夏季出國旅行需注意什麼?

Cholera in the Dominican Republic. Dengue fever in the Caribbean. Measles in Ukraine.

Lee Tamplin聖布拉斯島海灘多米尼加共和國的霍亂，加勒比海的登革熱，烏克蘭的麻疹。

With summer travel season here, so are new warnings about health hazards in many exotic destinations. Granted, I'm probably more paranoid than the average middle-aged traveler, having been a bone-marrow transplant patient with a weakened immune system. And my idea of adventure travel is anywhere without a Four Seasons hotel. But in developing countries-and even in many developed ones-many travelers over 50 face special concerns, especially if they have chronic health conditions or take medications such as steroids that suppress the immune system.

隨着夏季旅遊旺季的到來，也出現了許多新的有關國外目的地的健康危險警示。的確，作爲一個做過骨髓移植、免疫系統減弱了的人，我可能比一般的中年旅行者更多疑。而且我所認爲的冒險旅行是去一個沒有四季酒店（Four Seasons）的地方。但在發展中國家，甚至在很多發達國家，許多50歲以上的旅行者的確面臨着特殊的問題，尤其是如果他們有慢性病或服用類固醇等抑制免疫系統的藥物，問題就更大了。

"We see a lot of people who, after retirement, want to take the trek of a lifetime in Nepal, but it isn't the same as going to Kansas City, and a lot of them don't realize this," says Phyllis Kozarsky, an infectious-disease expert at Emory University and travel health consultant for the Centers for Disease Control and Prevention, both in Atlanta. Many popular areas lack basic Medical care, let alone easy access to a local drugstore.

埃默裏大學（Emory University）傳染病研究專家、美國疾病控制和預防中心（Centers for Disease Control and Prevention）旅行健康顧問科扎斯基（Phyllis Kozarsky）說，我們看到很多人在退休後想去尼泊爾徒步，但這跟去堪薩斯城可不一樣，而他們很多人都意識不到這一點。埃默裏大學和疾控中心均位於亞特蘭大。很多熱門地區都缺乏基本的醫療保健設施，更別說方便地在當地藥店買到藥了。

See Your Doctor

看醫生

Four to six weeks before foreign travel, it's wise to visit a doctor for recommended vaccines and cautionary medications such as malaria pills and a prescription antibiotic in the event of a bad stomach bug. But it is also important to pack mosquito repellent and other precautions for outdoor activities in areas where malaria, yellow fever and other insect-borne diseases abound─and to stock up on other important items.

出國旅行前四到六週去看醫生是明智的做法，詢問醫生應接種哪些疫苗，以及應該準備哪些預防藥物，比如瘧疾丸和用於治療嚴重胃病的處方抗生素。但要是在瘧疾、黃熱病及其他昆蟲傳播疾病多發地進行戶外活動，攜帶驅蚊劑及採取其他預防措施也同樣重要，還應儲備其他重要物品。

"I walk through the aisles of my local pharmacy and carry the things I'd like to have with me in the event of a minor illness," such as pain relievers and anti-diarrhea medication, says Dr. Kozarsky.

科扎斯基博士說，我會去自己本地的藥店轉一轉，拿些防治小病的藥物，比如止痛藥和抗腹瀉藥物。

The CDC travel health website has a regularly updated list of health risks and vaccination recommendations and requirements for specific countries. Some clinics use a software program, Travax, which tracks disease risk data. Paul McKinney, developer of the program and medical director of the travel clinic at the University of Louisville in Kentucky, says it also helps identify vaccine requirements for travelers who may be going from one foreign country to another. For example, travelers going to India from the U.S. don't require a yellow-fever vaccination, but if they are first visiting countries where yellow fever is endemic, India may require them to be vaccinated.

疾控中心旅行健康網站列出了具體國家的健康風險和建議接種的疫苗及要求清單，並且會定期更新。有些診所會用Travax軟件程序，它能夠跟蹤疾病風險數據。該軟件的開發者、肯塔基州路易斯維爾大學（University of Louisville in Kentucky）旅行診所主任醫師麥金尼（Paul McKinney）說，該軟件還能幫助確認在國外不同國家間旅行者的疫苗要求。例如從美國到印度的旅行者不需要接種黃熱病疫苗，但如果他們要先去黃熱病多發的國家，印度可能會要求他們接種疫苗。Vaccine Risk

疫苗風險

Live vaccines such as the one for yellow fever can be risky for those over 60 or 65, Dr. McKinney warns, because of a higher likelihood of side effects. Patients taking steroids, which lower resistance to viral infection of any kind, are also less likely to have a good response to a vaccine.

麥金尼博士警告說，黃熱病疫苗等活疫苗對60或65歲以上的人會有危險，因爲產生副作用的可能性較大。服用類固醇的病人也可能對疫苗的反應不佳，因爲類固醇會降低人體對各種形式病毒感染的抵抗力。

It's also important to be up-to-date on routine vaccinations such as flu and tetanus before leaving the U.S. A shingles vaccine for those over 65 can reduce the chance of being struck with a painful and debilitating case of the virus, which is related to childhood chickenpox. Measles are also a growing concern in Europe, Dr. Kozarsky says. If you're unsure whether you had measles or a childhood vaccination for it, a blood test can determine if there are antibodies to the disease.

還有很重要的一點是，在離開美國前應接種最新的流感和破傷風等常規疫苗。65歲以上者接種帶狀皰疹疫苗能減少嚴重感染這種病毒的機率，這種病毒與兒時的水痘有關。科扎斯基博士說，麻疹在歐洲也日益受到關注。如果你不確定自己是否得過麻疹或小時候接種過疫苗，那麼血液化驗可以判定你是否有麻疹抗體。

Travelers also need to be careful about organisms that can penetrate the skin while swimming, or bacteria found in drinking water-as well as raw foods such as salad and fresh fruit.

旅行者還需要小心在游泳時能穿透皮膚的有機生物或飲用水中以及沙拉和新鮮水果等生食中發現的細菌。

In Case of Emergency…

萬一遇到緊急情況……

For the worst-case scenario, it is also a good idea to consider an emergency medical evacuation program. Before a trip to Russia last year, Marvin Freedman, a retired Justice Department investigator and avid world traveler, bought a membership from MedjetAssist, on the recommendations of some fellow travelers. He admits he was skeptical it could deliver as promised: evacuation to the hospital of his choosing for the $260 plan.

如果遇到最壞的情況，最好是考慮緊急醫療後送方案。去年前往俄國之前，熱衷世界旅行的美國司法部退休調查員弗裏德曼（Marvin Freedman）在一些同行者的建議下，購買了MedjetAssist的會員計劃。他選擇的是價格260美元的計劃，保證能在發生情況時將他護送到醫院。他承認起初自己對其是否能實現承諾有所懷疑。

While poking around historic towns in the Golden Ring area outside Moscow, Mr. Freedman picked up a bug that worsened by the time he got to St. Petersburg. Admitted to a hospital there, he was pumped full of antibiotics by doctors who diagnosed a bacterial infection. But he wasn't getting better. After a few days he placed a call to MedjetAssist, where he was connected to doctors at the University of Pittsburgh Medical Center who determined he needed to be brought home.

在遊覽莫斯科郊外金環地區（Golden Ring）的古鎮時，弗裏德曼感染了一種疾病，在他到聖彼得堡時病情開始惡化。他住進了當地的一所醫院，醫生診斷他是細菌感染，給他注射了抗生素。但他並沒有好轉。幾天後，他打電話給MedjetAssist，聯繫上了匹茲堡大學醫學中心（University of Pittsburgh Medical Center）的醫生，他們認爲他需要被送回美國。

The next morning, a Lear Jet with a flight doctor and a nurse arrived to take him on the first leg of a long journey back to Wisconsin. Doctors there determined it was in fact a viral infection-which doesn't respond to antibiotics-and discontinued the drugs. After making a full recovery, Mr. Freedman says he is undaunted from globe-trotting and already has a journey to India in the planning stages.

第二天一早，一位航空醫生和護士乘坐一架Lear噴氣式飛機抵達，帶他回到了威斯康星州。那裏的醫生認爲這實際上是一種病毒感染，因此不會對抗生素產生反應，醫生停用了之前的藥物。完全恢復後，弗裏德曼說自己對環球旅行的熱情並沒有受到打擊，現在已經開始籌備印度之行了。