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Chapter 2 The Pre-Travel Consultation Counseling & Advice for Travelers

Travel Health Kits

Amanda W. Lee

Regardless of the destination, all international travelers should assemble and carry a travel health kit. The contents of a travel health kit should be tailored to the traveler’s needs, type and length of travel, and destinations. Kits can be assembled at home or purchased at a local store, pharmacy, or online.

A travel health kit can help to ensure travelers have supplies they need to

  • Manage preexisting medical conditions and treat any exacerbations of these conditions
  • Prevent illness and injury related to traveling
  • Take care of minor health problems as they occur

By bringing medications from home, travelers avoid having to purchase them at their destination. See Perspectives: Pharmaceutical Quality & Counterfeit Drugs later in this chapter for information about the risks associated with purchasing medications abroad. Even when the quality of medications is reliable, medications people are used to taking at home may be sold under different names or with different ingredients and dosage units in other countries, presenting additional challenges.

TRAVELING WITH MEDICATIONS

All medications should be carried in their original containers with clear labels, so the contents are easily identified. The patient’s name and dosing regimen should be on each container. Although many travelers prefer placing medications into small containers or packing them in daily-dose containers, officials at ports of entry may require proper identification of medications.

Travelers should carry copies of all prescriptions, including their generic names and preferably translated into the local language of the destination. For controlled substances and injectable medications, travelers should carry a note from the prescribing clinician or from the travel clinic on letterhead stationery. Translating the letter into the local language of the destination and attaching this translation to the original document may prove helpful if the document is needed during the trip. Certain medications are not permitted in some countries. If there is a question about these restrictions, particularly regarding controlled substances, travelers should contact the embassy or consulate of the destination country.

A travel health kit is useful only when it is easily accessible. It should be carried with the traveler at all times (such as in a carry-on bag), although sharp objects must remain in checked luggage. Travelers should make sure that any liquid or gel-based items packed in the carry-on bags do not exceed the size limits. Exceptions are made for certain medical reasons; check the Transportation Security Administration for US outbound and inbound travel (visit www.tsa.gov/traveler-information/medically-necessary-liquids; call toll-free at 866-289-9673 M–F 8 am to 11 pm, weekends and holidays 9 am to 8 pm; or e-mail TSA-ContactCenter@dhs.gov) and the embassy or consulate of the destination country for their restrictions.

SUPPLIES FOR PREEXISTING MEDICAL CONDITIONS

Travelers with preexisting medical conditions should carry enough medication for the duration of their trip and an extra supply, in case the trip is extended for any reason. If additional supplies or medications would be needed to manage exacerbations of existing medical conditions, these should be carried as well. The clinician managing a traveler’s preexisting medical conditions should be consulted for the best plan of action (see Chapter 8, Travelers with Chronic Illnesses).

People with preexisting conditions, such as diabetes or allergies, should consider wearing an alert bracelet and making sure this information (in English and preferably translated into the local language of the destination) is on a card in their wallet and with their other travel documents.

GENERAL TRAVEL HEALTH KIT SUPPLIES

Although the following is not a comprehensive list, basic items that should be considered for a travel health kit are listed below. See Chapter 8 for additional suggestions that may be useful in planning the contents of a kit for travelers with specific needs.

Prescription Medications and Supplies

  • Medications taken on a regular basis at home
  • Antibiotic for self-treatment of moderate to severe diarrhea
  • Medication to prevent malaria, if needed
  • Medication to prevent or treat altitude illness, if needed
  • Prescription glasses/contacts for people who wear corrective lenses (consider packing an extra pair of each in case lenses are damaged)
  • Epinephrine auto-injectors* (such as an EpiPen 2-Pak), especially if history of severe allergic reaction or anaphylaxis; smaller-dose packages are available for children
  • Diabetes testing supplies and insulin
  • Needles or syringes, if needed, such as for people with diabetes. Needles and syringes can be difficult to purchase in some locations, so take more than what is needed for the length of the trip. (These items will require a letter from the prescribing physician on letterhead stationery.)
  • Medical alert bracelet or necklace

*Note: Injectable epinephrine and antihistamines should always be carried on one’s person, including during air, sea, and land travel, for immediate treatment of a severe allergic reaction. Travelers with a history of severe allergic reactions should consider bringing along a short course of oral steroid medication (prescription required from doctor) and antihistamines as additional treatment of a severe allergic reaction.

Over-the-Counter Medications

  • Medications taken on a regular basis at home
  • Treatment for pain or fever (one or more of the following, or an alternative):
    • Acetaminophen
    • Aspirin
    • Ibuprofen
  • Treatment for stomach upset or diarrhea:
    • Antidiarrheal medication (such as loperamide [Imodium] or bismuth subsalicylate [Pepto-Bismol])
    • Packets of oral rehydration salts for dehydration
    • Mild laxative
    • Antacid
  • Treatment for upper respiratory tract discomfort:
    • Antihistamine
    • Decongestant, alone or in combination with antihistamine
    • Cough suppressant or expectorant
    • Cough drops
  • Anti-motion sickness medication
  • Mild sedative or sleep aid
  • Saline eye drops
  • Saline nose drops or spray

Basic First Aid Items

  • Disposable latex-free gloves (≥2 pairs)
  • Adhesive bandages, multiple sizes
  • Gauze
  • Adhesive tape
  • Antiseptic wound cleanser
  • Cotton swabs
  • Antifungal and antibacterial spray or creams
  • 1% hydrocortisone cream
  • Anti-itch gel or cream for insect bites and stings
  • Aloe gel for sunburns
  • Moleskin or molefoam for blister prevention and treatment
  • Digital thermometer
  • Tweezers**
  • Scissors**
  • Safety pins
  • Elastic/compression bandage wrap for sprains and strains
  • Triangular bandage to wrap injuries and to make an arm or shoulder sling
  • For travel to remote areas, consider a commercial suture kit
  • First aid quick reference card

**Note: If traveling by air, travelers should pack these sharp items in checked baggage, since they could be confiscated by airport or airline security if packed in carry-on bags. Small bandage scissors with rounded tips may be available for purchase in certain stores or online.

Supplies to Prevent Illness or Injury

  • Antibacterial hand wipes or an alcohol-based hand sanitizer, containing ≥60% alcohol
  • Insect repellents for skin and clothing (see the Protection against Mosquitoes, Ticks, & Other Arthropods section earlier in this chapter for recommended types)
  • Bed net (if needed, for protection against insect bites while sleeping)
  • Sunscreen (≥15 SPF with UVA and UVB protection)
  • Water purification tablets (if visiting remote areas, camping, or staying in areas where access to clean water is limited)
  • Latex condoms
  • Ear plugs
  • Personal safety equipment (such as child safety seats and bicycle helmets)

Documents

Travelers should carry the following documents and leave a copy of these documents with a family member or close contact who will remain in the United States, in case of an emergency.

  • Proof of vaccination on an International Certificate of Vaccination or Prophylaxis (ICVP) card or medical waiver (if vaccinations are required)
  • Copies of all prescriptions for medications, eye glasses/contacts, and other medical supplies (including generic names and preferably translated into the local language of the destination)
  • Documentation of preexisting conditions, such as diabetes or allergies (in English and preferably translated into the local language of the destination)
  • Health insurance, supplemental travel health insurance, medical evacuation insurance, and travel insurance information (carry contact information for all insurance providers and copies of claim forms)
  • Contact card to be carried with the traveler at all times, including street addresses, phone numbers, and e-mail addresses of the following:
    • Family member or close contact remaining in the United States
    • Health care provider(s) at home
    • Place(s) of lodging at the destination(s)
    • Hospitals or clinics (including emergency services) in your destination(s)
    • US embassy or consulate in the destination country or countries

See the Obtaining Health Care Abroad for the Ill Traveler section later in this chapter for information about how to locate local health care and embassy or consulate contacts.

COMMERCIAL MEDICAL HEALTH KITS

Commercial medical kits are available for a wide range of circumstances, from basic first aid to advanced emergency life support. For more adventurous travelers, a number of companies produce advanced medical kits and will even customize kits based on specific travel needs. In addition, specialty kits are available for managing diabetes, dealing with dental emergencies, and handling aquatic environments. Many pharmacy, grocery, retail, and outdoor sporting goods stores, as well as online retailers, sell their own basic first aid kits. Travelers who choose to purchase a preassembled kit should review the contents of the kit carefully to ensure that it has everything needed. Additional items may be necessary and can be added to the purchased kit.

BIBLIOGRAPHY

  1. Goodyer L. Travel medical kits. In: Keystone JS, Freedman DO, Kozarsky PE, Connor BA, Nothdurft HD, editors. Travel Medicine. 3rd ed. Philadelphia: Saunders Elsevier; 2013. p. 63–6.
  2. Harper LA, Bettinger J, Dismukes R, Kozarsky PE. Evaluation of the Coca-Cola company travel health kit. J Travel Med. 2002 Sep–Oct; 9(5):244–6.
  3. Rose SR, Keystone JS. Chapter 2, trip preparation. In: Rose SR, Keystone JS, editors. International Travel Health Guide. 14th ed. Northampton: Travel Medicine, Inc; 2008.
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