Food and waterborne diseases are the number one cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout the region and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe.
Here are other things to keep in mind to make your visit to the region a healthy one:
- Travelers to malaria-risk areas, including infants, children, and former residents of the Indian Subcontinent, should take an antimalarial drug. NOTE: Chloroquine is NOT an effective antimalarial drug in the Indian Subcontinent and should not be taken to prevent malaria in this region.
- Dengue, filariasis, Japanese encephalitis, leishmaniasis, and plague are diseases carried by insects that also occur in this region. Protecting yourself against insect bites will help to prevent these diseases.
- If you visit the Himalayan Mountains, ascend gradually to allow time for your body to adjust to the high altitude, which can cause insomnia, headaches, nausea, and altitude sickness. In addition, use sunblock rated at least 15 SPF, because the risk of sunburn is greater at high altitudes.
- Because motor vehicle crashes are a leading cause of injury among travelers, walk and drive defensively. Avoid travel at night if possible and always use seat belts.
- There is no risk for yellow fever in the Indian Subcontinent. A certificate of yellow fever vaccination may be required for entry into certain of these countries if you are coming from countries in South America or sub-Saharan Africa.
- During your stay, wash hands often with soap and water.
- Drink only bottled or boiled water, or carbonated drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, you can make water safer by both filtering through an “absolute 1-micron or less” filter and adding iodine tablets to the filtered water. These filters are found in camping/outdoor supply stores.
- Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself.
- Pay special attention to mosquito protection between dusk and dawn. This is when the type of mosquito whose bite transmits malaria is active.
- Wear long-sleeved shirts, long pants, and hats.
- Use insect repellents that contain DEET (diethylmethyltoluamide). Apply insect repellent to exposed skin but do not put repellent on wounds or broken skin. Do not breathe in, swallow, or get into the eyes (DEET is toxic if swallowed). If using a spray product, apply DEET to your face by spraying your hands and rubbing the product carefully over the face, avoiding eyes and mouth.
- Unless you are staying in air-conditioned or well-screened housing, purchase a bed net impregnated with the insecticide permethrin or deltamethrin. Or, spray the bed net with one of these insecticides if you are unable to find a pretreated bed net.
- DEET may be used on adults, children, and infants older than 2 months of age. Protect infants by using a carrier draped with mosquito netting with an elastic edge for a tight fit.
- To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
- Always use latex condoms to reduce the risk of HIV and other sexually transmitted diseases.