisoning. Remember to escape a
fire by crawling low under smoke.
Other major causes of
injury trauma include drowning (see the Swimming
Precautions below) and injuries to water skiers and
divers due to boat propellers. Boats equipped with propeller
guards should be used whenever possible. Wear a personal
flotation device (PFD) whenever you ride on a boat.
Travelers should also be
aware of the potential for violence-related injuries. Risk
for assault or terrorist attack varies from country to
country; heed advice from residents and tour guides about
areas to be avoided, going out at night, and going out
alone. Do not fight attackers. If confronted, give up your
valuables. For more information click
here.
Animal-Associated
Hazards
Animals in general tend to avoid human beings, but they
can attack, particularly if they are protecting their young.
In areas of endemic rabies,
domestic dogs, cats, or other animals should not be petted.
Wild animals should be avoided; most injuries from wild
animals are the direct result of attempting to handle or
feed the animals.
The bites, stings, and
contact with some insects cause unpleasant reactions.
Medical attention should be sought if an insect bite or
sting causes redness, swelling, bruising, or persistent
pain. Many insects also transmit communicable diseases. Some
insects can bite and transmit disease without the person
being aware of the bite, particularly when camping or
staying in rustic or primitive accommodations. Insect
repellents, protective clothing, and mosquito netting are
advisable in many parts of the world. (See the Insect
Protection section for more information.)
Poisonous snakes are
hazards in many parts of the world, although deaths from
snake bites are relatively rare. The Australian brown snake,
Russell's viper and cobras in southern Asia, carpet vipers
in the Middle East, and coral and rattlesnakes in the
Americas are particularly dangerous. Most snakebites are the
direct result of handling or harassing snakes, which bite as
a defensive reaction. Attempts to kill snakes are dangerous,
often leading to bites on the fingers. The venom of a small
or immature snake may be even more concentrated than that of
larger ones; therefore, all snakes should be left alone.
Fewer than half of all
snake bite wounds actually contain venom, but medical
attention should be sought any time a bite wound breaks the
skin. A pressure bandage, ice (if available), and
immobilization of the affected limb are recommended first
aid measures while the victim is moved as quickly as
possible to a medical facility. Specific therapy for
snakebite is controversial, and should be left to the
judgment of local emergency medical personnel. Snakes tend
to be active at night and in warm weather. As a precaution,
boots and long pants may be worn when walking outdoors at
night in snake-infested regions. Bites from scorpions may be
painful but seldom are dangerous, except possibly in
infants. In general, exposure to bites can be avoided by
sleeping under mosquito nets and by shaking clothing and
shoes before putting them on, particularly in the morning.
Snakes and scorpions tend to rest in shoes and clothing.
Anthrax-Contaminated
Goatskin Handicrafts
Anthrax is a disease caused by a bacterial organism that
produces spores that are highly resistant to disinfection.
These infectious spores may persist on a contaminated item
for many years. Anthrax spores have been found on goatskin
handicrafts from Haiti. Travelers to Caribbean countries are
advised not to purchase Haitian goatskin handicrafts.
Because of the risk, importation of goatskin handicrafts
from Haiti is not permitted at U.S. ports of entry; such
items will be confiscated and destroyed.
Swimming
Precautions
Swimming in contaminated water may result in skin, eye,
ear, and certain intestinal infections, particularly if the
swimmer's head is submerged. Generally for infectious
disease prevention, only pools that contain chlorinated
water can be considered safe places to swim. In certain
areas, fatal primary amebic meningoencephalitis has occurred
following swimming in warm dirty water. Swimmers should
avoid beaches that might be contaminated with human sewage
or with dog feces. Wading or swimming should be avoided in
freshwater streams, canals, and lakes liable to be infested
with the snail hosts of schistosomiasis
(bilharziasis) or contaminated with urine from animals
infected with Leptospira.
Biting and stinging fish and corals and jelly fish may be
hazardous to the swimmer. Never swim alone or when under
the influence of alcohol or drugs, and never dive head first
into an unfamiliar body of water.
See the sections on Safe
Food and Water and on Diseases
for more information about waterborne diseases such as schistosomiasis,
E. coli, leptospirosis,
and cryptosporidiosis.
Emerging
Infectious Diseases
Emerging infectious diseases are diseases of infectious
origin whose incidence in humans has increased within the
past two decades or threatens to increase in the near
future. Many factors, or combinations of factors, can
contribute to disease emergence. New infectious diseases may
emerge from genetic changes in existing organisms; known
diseases may spread to new geographic areas and populations;
and previously unknown infections may appear in humans
living or working in changing ecologic conditions that
increase their exposure to insect vectors, animal
reservoirs, or environmental sources of novel pathogens.
Reemergence may occur because of the development of
antimicrobial resistance in existing infections (e.g.,
gonorrhea, malaria,
pneumococcal disease) or breakdowns in public health
measures for previously controlled infections (e.g., cholera,
tuberculosis,
pertussis).
For current outbreak bulletins on diseases of concern for
international travelers, check the Outbreaks
section or call the CDC Travelers' Health hotline at
1-877-FYI-TRIP (1-877-394-8747).
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Travel Health: Making Travel Safe