Desperately needing a toilet is as close to panic as it gets when one isn't available. But toilets can be the least of your worries if you fail to take precautions when travelling.
Dr. Jay Keystone, professor of medicine at the University of Toronto is emphatic that long before you pack your bag it's prudent to obtain protection from infectious disease.
Think "booster shots" as a start. Too many people fail to get shots for diphtheria, tetanus, whooping cough and polio. Polio came close to being wiped until Nigeria removed the vaccine due to worries that it was contaminated with the AIDS virus. So it's still a risk in Africa and South Asia.
Malaria, a killer of millions, flourishes in the developing world, particularly in Africa. But even in the Caribbean you can contact malaria in Jamaica and Dominican Republic.
Dr. Keystone says that typhoid is an uncommon imported infection. But for those who immigrated to North America from a developing country and plan to return to their native land to visit relatives, it's wise to be vaccinated against this disease. Or for adventuresome types who want to wander off the usual tourist routes.
It's a rare traveller who thinks "rabies" prior to a trip. But Keystone reports that nearly 4,000 people die from rabies every year in China. The culprits are usually infected dogs. Some dogs don't have to be petted to bite. But currently this vaccine is in short supply globally.
It's tragic to succumb to a disease that should never happen. Hepatitis A is 100 times more common than typhoid and 1,000 times that of cholera and it's easily transmitted by contaminated food or the ice-cube in your drink. Most patients are ill for a couple of weeks and many experience dark urine, vomiting, fatigue and abdominal pain. But a few people also die, especially older travelers.
Hepatitis B impacts 50 million people. It results in two million deaths each year and is spread primarily by sexual contact or contaminated needles.
The vaccine Twinrix offers protection against both of these diseases.
Don't buy food from street vendors. Don't put ice in your drink and wash your hands frequently.
Even experienced travellers fall victim to Montezuma's revenge. That's why I carry an antibiotic and give myself an oral booster shot of Dukoral when I travel out of the country.
Visit Gifford-Jones' website at www.mydoctor.ca/gifford-jones
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