You've booked airline tickets, bought new clothes, hired a petsitter and read up on things to do in your exotic travel destination. You feel prepared for your upcoming trip ... but are you?

Not if you haven't consulted with a travel health physician about immunizations and other precautions you may need to ensure a fun-filled and healthy trip, says Mashiul Chowdhury, M.D., Director of Drexel University College of Medicine's TravelHealth Center and Assistant Professor, Division of Infectious Diseases and HIV Medicine.

Listen to Dr. Chowdhury's Medcast on travel health

"International travelers are often exposed to parasitic, viral and bacterial diseases that are uncommon in the United States," says Dr. Chowdhury, an expert in infectious diseases and tropical medicine. "In addition, changes in food, water, climate and altitude can cause illness in the traveler."

According to the U.S. Centers for Disease Control and Prevention (CDC), diarrhea is the most common travel illness, affecting 20-50% of international travelers each year -- an estimated 10 million individuals. People at particularly high risk include those with inflammatory bowel disease, diabetes or suppressed immune systems, as well as individuals taking acid suppressors, such as Pepcid or Tagamet, or antacids.

"By taking the proper precautions, you should be able to enjoy your trip in good health," says Dr. Chowdhury.

Drexel University College of Medicine's TravelHealth Center provides travel health planning for individuals and groups, including schools, missions, and other organizations. "Our Center is staffed by knowledgeable specialists who have firsthand experience in treating infectious and tropical diseases in developing countries," notes Dr. Chowdhury. A travel health physician conducts a comprehensive review of each individual's travel itinerary and medical history, and provides personalized recommendations for effective healthcare precautions to optimize disease prevention.

"During the itinerary review, we cover every site the traveler may visit and provide advice regarding disease outbreaks and preventative measures," notes Dr. Chowdhury. "If a traveler is going to China, for example, and plans to stay in the city, he or she would not be at high risk for malaria. But if the person decides on the spur of the moment to take a side trip to a rural area, the risk of being bitten by a malaria-carrying mosquito increases dramatically. We try to anticipate every possible stop on the trip to ensure that the individual has the necessary medications to be protected from disease."

Dr. Chowdhury notes that malaria is prevalent in developing countries, and that many people don't realize that the disease has numerous strains. "Some are resistant to certain antibiotics," he explains. "We have the expertise to recommend the most appropriate anti-malaria drug for prevention in the area where they will be traveling."

Travelers participating in mission trips could be at higher risk of contracting some diseases if their mission work involves direct contact with infected individuals. Southeast Asia, for example, is a high-risk area for tuberculosis. In Angola, an outbreak of Marburg virus hemorrhagic fever (VHF) was reported last year. However, no cases have been exported to any other countries or even beyond the region where it initially occurred. According to the CDC, the likelihood of contracting any VHF, including Marburg, is considered extremely low unless the traveler has direct contact with the blood or body fluids of an infected person or animal.

With some diseases, the best prevention is immunization before travel. Drexel University College of Medicine's TravelHealth Center is certified as an official yellow fever vaccination center, and provides immunizations for hepatitis A, hepatitis B, Japanese encephalitis, MMR (measles/mumps/rubella), meningitis, polio, rabies and typhoid, which are not generally available from a primary-care physician. "We can advise travelers which vaccinations are recommended or required for the area they're visiting," says Dr. Chowdhury. "We usually have such vaccines on hand, or we can obtain them within 24 hours. We also review the status of the individual's routine immunizations, such as tetanus, to make sure they are up to date."

Dr. Chowdhury notes that some immunizations and medications may not be advised for travelers who are pregnant or whose immune systems have been altered by certain health conditions or treatments such as chemotherapy or transplantation. "This is one reason that a very extensive review of the traveler's medical history is crucial," he says. "If someone is pregnant or has a history of depression or irregular heartbeat, for example, we would not prescribe certain types of anti-malaria medications, while a person who has received an organ transplant or who is immunocompromised would not be a candidate for live vaccines, like yellow fever, oral typhoid or MMR vaccinations."

For all travelers, Dr. Chowdhury recommends taking universal health precautions against infectious disease. These include frequent hand-washing, using insect repellents that contain 30% DEET, drinking only bottled or boiled water, and eating only thoroughly cooked food or fruits and vegetables you have peeled yourself. In Southeast Asia, people have been infected with avian flu from eating undercooked poultry products. As the CDC says, "Boil it, cook it, peel it, or forget it!"

In addition to infectious diseases, the TravelHealth Center advises travelers regarding health concerns such as altitude sickness. "If you're going to a mountainous area, we can prescribe medication to be taken before starting a climb," relates Dr. Chowdhury.

The TravelHealth Center provides a checklist of essential items to pack such as malaria pills, insect repellent and prescription medications. "Think about all the medications you might take over a six-month period and be sure to take a supply of each," says Dr. Chowdhury, who also advises travelers not to rely on antibiotics or other prescription medications they obtain in developing countries. "They may not be authentic or they may be expired," he says. "So be sure to take enough medication to last for the whole trip."

After the Trip

Drexel University College of Medicine TravelHealth Center physicians are also available to diagnose and treat infectious or tropical diseases that may follow you home. Malaria or parasitic infections, for example, can surface months after you return home; the first three to six months is the most critical time.

If you become ill with a fever or flu-like illness after visiting a malaria-risk area, seek immediate medical attention and tell your physician where you have traveled. "The physician can perform a simple test called a malaria smear that provides an immediate diagnosis," advises Dr. Chowdhury, who stresses the importance of quick action. "A recent CDC study showed that malaria-related death occurred most often because of a delay in diagnosis and/or treatment."

Travelers returning from Africa and Southeast Asia who develop a fever and abdominal pain could have a parasitic infection and should also consult with a physician immediately.

Dr. Chowdhury concludes, "Our goal is to help ensure the healthiest and safest travel possible."

To make an appointment at Drexel University College of Medicine's TravelHealth Center, call 215-762-6655.