Enjoying food and drink from different parts of the world is one of the most exciting aspects of travelling. Unfortunately, gastrointestinal infections from improperly prepared or unsanitary food is the most common illness amongst travellers leaving them travelling to the bathroom instead of enjoying their trip. Even if travellers are selective of their food choices, what is served may have been contaminated in the process of storage, preparation or handling.

Food Recommendations

• Boil it, cook it, peel it, or leave it!
• Raw food is a common source of contamination.
  • Undercooked and raw meat, fish and shellfish can carry various intestinal pathogens and should be avoided.
  • Avoid salads, uncooked vegetables, and unpasteurized milk and milk products, such as cheese.
  • Cooked food that has been allowed to stand for several hours (such as at buffets) can become contaminated and harbour bacteria. Be sure to thoroughly reheat before serving.
• Washed and peeled fruit is acceptable. Avoid fruit that you do not normally peel, such as grapes and berries.
• Food and beverages from street vendors is associated with a higher risk of illness.
• Use alcohol-based hand cleaners (with min. 60% alcohol) before eating.

Beverage Recommendations
Hygiene

• Brush your teeth with purified or bottled water
• Water may look clean but could still be polluted or contaminated. You can get sick if you inhale or swallow it while bathing, showering or swimming. Try to avoid getting water into your mouth or nose when swimming or participating in activities in freshwater (streams, canals, lakes) or water in pools or hot tubs, which may not be adequately treated.

Many travel-related diseases are spread by infected insects such as mosquitoes, ticks, fleas, or flies. Before you travel, be aware of the insects at your destination that cause disease and know their peak biting times (day or night) and high-risk areas, such as indoors vs. outdoors or rural vs. urban.

To minimize your risk, you should always take protective measures to avoid insect bites and ensure you have the appropriate preventive vaccines and/or medications.

Protect yourself from insect bites:

Cover up: Wear light-coloured, long-sleeved, loose fitting, tucked-in shirts, long pants, shoes or boots (not sandals), and a hat. In tick infested areas, you can also tape the cuffs of your pants or tuck them inside your socks, shoes or boots.

Use insect repellent on exposed skin: In Canada, insect repellents that contain DEET or Icaridin are the most effective. When used as directed, insect repellents have an excellent safety record. Repellents that contain icaridin (20%) should be the first choice for children aged six months to 12 years. Repellents containing age-appropriate concentrations of DEET should be considered as a second choice for children aged six months to 12 years.

In general, as the concentration of DEET or icaridin increases, so too does the period of bite protection. Currently, the maximum concentrations permitted for adult use in Canada are: 30% DEET or 20% icaridin. Products with less than 10% active ingredient may offer only limited protection, often 1-2 hours.

Follow the instructions by the manufacturer. Do not spray the product directly on the face or to cuts, abrasions or irritated skin. Wash your hands after application and avoid contact with lips and eyes.

Do not use products that contain both insect repellent and sunscreen. If you need to apply both sunscreen and repellent with DEET, apply the sunscreen first and let it soak into the skin for about 15 minutes, then apply the repellent.

When travelling to areas with a high risk of diseases spread by insects, reapply repellent when required. If you are being bitten but the time span noted on the label has not ended, it is recommended that you reapply the repellent.

After returning indoors, bathe or wash treated skin with soap and water. This is particularly important when repellents are used repeatedly throughout the day or used on consecutive days. Wash treated clothing before wearing it again.

Consider your accommodations: Stay in a well-screened or completely enclosed air-conditioned room. Avoid staying in poorly constructed housing such as mud, adobe, or thatch (plant stalks or foliage used for roofing) structures. Check for ticks when returning from outdoor activities, and showering within 2 hours of being in a tick-infested area reduces the risk of tickborne diseases.

Sleep under a bed net, preferably treated with insecticide: Insecticide-impregnated nets either repel or kill the insects after they land on the net. They are safe for pregnant women and children. Make sure the net is intact, with no tears. Tuck it under the mattress. Make sure it is not touching you, as you could be bitten through the net. Daytime use is recommended, especially for playpens, cribs, or strollers to protect young children. Nets treated with insecticide will be effective for several months if they are not washed.

Wear permethrin-treated clothing for greater protection: Adult clothing pretreated with the insecticide permethrin can now be purchased in Canada. Children's permethrin-treated clothing is not available since permethrin has not been proven to be safe for children. Permethrin-treated clothing is effective through several washes.

Strong sunlight and extremely hot temperatures can be dangerous to your health. Health risks are greatest for older travellers, infants and young children, those who have chronic illnesses, difficulty breathing or are physically impaired.

Sun safety tips

Dress for the weather: Wear loose-fitting, light-coloured clothing made from breathable fabric. UV-protective clothing can offer an additional level of protection.

Stay hydrated: Drink plenty of cool liquids, especially water, before you feel thirsty to decrease your risk of dehydration.

Avoid sun exposure: Wear a wide-brimmed, breathable hat or use an umbrella.

Wear sunglasses: make sure they provide protection against UVA and UVB rays.

Limit your time in the sun: Stay indoors or seek shade between 10am and 4pm. Reflections off snow, water, sand and concrete can increase the effect of UV rays. Protect yourself on cloudy days, while swimming and skiing.

Use sunscreen: Broad spectrum sunscreen with a SPF30 or greater is recommended. Choose a product that is sweat and water resistant. Apply the sunscreen liberally 30 minutes prior to sun exposure, ensuring all exposed areas are protected. Reapply every 1-2 hours, after swimming, profuse sweating or towel drying. Wait 15 minutes before applying insect repellant.

Sunburn

Sunburn is caused by overexposure to UV rays.

Spectrum	Characteristics
UV A Spectrum	Does not cause sunburn Associated with photosensitivity reactions, premature aging and skin cancer Present throughout the day Penetrates the skin deeply Passes through window glass
UV B Spectrum	Most responsible for sunburn and skin cancer Strongest between 10 a.m. and 4 p.m. Blocked by window glass

Possible symptoms of sunburn include:

 

• Red, tender skin that is warm or sensitive to the touch
• Blisters that develop hours or days later
• Peeling skin on sunburned areas several days after the sunburn

 

If you have been in the sun long enough to get a severe sunburn you may be at increased risk of heat illness. Some symptoms of heat illness are similar to sunburn so it is important to be aware of both to protect yourself.

While the symptoms are usually temporary, skin damage is cumulative throughout a person's life and can develop into serious long-term health effects, including skin cancer.

Some medications increase the risk of photosensitivity reactions. Medications that are especially concerning to travellers are some antibiotics, altitude sickness medications, blood pressure medications and anti-inflammatory medications. Talk to your pharmacist to determine if you are at risk.

Heat Illness

Heat illnesses include heat stroke, heat exhaustion, heat fainting, heat edema (swelling of hands, feet and ankles), heat rash and heat cramps (muscle cramps). Heat illnesses can affect you quickly and are mainly caused by overexposure or overexertion in the heat.

Watch for symptoms of heat illness, which include:

• dizziness or fainting
• nausea or vomiting
• headache
• rapid breathing and heartbeat
• extreme thirst (dry mouth or sticky saliva) and
• decreased urination with unusually dark yellow urine

If you experience any of these symptoms during hot weather, immediately move to a cool place and drink liquids. Water is best.

Heat stroke is a medical emergency! Call 911 or the local emergency number immediately if someone has a high body temperature and is either unconscious, confused, or has stopped sweating.