Tuesday, June 4, 2019

Staying Safe When Traveling With Children

TMA staff member Erin Behncke and her family explore Tokyo, Japan. Courtesy of Erin Behncke.

By Mark Shelton, MD
Pediatric Infectious Diseases and Pediatrics, Fort Worth
Member, Texas Medical Association Committee on Infectious Diseases
Summer’s here, school’s out, and it’s a great time to hit the road.

Traveling is fun, and with children, it can be a great time to make lasting family memories. However, nothing spoils a trip like an accident or illness. With a few easy precautions, your trip need not turn into a disaster for you or your kids. 

The first step to safe travel is to know where you are going, what health risks may await you, and how to best minimize those risks. Map out your destination and find out such things as: what medical care may be available, what the vaccine requirements are, and the safety of the drinking water. The Centers for Disease Control and Prevention (CDC) has an excellent website, Travelers’ Health, and a mobile app version, TravWell, that lists CDC recommended vaccines, medicines, and potential health advisories for most destinations.

Avoiding Accidents
Believe it or not, the laws of physics apply to Texans on vacation! If not properly restrained, momentum will carry an adult or child traveling in a car through the windshield. Wear your seatbelts – even in a cab or a ride-sharing vehicle.

Just as your mother told you when you were little, look both ways before crossing the street – particularly if the drivers in the country you’re visiting drive on the left side of the road. This applies to people coming to the U.S. as well. There is a famous story about Winston Churchill looking the wrong way when crossing a street in New York City and spending months in a hospital.  

TMA staff member Debra Heater and her family at the
beach in Destin, Florida. Courtesy of Debra Heater
Accidents are one of the biggest health risks to Americans abroad. So, heads up, eyes open, and buckle up. Don’t forget car seats if appropriate for your child’s age and weight. Be smart and think before you do something you will regret later – especially on those popular new electric scooters!

Drowning is a leading cause of death among children and teens worldwide, so even on vacation, be sure to practice good water and swimming safety. Never leave children unattended near bodies of water (including small pools and spas), even for a moment, and be sure to put life jackets on children while on a boat. Choose swimming locations with a lifeguard on duty, and never allow children to swim alone in open water.

Food (and Drink) For Thought
Watch what you eat and drink. Nothing can spoil a trip abroad like five days of diarrhea. Be cautious in buying foods from street vendors and restaurants that appear to be unsanitary. The old adage of “cook it, peel it, or boil it, or forget it” is still great advice. This goes for water as well.

Bottled water and bottled drinks may be safer than public water supplies, but that is not always the case. Check the seal of your purchased bottled drinks. It is also important to make sure that if traveling with an infant and mixing formula, that a safe supply of water is available. If unsure, boil the water first. The CDC’s Can I Eat This? mobile app allows travelers to input the foreign food and drink they may be considering to help determine whether or not it’s safe for consumption.

A travel physician (a physician specialized in travel-related medicine) may prescribe antibiotics for diarrhea, depending on your trip. Mild diarrhea can be treated with bismuth salts like Pepto-Bismol, but prevention is best.


Be Wise, Immunize

TMA staff member Helen Kent Davis with her husband and
son in Spain. Courtesy of Helen Kent Davis
The most important travel vaccines for children are their routine vaccines. For the most part, and for most destinations, if children are up-to-date on their routine schedule, they may not need any additional vaccines. Depending upon where you are traveling and the child’s age, they may need vaccines for yellow fever, typhoid, hepatitis A, or meningitis. There may also be a resurgence of vaccine-preventable diseases at your destination, such as the recent measles outbreak in different states in the U.S. and other countries. This requires travelers to check that they are fully vaccinated against these highly-infectious diseases.

Most countries in the world do not have any vaccine requirements to visit. However, there are numerous countries that require yellow fever vaccine and a certificate when traveling from another country where yellow fever exists.

TMA staff member Amy Sorrel and her
husband in Byblos, Lebanon.
Courtesy of Amy Sorrel
Check with your travel medicine physician to determine what out of the ordinary vaccines might be needed depending on your destination. It is best to do this at least one or two months prior to travel, in order to have enough time to obtain an appointment, receive the vaccines, and for the vaccines to take effect – which usually occurs about two weeks after immunization.

If travel takes you to an area of the world where there is endemic malaria (mostly Central America and central Africa), it is important to take malaria prophylaxis. Multiple medication options are available. It is also important to have protection against mosquitoes, such as topical sprays or lotions which contain an EPA-approved repellant such as DEET.

Plan ahead, be prepared, and have a safe trip. When in doubt, consult your primary care or travel medicine physician.

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