Travel Well

Ask the Nurse

traveler ventures into a snake cave on the Indonesian island of Flores and is bitten by an angry python while standing waist-deep in bat guano. An old Indiana Jones plot? Nah, it’s just one true-life challenge deftly handled by Karen Barry, the unflappable nurse for the National Geographic Society. From HQ in Washington, D.C., Barry is charged with keeping explorers safe and free of disease in every corner of the globe, from Papua New Guinea to the jungles of Peru. Here she answers your travel wellness questions.

I just booked a safari/Amazon boat trip/Himalaya expedition. Now what? Visit a travel medicine clinician at least one month prior to departure. A consultation will include risk assessment, which takes into account your exact itinerary—specific cities, types of accommodations, seasons, style of travel.

I love street food, but it doesn’t always love me. How can I avoid Delhi belly (traveler’s diarrhea)? Remember the golden rule about food: Boil it, peel it, cook it—or forget it. Wash hands often, and carry hand sanitizer. Don’t eat raw veggies washed in water or anything in which water has (or may have) been added, such as juices or fruit sold by weight. Still, you may get diarrhea anyway. Before leaving, ask your physician for an antibiotic. If meds don’t help, you could have a parasite and should report symptoms to a doctor.

How can I stay malaria-free? Mosquitoes feed from dusk to dawn. Stay in well-screened areas, use insecticide-treated bed nets, and cover up. Travel clinicians can identify which medications are effective in the specific areas you’re visiting, as resistance to some drugs has developed in parts of the world. Bring a map of where you’re going. No detail is too small.

I have itchy bug bites, and my knees hurt. Do I have malaria? Probably not, but it’s true that joint pain can be a warning sign of malaria. Same with flu-like symptoms, fever, headache, and fatigue. Symptoms can develop as early as seven days after exposure to the Anopheles mosquito bite. Severe cases can cause seizures, mental confusion, kidney failure, coma, even death—so report any concerns immediately.

How do I deal with motion sickness? Stay away from alcohol and heavy, spicy, or fatty foods before and during travel; avoid strong odors; find a part of the plane or boat that’s less bumpy, like the area over the wing on an aircraft. Low cabins near the center of the vessel generally rock less. Bonine helps and is sold over the counter.

What about altitude sickness? Climb high, sleep low, and rest every couple of days. Avoid alcohol, stay hydrated, and eat a high-carb diet. Start out slow. Treat headaches with over-the-counter nonaspirin painkillers. And never ascend with symptoms.