A shot in the arm for travel

Before they ever stepped on the plane to Tanzania in January, Linda and Chuck Blaksmith got their shots. Yellow fever. Hepatitis A and B. Tetanus. Polio booster. Typhoid. A flu shot. They packed antibiotics, Imodium and Pepto-Bismol. They started their anti-malaria pills.

Then the Michigan couple flew off and had a fabulous time on safari. "I can't imagine what would top this wonderful experience," Linda Blaksmith said.

Despite the recession, the overall trend in the world is that more people than ever are traveling abroad. More than 903 million people traveled internationally in 2007, according to the United Nations World Travel Organization, compared with 457 million in 2004. By 2020, the number is expected to be 1.6 billion. That means more people enjoying themselves in every corner of the globe -- including spots where exotic diseases and health nuisances flourish.

But researchers say that many travelers don't take precautions seriously -- particularly people who are going back to the country of their birth to visit relatives or friends and assume they're immune.

Many travelers don't get shots

The World Health Organization estimates that only 34 percent of Americans visiting areas high in hepatitis A get immunized. Only 8 percent of international travelers to malaria-prone countries take pills to prevent it. As many as 30,000 travelers come down with malaria each year.

There also are lesser-known illnesses causing problems in parts of the world.

Chiku-what? Turns out it's a virus spread by mosquitoes, similar to Dengue fever, that is found in Africa and parts of Asia -- with current outbreaks in Indonesia, Malaysia, Singapore, Sri Lanka and even Italy. Flu-like reactions, rash and joint pain are symptoms. There is no immunization for it -- you protect against it with strong mosquito repellent.

However, of all the things to worry about while traveling, Chikungunya fever probably shouldn't be at the top of your list. Worry more about travelers' diarrhea, by far the most common travel illness.

A survey by the GeoSentinel Surveillance Network, which estimates the risk of illnesses in various parts of the world, found that 60 percent of all visitors to developing countries get travelers' diarrhea because of bad bacteria in food and drinks, no matter how many precautions they take

Don't let fear keep you home

Along with travelers' diarrhea, mishaps most likely on a trip are sunburn, jet lag, motion or altitude sickness, respiratory infections and accidents.

And the main cause of death while traveling? A pre-existing health problem like heart disease.

So he doesn't want to scare off travelers from their adventures.

"I've not seen yellow fever," he says. "I have about five or six patients a year with malaria."

On the other hand, if pressed, he admits he's seen some unusual cases -- from a patient with a weird parasitic disease caused by eating unpasteurized cheese to a traveler who contracted rabies from a puma bite.

When people travel, diseases travel, too. Think SARS. HIV. TB. Flu. Colds. Meningitis.

Band points out that not all travel illnesses come from exotic countries -- Martha's Vineyard, the upscale vacation island in Massachusetts, has a high risk of Lyme disease, for instance.

But fewer than half of travelers get pre-trip counseling and advice, and very often, they receive the wrong advice, says Band. He'd like that to change.

"I spend a lot of time talking people out of immunizations they don't need. So many people treat travel medicine like it's a cookbook -- you find online what you need. But it needs to be personal," depending on the traveler's age, health conditions, he says.

The other thing that worries him is that physicians back home may not bother to ask a sick patient if they've been out of the country recently, which is critical in correctly diagnosing illnesses like malaria or hepatitis that have been picked up abroad.