Your mother was right: wash your hands

A story in the San Francisco Chronicle on January 22, 2006, by David Brown reports that the best advice to avoid getting sick while abroad is to "Use insect repellent, watch what you eat and take your malaria pills."

A study published in the January 12, 2006, issue of the New England Journal of Medicine was based on interviews with patients having problems requiring treatment after they returned home to the US; it did not cover those seeking treatment abroad, nor did it cover those with symptoms not requiring treatment by a doctor.

Of those seeking treatment after a trip overseas, fever was the most common ailment, followed by diarrhea then skin problems (insect bites and hookworms). The most common causes of fever were malaria and dengue, and the most common destination of those reporting a fever was Africa. Illnesses varied greatly by geographic locations, with locations we might think of as similar showing differences in disease. Visitors to South America, for example, reported twice as many infections from leishmaniasis as those who visited Central America, and leishmaniasis was not reported by Caribbean travelers.

Other studies have found that heart attacks, strokes, and trauma (mainly auto accidents) are the main causes of death overseas, with heart disease the clear leader.

An abstract of the article is at

Spectrum of Disease and Relation to Place of Exposure among Ill Returned Travelers

The full article is available to subscribers.

Insect repellents will help with many of the fevers and skin infestations, and washing our hands frequently will help prevent diarrhea, as will washing fruits and vegetables -- in either case, be sure the water is clean. Your Civilized Explorer team recommends checking the health reports for your intended destination to see if there are any outbreaks. The US Centers for Disease Control and Prevention has a page called

Travelers' Health

with information sorted by destination, safe food and water, diseases, outbreaks, and health news around the world.

We also visit

MD Travel Health

for destination reports, illness prevention, and special needs. Finally, we have our RSS news aggregator keep watch on

World Travel Watch and report to us on disease outbreaks and other news, including violence (strikes, riots, terrorism), visa changes, and closings and delays.

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