Going to volunteer on a medical service trip for a week or two? There is so much to plan and pack. After doing several of these trips to the Dominican Republic and Nicaragua, here are my top 10 tips to help you be better prepared.

1. Bring a hat (ideally a foldable one) and a bandanna. 
2. Small packages of personal wet wipes. Clean up and freshen up when it's hot and humid.
3. Take a picture of your passport, credit card (front and back) that you are traveling with, where you are staying, immunization record, location of embassy, etc. Keep on camera roll or email to yourself.
4. Bring snacks like peanut butter, crackers, granola, instant oatmeal, favorite teas,   etc. Store all in zip lock bags. 
5. Buy cheap scrubs at discount stores. Leave them behind. 
6. Pack extra shoes, glasses, contact lenses. 
7. Bring an inexpensive travel rain poncho. 
8. Women should bring pads or tampons and leave what you don't use behind. 
9. Don't forget a deck of cards, books, your...

There are four shots that every NP needs to know about to protect adults.  Every visit is an opportunity to check every adult's immunization status. It's as important as checking their vital signs. 

1. Influenza vaccines - While I bet this is no surprise,  most adults in the US are not properly immunized for influenza. You probably think to advise it for those over 65 but by immunizing all adults 18 and over, you are not only protecting your patient but decreasing influenza in your community better protecting vulnerable populations.

2. Pneumococcal vaccines- There are 2 different pneumococcal vaccines for adults over 65 but certain high risk adult populations need them sooner.

3. Tdap - One dose of Tdap is recommended once for all adults and then Td booster every 10 years thereafter unless they get a tetanus prone wound and  then they need a booster if it has been more than 5 years . Any adult who is around young children should receive a Tdap vaccine....

Ever have a patient say, "I am going on a trip. Do I need any shots?" Do you know where to get up to date, accurate information to all their questions about travel shots?Sometimes , they just want to know if any shots are required for their trip. Some people think if a shot isn't required they then don't need anything to protect themselves. Whether you administer travel vaccines or not, you need to know what to say when patients ask you about travel shots.

3  Categories of Immunizations

               1. Routine

               2. Recommended

               3. Required

For starters, everyone needs to have their routine adult immunizations up to date whether they are traveling or not.  Take this as a golden opportunity to update their routine vaccines. Next, look up what recommended immunizations are suggested for their trip at www.cdc.gov/travel. ...

Did you know there is a widespread measles outbreak in Europe?  Since most people don't think there are any travel alerts associated with going to Europe, they they don't visit a travel clinic or talk to their PCP's before they go.  So, many don't know this and aren't taking any precautions.

People of all ages can contract the measles.  Children are particularly vulnerable to morbidity and mortality from the measles and many children in the US are not fully protected against it.  We need to protect travelers from getting the measles and bringing it back home.

International Tourists Import Measles

In March 2018 there were 2 international travelers who were diagnosed with  measles who exposed hundreds of people in Detroit, Newark and Memphis airports. Measles is transmitted by cough and sneezes and can remain in an area for up to 2 hours after the infected person has left.  Most of the modern outbreaks of measles in the US were traced to...

Traveler’s diarrhea can be really miserable when people are far from home. Despite following food and water precautions, there is still a good chance of contracting it especially in low resource countries, and popular destinations like Mexico and the Caribbean. It doesn’t matter whether if your traveler is staying in a 5- star resort or a hostel. The water comes from the same source. 

In most cases, travelers' diarrhea clears up on its own within  a day or two. The majority of cases resolve within a week. 

There has been much debate about the best way to treat traveler’s diarrhea and to still be good stewards of antibiotic use. In the US, we rarely treat diarrhea with antibiotics because most diarrhea is viral in origin. In low resource countries, most diarrhea is bacterial, so there is a role for treatment with antibiotics.

What can you recommend for mild diarrhea?

According to the International Society of Travel Medicine’s evidence based ...

Travelers diarrhea is one of most common travel-related illness, affecting about 10 million people who travel every year. The most common cause is bacteria from water contaminated with feces.

It's most common in low resource countries with the highest risk is in Latin America, Africa, the Middle East, and Asia.

Here are 10 ways to help prevent travelers’ diarrhea.

1. Don’t trip the tap water. Drink only bottled water and beverages.
2. Avoid ice that may be made with tap water. Don’t forget those drinks made with crushed ice, the one’s with the little umbrellas in them.
3. Use bottled water to brush your teeth, not the tap water. If you contaminate the tooth brush by mistake, get a new one.
4. Avoid fruit that may have been cleaned with tap water. Peel it yourself carefully avoiding contact with what’s on the outside with what’s on the inside.
5. Vegetables should be thoroughly cooked. So that means no salads or lettuce and tomato on a...