Travel in Good Health – Part 3 of 3

26 07 2014

Babies and small children are less able to fight off foodborne and waterborne infections. Little ones who are crawling or walking around and putting things in their mouths increase their exposure risk.

What comes from those infections? Yes, you knew we had to get there. We’re talking poo. The kind that makes you want to pay strangers good money to change an oozing diaper.

But, there are a few things we can do to help prevent the big D.

Breastfeeding helps eliminate foodborne and waterborne transmission to infants.

Use purified water for drinking, ice cubes, formula, brushing teeth, washing food if eating food raw, or just anytime you’d use water. Purify the water, unless you know the water source is safe.

Wash hands with soap and water frequently each day and certainly before eating anything and before preparing foods, after changing diapers, after going to the restroom, after coming in from outdoor activities (this includes shopping!), when you get up in the morning and before going to bed at night. Use soap and water if available and always when you can see any grime on the hands. Alcohol-based hand sanitizer can be used to help disinfect your hands.

Pacifiers and other items made to go into a baby’s mouth that you bring or buy on the trip need frequent cleaning.

Don’t eat food from street vendors. Make sure all your food is either cooked thoroughly or washed with purified water and, if applicable, peeled.

Dehydration due to diarrhea and vomiting

Infants and young children can easily become dehydrated due to diarrhea and vomiting. They need plenty of liquids each time they have a watery stool or vomit. If you’re unaware of the signs of dehydration, you should read up on it prior to departure. Prevention is the best thing, but just in case, there are commercial oral rehydration solutions, or you can make your own. Here are some suggestions from rehydration.org:

Make sure the rehydration drink has in it starches and/or sugars, a little sodium and some potassium. Breastmilk is great for those nursing, or watery cooked cereal, carrot soup, or rice water is fine as long as they’re made with purified water.

You can make a simple solution yourself by using salt and sugar (molasses, raw sugar or white sugar) and something like orange juice or mashed banana for potassium. Add one teaspoon of salt to eight teaspoons of sugar and stir into a liter of boiled and cooled water, stirring until everything is dissolved.

Fresh fruit juice, weak tea or even simply boiled and cooled water will help, if nothing else is available.

Parasites in the soil

There are parasites in sand and soil where children love to play. They should wear enclosed footwear and play on a tarp or covering. Don’t put clothing or towels on the ground to dry, and iron anything you hang out to dry before using. All of these precautions are dependent on your destination, of course.

Rabies

Children are more likely to be bitten by animals yet less likely to tell parents about the bite. Remind the children to stay away from animals and to report any wound immediately. If a child is bitten or wounded, wash the area with soap and water and take the child in for evaluation. If possible, bring the animal in as well.

Water and infectious agents

Children and adults can pick up illnesses or infections by swallowing or simply being in contact with contaminated water. If you don’t know the area, don’t swim in fresh, unchlorinated water and, depending on where you travel, be careful with washing in the bathtub.

Well, that’s about it. We’ve come to the end of our Travel in Good Health series. Hope you enjoyed it as much as we did and, hey, maybe we’ll meet you on the road somewhere and do some trading. Ten diapers for a barf bag?  Anybody?

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Travel in Good Health – Part 1 of 3

24 07 2014

[Editor’s note: We posted this a few years ago, but find the info timely, so what the heck, we’re running it again! Parts 2 and 3 run 25 and 26 July.]

Traveling with children, no matter their age, can be a joyful, tiring, exciting, and exhausting endeavor. Traveling with children who get sick on the trip is just plain exhausting and, sometimes, exciting in a way that we don’t want to experience.

Although dealing with illness in the midst of a family trip isn’t ideal, you can take steps to prevent illness before traveling and equip yourself with supplies to make the treatment of illness easier and more comforting.

Prevention is key, and no one does that better than the CDC. This article captures some tips for traveling families from CDC’s website, and a few other places.

If anyone in your travel group has an existing condition that may affect his or her health, it’s important to discuss travel health safety with a healthcare provider.

If you’re traveling outside the United States and you love detail, download a copy of CDC’s Yellow Book . It’s written for healthcare providers, but many people find it useful. Wherever you’re traveling, these suggestions may help you and yours avoid infectious diseases on the road.

There are steps you can take prior to departure that will protect you and your kids, and many things you can do while traveling. First, the pre-departure list:

Time Zones and Rest

If you’re changing time zones, spend a few days just before travel adjusting your sleep/wake periods to match the destination’s time zones. When you arrive, get out during the sunny periods so that you body realizes it’s time to be awake. Good sleep is critical to good health. Make sure everyone gets lots of rest a few days before and then during the trip.

Vaccinations

You and your kids should be up-to-date on currently recommended vaccines in the U.S.

If you’re traveling outside the United States, you need to check the destination country for recommended vaccines for you and your children, and if you have special health concerns, you need to determine which vaccines to get and which you should not have. Not all vaccines recommended for international travel are licensed for children.

Health Notices

If you’re traveling outside the U.S., read the CDC’s Health Notices first to get the latest updates on infectious diseases in various areas of the world. What you learn may affect your travel plans.

First Aid Kits

Prepare a first aid kit for the trip or purchase one from a commercial vendor. This is a sample list, as not all destinations require the same things.

  • 1% hydrocortisone cream
  • Ace wrap
  • Acetaminophen, aspirin, ibuprofen, or other medication for pain or fever
  • Address and phone numbers of area hospitals or clinics
  • Adhesive bandages
  • Aloe gel for sunburns
  • Antacid
  • Anti-anxiety medication
  • Antibacterial hand wipes (including child-safe) or alcohol-based hand sanitizer containing at least 60% alcohol
  • Antibacterial soap
  • Antibiotic for general use or travelers’ diarrhea (azithromycin, cefixime)
  • Antidiarrheal medication (e.g., bismuth subsalicylate, loperamide)
  • Antifungal and antibacterial ointments or creams
  • Antihistamine (such as Benadryl)
  • Antimalarial medications, if applicable
  • Anti-motion sickness medication
  • Commercial suture/syringe kits (to be used by local health-care provider with a letter from your prescribing physician on letterhead stationery)
  • Cotton-tipped applicators (such as Q-tips)
  • Cough suppressant/expectorant
  • Decongestant, alone or in combination with antihistamine
  • Diaper rash ointment
  • Digital thermometer
  • Epinephrine auto-injector (e.g., EpiPen), especially if anyone has a history of severe allergic reaction. Also available in smaller-dose package for children.
  • First aid quick reference card
  • Gauze
  • Ground sheet (water- and insect-proof)
  • High-altitude preventive medication
  • Insect repellent containing DEET (up to 50%)
  • Latex condoms
  • Laxative (mild)
  • Lice treatment (topical)
  • Lubricating eye drops
  • Malaria prophylaxis and standby treatment, as required by itinerary
  • Medications that the child has used in the past year
  • Moleskin for blisters
  • Mosquito netting, if applicable
  • Oral rehydration solution (ORS) packets
  • Personal prescription medications in their original containers (carry copies of all prescriptions, including the generic names for medications, and a note from the prescribing physician on letterhead stationery for controlled substances and injectable medications)
  • Safe water
  • Scabies topical ointment
  • Sedative (mild) or other sleep aid
  • Snacks
  • Sunscreen (preferably SPF 15 or greater)
  • Throat lozenges
  • Tweezers
  • Water purification tablets

Discuss with your family’s pediatrician any special needs your children might have that require you to prepare beyond this basic list. Also, your pediatrician may be able to give you sample sizes of antibiotics and other meds that may be useful for your kit.

Health Insurance

Before traveling, check your health insurance policy to see what it pays for. It will probable reimburse you for most of the cost of emergency medical care abroad, excluding any deductible or co-payment. For non-emergency care overseas, you may be covered, but check with your health plan about this before you leave home. Failure to get authorization may mean denial of reimbursement.

Travel Regulations

Check travel regulations and carry what you can onboard the plane, particularly prescription medication. Put the rest in your checked baggage. Put your first aid kit in a fanny pack or backpack that you take with you everywhere you go. There’s no sense bringing the kit if you don’t have it when you need it.

Now that you’ve done your pre-departure prep, stay tuned for Part 2 for some tips on problems you may encounter on the road.

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Vaccine Education Center

28 04 2011

Dr. Paul Offit, Director, VEC

The science of vaccines can be . . . daunting. The lists of ingredients and potential side effects make us want to second guess ourselves and our children’s providers. We need to be sure we’re making safe choices.

And the complicated schedules! They’re enough to make sane people pound their heads.

The folks at the Vaccine Education Center (VEC) at Children’s Hospital of Philadelphia have a gift for presenting the complexities of vaccines and attending issues in a way that’s easy to understand yet comprehensive in scope.

The VEC website has a special section for parents and adults of all ages.  While there, you can sign up for the Parents PACK newsletter to get monthly immunization updates.  In the March issue, there’s a timely post on measles and the dangers of rubella parties.

You’ll also find age-specific information on vaccines and the diseases they prevent. There are FAQs, but if you can’t find your question, you can send it in via a form provided on the site.

The VEC has created a library of educational materials on specific vaccines and commonly asked questions. These resources range from information sheets to more consumer-friendly bookmarks and brochures.

They also maintain essential tools, including vaccine schedules, facts about vaccine preventable diseases, and the latest in vaccine science.

To keep information fresh, the VEC pens a monthly “Ask the VEC” on a myriad of topics.

Starting in 2011, the VEC will present three or four webinars a year addressing evolving issues, recent ACIP meetings, new science and media reports.

There are layers and layers of information available on the website, for those of us who feel more is better.  And what parent doesn’t?

The VEC staff constantly works at sifting vaccine fact from fiction and explaining the difference in ways we can all understand.  If you have questions, they’re worth checking out.





Sand, Surf, and What?!

25 04 2011

Kids love to dig in the sand and build castles. They’ll work for hours, crafting structures of dizzying heights, sculpting the turrets and drawbridges just so with their hands.

Oh, and getting buried in the sand? Even better.

Turns out, all that digging and getting buried can expose kids to lots of germs.  Researchers found “… evidence of gastrointestinal illnesses, upper respiratory illnesses, rash, eye ailments, earache and infected cuts. Diarrhea and other gastrointestinal illnesses were more common in about 13 percent of people who reported digging in sand, and in about 23 percent of those who reported being buried in sand.”

Just makes your skin crawl, doesn’t it?  Before you give up on the beach, know that there are things we can do to combat the germs.

Tell the kids they can play in the sand, but not to touch their faces with sandy hands, and make sure they clean their hands with soap or sanitizer when they’re done playing.  Also, send them to scrub down in a shower as soon as possible after play.  There’s no guarantee they’ll avoid an infection, but it’ll help.

Kids (and adults) love to swim in pools, lakes, and oceans. We’re usually swimming in urine,  garbage, or who knows what contaminants.  Due to the reality of raw sewage runoff, we could come down with all sorts of infections, including E. coli, after practicing the backstroke.

Blech, but hey, everything carries a risk. There’s no guarantee we’ll get sick or we won’t get sick from swimming.

So go. Swim. Enjoy and shower when you’re done.

Life is too short not to have fun on vaca!

(Photo from dMap Travel Guide)





Meningitis: A College Memory You Don’t Want

21 04 2010

Going away to school is a lifechanging experience. For many students, four years disappear into a haze of studying, working, and partying with their classmates. It’s a chaotic time where everything is shared: space, feelings, clothes, cars, and germs.

When a meningitis outbreak shows up in the news, it’s a good bet that it showed up at a school. Any shared spaces like schools, dorms, or barracks where crowds of young adults converge are favorite territories for bacteria and viruses to spread.

Meningitis, a serious but rare infection, is an inflammation of the membranes covering the brain and spinal cord. It affects about 1,500 Americans each year.

Meningitis is commonly mistaken for the flu in its early stages, and therefore left untreated. When this happens, it can do a lot of damage within hours, sometimes causing confusion, seizures, and brain damage. Survivors are often left with amputated limbs—permanent reminders of their experience.

So what does meningitis act like and why are colleges a prime environment for it?

Most meningitis patients complain of excruciating headaches, unyielding fevers, nausea, and vomiting. Sound like just a bad case of the flu? More telling are other symptoms, which include stiffness and pain in the neck (due to the swelling around the spinal cord and brain), sensitivity to light, numbness or loss of sensation in limbs, rashes, mental confusion, and convulsions and seizures.

Most at risk are college students. Busy, exhausted, and stressed students often have lowered immune systems. A wide variety of lifestyles and health choices create a melting pot of germs, especially when bathrooms and eating areas are shared. Meningitis is spread through contact with an infected person’s bodily fluid: a shared cigarette or drink, a kiss, a cough. It’s possible to carry a germ that causes meningitis and never be sick, while unknowingly passing it on to someone else. There are lots of ways to spread it.

Many such infections could be prevented with vaccination. Some schools are now requiring proof of vaccination; others only provide information about meningitis. Before heading off to college, make sure you’re protected and know what the warning signs are. Parents, if you’re reading this, make sure your son or daughter is protected before they leave you.  It could be the most important going-away gift you give your child.

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Flu Season Roundup and the Importance of Annual Vaccination

19 04 2010

By Laura Scott, Executive Director of Families Fighting Flu

If you are like most parents, you’ve had a lot of questions this flu season, like: What exactly is the flu? Why do we need to get vaccinated against the flu every year? If my child or I received the H1N1 flu vaccine this year, do we need to get vaccinated again next season?

Courtesy Retrofuturs

Influenza (or “the flu”) is often mistaken for the common cold.  But, the flu is not a bad cold or a stomach bug.  Rather, it’s a serious virus that claims the lives of nearly 100 children younger than five years of age in the U.S. annually, and more than 20,000 children under the age of five are hospitalized every year.

Since April 2009, the CDC has received reports of 337 laboratory-confirmed pediatric deaths from influenza.  However, unlike seasonal influenza where younger children under the age of five are typically most affected, 71 percent of this season’s pediatric deaths from H1N1 influenza occurred in school-age children, ages five to 17 years.

Annual vaccination is the single best way to help prevent illness and death caused by influenza in people of all age groups.  As of the end of February 2010, between 72 and 81 million people—more than 30 percent of children and nearly 20 percent of adults—were reported as being vaccinated against H1N1 in the U.S.  That’s good, but not good enough.  In order to help slow and ultimately stop the spread of the virus, more people, especially children, need to get vaccinated.

This year, we’ve seen H1N1’s path of destruction across the globe, and it continues to be the dominant strain of influenza.  In fact, more than 213 countries and territories have reported laboratory-confirmed cases of H1N1, resulting in more than 17,700 deaths worldwide.  Although this number is less than what we typically see in an average flu season in the U.S. (36,000 deaths), it is still a large number, representing lives lost to a vaccine-preventable illness.

It’s important to understand why people need to get an annual flu vaccination. Most years, the strains of flu virus that spread throughout the world change genetically.  When that happens, the previous year’s flu vaccine may not be effective.

Therefore, every February, the Vaccines and Related Biological Products Advisory Committee advises the Food and Drug Administration on which flu strains to include in the next season’s vaccine.

The selection of the flu strains is made early in the year. This gives flu manufacturers time to make enough vaccine for the upcoming flu season.  The manufacturers need a good length of time to produce the vaccines because it takes a while to grow vaccines in eggs, which is currently the only licensed method for making flu vaccines.

It is worth noting that the 2009 H1N1 strain was a separate vaccine this flu season because the pandemic strain didn’t rear its ugly head until last April, which by then was too late to be included in the seasonal vaccine.

Each year, the vaccine is comprised of three different strains to help protect people against the most common types of influenza viruses circulating around the world for that particular year.  Flu vaccines typically contain two “A” strains and one “B” strain.

Based on global surveillance data and the World Health Organization’s recommendation, the following three strains will be included in the flu vaccines (shot form and nasal spray) for the 2010-2011 U.S. season:

  • an A/California/7/09 (H1N1)-like virus
  • an A/Perth /16/2009 (H3N2)-like virus
  • a B/Brisbane/60/2008-like virus

The 2009 H1N1 strain that people got vaccinated against this season will be in next flu season’s vaccine.  But, even if you got vaccinated against the H1N1 strain, you still need to get vaccinated again next season because now that strain will be part of the seasonal flu vaccine, which includes two other strains of flu virus.

So, what will next flu season bring in the way of disease?  Generally, we can gauge what the U.S. flu season will be like next season from looking at flu trends in the Southern Hemisphere, where the winter flu season starts in April or May.  Based on what we’re seeing right now, I expect that H1N1 will continue to be the dominating strain during the 2010-2011 flu season in the U.S.  In fact, until a large majority of the population gets vaccinated, the strain is likely to continue to circulate on a global scale.  Once enough immunity has been built over the next several years, the virus will begin to act more like a seasonal strain.

Now for the question of who should get vaccinated against the flu each year.

Just this past February, the CDC’s Advisory Committee on Immunization Practices voted for universal influenza vaccination, which means everyone 6 months and older should get vaccinated against the flu starting with the 2010-2011 flu season.  The important thing to remember is, in order to safeguard our children from this serious virus, everyone must do their part by getting vaccinated, because prevention from the flu is only as good as the number of people who actually get vaccinated.

To drive awareness about the seriousness of influenza and the importance of getting an annual vaccination, Families Fighting Flu (FFF) leads educational campaigns, including its most recent campaign called Be a Flu Free Family, which was launched in January during National Influenza Vaccination Week.  The multi-pronged campaign included:

  • An original animation, which provides a six-year-old boy’s perspective on why it’s important for his whole family to be vaccinated against the flu, as well as a fun downloadable coloring book with scenes from the animation to help parents talk to their kids about how to stay protected against the flu
  • Audio and video podcasts with Families Fighting Flu members
  • A WebEx for media with the U.S. Department of Health and Human Services and the CDC

For more information on influenza and FFF, visit www.familiesfightingflu.org.

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Haitian Children in Need

12 04 2010

Why are our most vulnerable so often our least protected?

Haitian pastor Jean Guillaume, determined to help the children of Haiti, moved some orphans to a mountainous region outside of Port-au-Prince to save them from that city’s sexual predators, thugs, and imminent flooding. About 200 children will live in his tent encampment, but without funds, it’s hard to say how long he can keep them sheltered, fed, and out of harm’s way.

Courtesy Marco Dormino

Those 200 children are, for now, the lucky ones. They have a temporary reprieve from the daily fear they felt in Port-au-Prince, and from the floodwaters that will soon hit the capital’s tent cities.

Various governing bodies from around the world, including the United States and the European Union, have pledged $9.9 billion in aid to Haiti. More than half of that will be laid out over the next 18 months to rebuild Haiti’s infrastructure, reform the agriculture industry, and rebuild hospitals, schools, and government buildings. The projects will also provide jobs for thousands who are out of work.

This is good news, in a 30,000 foot level sort of way. But, we’re still left with the vulnerable—those who in any society should not be expected to care for themselves—the children.

Almost half of Haiti’s population is under the age of 18.

The children of Haiti are psychologically and physically worn down. What do they need right now? They need to feel safe again. They need to be safe again. They need three square meals a day, shelter from the storms, working toilets and running water, an education to lift them out of illiteracy and poverty, and someone to tuck them in at night.

This is an opportunity for Haitians and the world community to change the status quo in in this weary land.

Find reputable agencies that have been working in Haiti for several years and give money to them, directing that your donations be put to use in Haiti. It’s easy to pass off tragedy of this scope as a societal or governmental problem, something that can’t be solved by you or me, but ask any changemaker what it takes. He or she will tell you that it takes one person, or a small group of friends, or a family, to decide. That’s it, they just have to decide, and then they do.

We’ve decided to make a habit out of Haiti this year. We hope you do the same.

We’ll post any stories or pictures you have about your Haiti habit. It’s going to be a great year.

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