The vaccination costs can often cause people to avoid receiving them. Usually, this is an attempt to save money by choosing to delay, or avoid certain vaccines.

Unfortunately, choosing to go unvaccinated can end up having the opposite effect. Treating vaccine-preventable diseases can be many times more expensive than the vaccine! A recent study provided a comprehensive look at the real value of vaccines.

Are Vaccines Worth the Cost?

The “cost-of-illness” tries to figure out how many dollars are saved for every dollar spent. But, this does not paint the most complete picture of the amount saved by vaccinating. It only includes the costs like medication, hospitalization, lost production at work and finding care. When using this method, researchers found that $16 USD was saved on every $1 USD spent.

The “Full Income Approach” seeks to find the complete value of vaccines. The research team attempted to find the value that people associated with living longer, healthier lives. This extra amount was added to the money saved on healthcare costs. This method also considers the broader economic and social benefits that vaccines bring. These costs can include management of a public outbreak, and the cost to the community. After compiling their data, researchers found that the actual amount saved is closer to $44 USD per $1 USD spent on vaccines.

It’s amazing that the amount of money we save by vaccinating increases by almost 275% in the second study. But it makes sense, because the value attached to comfort and being healthy is more than just productivity lost at work. It means living a full life, and having the freedom to do what you want. The choice seems pretty clear, vaccination is the savvier, more fiscally responsible move.

What Is the Global Vaccine Action Plan?

The world’s poorest countries often suffer from the lowest standards of living. These countries also tend to have higher rates of death due to infectious and preventable disease. The Global Vaccine Action Plan seeks to provide three crucial childhood immunizations to the world’s 73 poorest nations. According to Johns Hopkins Bloomberg School of Public Health, vaccines can prevent the loss of 3.7 million lives and over $63 billion USD.

These are common vaccines in the Canada, and are widely available to travellers.

• Meningitis
• Pneumonia
• Polio
• Tdap
• MMR

These diseases can be easily avoided in wealthier countries. But they low standard of healthcare in developing nations makes this a danger for locals, as well as travellers looking to visit. That’s why it’s important to make sure that all your regular vaccinations don’t require boosters prior to your trip. They aren’t as exotic as yellow fever, but they are just as harmful and should be regarded as such.

Worth The Price – Every Time

Some vaccines can seem expensive, but the diseases they prevent are much costlier. Many people undervalue vaccinations, even when there are billions of people without that privilege. These individuals don’t always live in poverty, either. The immunocompromised, the elderly and the very-young may not be vaccine-eligible.

The effect of herd immunity as a tool of societal protection is huge, and often understated. We are able to keep others safe from disease, because we take care of ourselves. The price to keep ourselves, and our neighbors, healthy is small compared to the cost of getting sick.

If you’re planning to leave Canada, make sure you are protected. The numbers never lie, it’s fiscally responsible. Call us at or book online to schedule an appointment with our travel health specialists today!

Have you ever weighed the price of the vaccine with the cost of the disease? How did you come to your conclusion? What factors led you to vaccinate? Share your story with us on Facebook or join us on Twitter!

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Vietnam is a land bathed in natural beauty. Lush valleys extend below cloud-piercing mountains and blue-green rivers wind their way through the countryside.

In contrast, Vietnam’s major cities are large and cosmopolitan. A diverse cuisine characterized by the freshest ingredients and a disciplined application of spices.

Together, the mix of old and new makes the country a must-see for any traveller. But, it’s important to make sure you are ready for your journey. Vietnam is a developing nation and a little extra preparation is needed for any trip.

Which Vaccinations Do I Need for Vietnam?

There are plenty of reasons to travel to Vietnam, but it’s important to be healthy during your trip. Mosquito- and foodborne illnesses are common in Vietnam. Take proper precautions before you leave to ensure an exciting, safe and fulfilling visit.

The Public Health Agency of Canada recommend the following vaccines for Vietnam:

Vaccine	How It Spreads
Typhoid	Contaminated Food and Water
Cholera	Contaminated Food and Water
Japanese Encephalitis	Mosquito-borne
Hepatitis A	Contaminated Food and Water
Hepatitis B	Bodily Fluids (Sharing Needles, Sexual Contact, etc.)
Rabies	Saliva, Bites, Scratches From Infected Animals
Measles	Contact With Infected People
Influenza	Airborne By Infected People

What Else Can I Do To Stay Healthy In Vietnam?

Vaccinations are just the first part of preparing Vietnam. Unfortunately, not every infection or situation is vaccine-preventable. Some things need extra awareness or just a few more items in your bag.

• Traveller’s Diarrhea– This symptom of an infection affects up to 70 percent of travellers worldwide. Vietnam is no exception. Consider bringing a traveller’s diarrhea kit containing a remedy like DiaResQ.
• Dengue Fever– This mosquito-borne disease is present in Vietnam. Cover exposed skin by wearing long-sleeved shirts, long pants, boots, and hats. Consider using a bednet when sleeping, especially if you’ll be outside.
• Zika Virus– The WHO reported a few cases of Zika in Vietnam in early 2016. Zero cases have been reported since that time. The PHAC advises travellers take precautions to avoid the virus.
• Reduce Exposure to Germs– Wash your hands with soap often. Washing your hands with soap and water before eating can prevent a variety of infections. If soap or clean water are not available use a sanitizer with at least 60% alcohol.
• Theft– Petty crime against tourists is increasing, particularly in larger cities. Try and travel in groups, and be aware of your surroundings. Motorcyclists sometimes try and snatch purses or shoulders bags from travellers. Cut a bag open to get to the contents is another common practice. Try to limit displays of affluence or wealth while in public.
• Travelling Within Vietnam– Try and stick to areas that you have familiarized yourself with. Travel in authorized, official taxis and NEVER share a taxi with a stranger. Driving standards are poor and road maintenance is worse. In Vietnam, be an alert and defensive pedestrian.

Where Should I Visit In Vietnam?

• Hanoi– Ancient buildings and glass skyscrapers decorate the 1000 year-old skyline. This city houses much of country’s foodie-culture, allow tourists to taste authentic Vietnamese cuisine.
• Ha Long Bay– This beautiful region draws scuba divers, rock climbers and hikers to its emerald shores. The jungle-topped, limestone islands tower above the bay creating a beautiful views.
• Cu Chi Tunnels– A historic tunnel system located about 40km northwest of Ho Chi Minh City. These were used as a base of operations for the Viet Cong during the Tet Offensive of the Vietnam War in 1968. Some of the areas of this interconnected system of passages are open to tourists.

Do you have any sightseeing recommendations for other travellers headed to Vietnam? Any crucial travelling tips for a better experience? Let us know by visiting us on Facebook or leaving us comment on Twitter!

Are you planning a trip to Vietnam? Call Passport Health at or book online to schedule a consultation with one of our travel health specialists! Together, we can develop a plan to keep you safe while you explore what the world has to offer.

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The beautiful landscape of the Peruvian countryside thousands of travelers every year. Home to wonders like Machu Picchu and Cusco, it’s no wonder it is such a popular destination.

Which Vaccines Do I Need For Peru?

Peruvian travel poses many health risks as well. Food- and mosquito-borne illnesses are common in more rural areas of the country. Fortunately, many of the diseases that exist in Peru are vaccine preventable. The PHAC recommends the following vaccines for Peru:

Vaccine	How It Spreads
Typhoid	Food- and Waterborne
Cholera	Food- and Waterborne
Yellow Fever	Mosquitoborne
Hepatitis A	Food- and Waterborne
Hepatitis B	Person-to-Person Usually by Blood or Sex
Influenza	Person-to-Person Usually Coughing
Rabies	Animal-borne
Measles	Person-to-Person Usually Coughing

Of course, there are some diseases that cannot be vaccinated against. Here are some of the other health risks that travel to Peru can pose:

• Altitude sickness– Known as soroche in Peru, altitude sickness is caused by insufficient oxygen in the blood. This is common in altitudes 2500m above sea-level. Our travel health specialists can prescribe medication to reduce the symptoms of altitude sickness.
• Street food– Even though street food can be the most authentic, there is often no oversight or regulation. The Public Health Agency generally advises against consuming street food. If you must consume street food, steer clear of salads or foods that are not served piping hot.
• Water Sources– The drinking water in Peru is not as clean as the water in North America. It may have foreign bacteria that your gut is unfamiliar with. This can cause digestive distress. Best practice is to avoid tap water and ice. Consider bringing a water filter, or at least purchasing bottled water.
• Dengue Fever– Where there are mosquitoes and tropical climates, dengue is sure to follow. The best way to avoid this nasty bug is to use a strong repellent. Always wear loose clothing that covers your arms and legs during sunset and sunrise when mosquitoes are most active.
• Zika Virus– This disease has been reported in Peru and is usually spread by the bite of an infected mosquito. It can spread through sexual contact with an infected person. This disease can cause birth defects in babies born to pregnant mothers who have it. The same guidelines for dengue fever apply here.
• Chikungunya– An outbreak is ongoing in Peru. Mosquitoes spread this viral disease. Make sure to pack loose clothing and a strong repellent!

What Else Should I Know For My Trip To Peru?

When you arrive in Peru, you will be given an Andean migration card instead of a visitor’s visa. This document is required when staying in hotels and leaving the country. Be sure to store this document safely with your passport!

If you plan on hiking the Inca Trail or Machu Picchu, pack plenty of sunscreen and stop to re-apply often. The sun is stronger than you might realize. Sunburns are possible even in cloudy weather. These are an easily preventable cause of discomfort on a vacation.

Another tip for Machu Picchu is bringing your passport along. You may or may not need it based on your specific travel plans. But, the novelty passport stamp is a great memento of your trip to Peru!

Making use of the concierge at your hotel can save you a lot of time and effort when coordinating trips. They can usually arrange long distance bus trips, or introduce you to local guides.

Planning a trip to Peru? Make an appointment with a Travel Health Specialist today by calling or booking online now.

The information above represents general travel information for Peru. For more specific advice, schedule an appointment with one of our travel health specialists. Besides vaccination, we have a variety of products to repel mosquitoes, prevent traveller’s diarrhea, and treat altitude sickness!

By considering your medical history, travel plans and the current public health situation in Peru, our specialists can tailor a plan to keep you safe while you explore the Land of the Inca.

To learn more about these vaccines see their respective pages or our main vaccinations page.

Going to Peru? Been there recently? Post your questions and answers below or contact us on Facebook or Twitter.

You’re all set to register for classes, your schedule is completely planned out. You log-in to the school’s website, hoping you can slide into one of your university’s coveted classes. You’re about to click the button to finish your registration but then you find you’ve got a hold on your account. The university needs proof of your meningitis vaccination!

Outbreaks of meningitis have been cropping up on college campuses throughout North America. Many universities in the U.S. and Canada now require students receive a meningitis vaccine.

Though it could add another item on your to-do list, getting the meningitis vaccine is important. The vaccine is key to keeping you healthy and able to pursue those big life goals.

What is Meningitis?

Meningitis comes in three forms: viral, bacterial and fungal. The disease causes an inflammation of the membranes surrounding the brain and spinal cord.

Symptoms of meningitis include:

• High Fever
• Headache
• Stiff Neck
• Confusion
• Nausea
• Sensitivity to light
• Vomiting
• Exhaustion

The two most common form of meningitis are bacterial and viral meningitis.

What Is Bacterial Meningitis?

Meningitis bacteria spreads through contact between individuals. The bacteria moves best in situations of close social contact like kissing, sharing silverware or drinks, exchanging lipstick or cigarettes, or coughing. It can also happen over time, like after sharing living conditions for an extended period.

Bacterial meningitis is serious and can be life-threatening. Potential cases should receive immediate medical attention for the best outcome. Early treatment can prevent serious complications, like hospitalization, brain damage, amputations, and even death.

According to the CDC, bacterial meningitis is as contagious as the viruses that cause the flu.

What Is Viral Meningitis?

Viral meningitis, as it suggests, is a viral infection. A person may become infected with viral meningitis through close contact with an infected person. But, there is a small possibility of actually contracting the virus. Only a small number of people who become infected will actually develop meningitis.

Viral meningitis is considered less severe than bacterial meningitis. People with normal immune systems can sometimes overcome it on their own. Vaccination will help protect against this infection as well.

Why Do Colleges Require Meningitis Vaccination?

College life increases the risk of infection, especially diseases like meningitis. The things that make college unique and fun are also some of the reasons that students are at an increased risk for meningitis.

Close living quarters, communal areas, irregular sleep habits, big social events, and potentially unsanitary living conditions can all contribute to spreading and catching disease. Infections tend to spread fast once one case occurs. College freshmen living in dorms are especially at risk.

One study showed freshman are seven times more likely than other students to contract the disease. Understanding the significant protection vaccinations provide can motivate incoming freshmen to get it done. If an incoming freshman was vaccinated before their 16th birthday, a booster is recommended.

Roommates should be aware of potential infection.

According to Dr. Thomas Clark, a meningitis expert at the CDC, “If you live in close quarters, the roommate is at very high risk to get infected.”

He adds, “We [often] give preventative antibiotics to people who are around an infected patient.”

Meningitis vaccines protect against four strains of the bacteria. Three strains are common in North America. The fourth protects travelers venturing out to places where the disease is more common. These vaccines help the body ward off the bacteria or viruses that cause infection.

Vaccination is one of the most effective ways to prevent most strains of meningitis. College students can decrease the risk by frequently washing their hands and not sharing personal items. Even if the body is sick or run down, a vaccination can help the body protect itself against meningitis.

Receiving vaccinations will allow you to focus on the most important things in college and pursue your next great adventure!

Do you still need to receive your meningitis vaccination? Feel free to book an appointment online or call to set up an appointment with a Passport Health Specialeist.

Learn more about meningitis vaccinations through our meningitis portal.

Do you have questions about what other vaccinations may be required for college or other types of school? Do you have experiences with experience serious illness while in school? Please feel free to comment below or contact us on Facebook or via Twitter. We would love to hear from you!

Written for Passport Health by Adrienne St. Clair

There are several world religions that have a pilgrimage that believers strive to make. But, no pilgrimage can compare to the Hajj, which is the Islamic trek to Mecca, Saudi Arabia. Not only is it a tough journey, but is the biggest mass gathering in the world. At least 2 million Muslims from over 180 countries attend annually. Islam requires every able-bodied Muslim to make the sojourn at least once in their lifetime.

The Hajj takes place between the 8th and 12th days of the last month of the Islamic year, Dhu al-Hijja. As Islam uses a lunar calendar, the timeframe varies. The Hajj often falls somewhere during September or October on the Gregorian calendar.

All foreign pilgrims participating in the Hajj fly into the nearby city of Jeddah. From there, they take a bus to Mecca and then continue on to Mina by bus or by foot. In Mina, the pilgrims stay in air-conditioned tents for the night to prepare for their trek the next day.

All pilgrims begin their journey at first light, starting with a long 14.4km walk to Mt. Arafat.

Throughout the trip from Mina back to Mecca, they stop at set points to take part in sacred rituals.

Back in Mecca, the travellers make their way to the Grand Mosque to visit the Ka’aba, the most sacred site in Islam. Each pilgrim will take part in rites particular to Mecca and the Grand Mosque. For example, a pilgrim perform a tawaf, circling the Ka’aba 7 times counterclockwise.

Pilgrims will leave Mecca after participating in each ritual and completing a final tawaf. Once done, their Hajj is over.

Which Vaccines Do I Need for Hajj?

No matter where you plan to travel, it’s important your routine vaccinations are up-to-date. But, if you are planning on participating in Hajj, you may need additional vaccines. The Public Health Agency of Canada and CDC recommend the following vaccines for Hajj:

Vaccinations for Hajj	Required or Recommended?
Meningitis	Required for entry
Polio	Recommended, may be required
Cholera	Recommended
Hepatitis A	Recommended
Hepatitis B	Recommended
Influenza	Recommended
Measles	Recommended
Pneumonia	May be recommended

If you are planning a trip to Hajj, be sure to speak with a travel health specialist. Our staff is uniquely suited to help you plan for your upcoming trip. Schedule your appointment today by calling or booking online now.

Other Health Risks

Due to the dense population of pilgrims during Hajj, risk increases for disease of all kinds. The stopping points where pilgrims congregate to perform rituals become crowded. These are some of the most dangerous points along the way.

Respiratory Infections and Communicable Diseases

Respiratory infections are common during Hajj. The most common reason for hospital admission being pneumonia. The Seasonal Influenza vaccine should guard against these infections. But, extra precautions are recommended including:

• Frequent washing hands
• Wearing a face mask
• Observing cough etiquette
• Avoid individuals with concerning symptoms

Seniors and travellers with immune issues should consider receiving a pneumonia vaccine.

Though less common, there is also an increased risk of tuberculosis due to the heavy crowds. See a doctor immediately if you begin to see signs of active tuberculosis.

Middle Eastern respiratory syndrome, first discovered in Saudi Arabia in 2012, is also a threat. Caused by a coronavirus, MERS is similar to the 2003 SARS virus. Cases have been identified all around the Arabian peninsula, as well as in the United States.

The virus has a wide range of symptom. Most often patients will experience fever, cough, and shortness of breath. Cases have ranged from mild to severe, but 35% of cases have been fatal.

Due to the crowded conditions, diarrhea and other communicable diseases spread easily. Awareness and prevention are key to protecting yourself against these and other issues.

Overheating

While the days of the Hajj vary from year to year, the pilgrimage will take place when the desert heat is heavy.

There are mist sprinklers to try to combat the high temperatures, but heat stroke is a major concern. Heat exhaustion and heat stroke are the leading causes of death during the Hajj. Travelers should take extra precautions to protect themselves against the heat. This includes staying hydrated, applying sunscreen, wearing appropriate clothing, and even using umbrellas.

Special Note for Women

Women are not allowed to perform a tawaf around the Ka’aba when they are menstruating. Consider requesting hormone suppression to help with menstruation cycles.

It’s a once in a lifetime journey.

The most important thing when planning to attend Hajj is making sure you have all necessary vaccinations. Prepare beforehand for prevention’s sake, and be aware and alert of your own needs and of others on the journey.

Do you have further questions about the Hajj or what vaccines you may need for an adventure you are planning? Feel free to contact us at or set up an appointment on our website.

Have you participated in the Hajj? Do you have any advice for future travelers to the Middle East? Please feel free to contact us on Facebook or via Twitter!

Written for Passport Health by Adrienne St. Clair

To ensure a happy and healthy trip away from home, don’t forget to protect yourself against cholera. Having cholera can keep you from enjoying your travels and stuck in the restroom instead. It’s always better to go to the beach instead of the bathroom.

What is Cholera?

Cholera is a bacterial infection usually spread through contaminated food or water. It is not spread from person-to-person. Symptoms of cholera include:

• Watery diarrhea
• Vomiting
• Dry mucous membranes
• Thirst
• Muscle cramps

Those with more severe cases of cholera may experience:

• Renal failure
• Severe dehydration
• Coma

In such cases, if untreated, the infection can be fatal within hours. Only 5-10% of people with cholera experience this severity.

Where is Cholera Found?

Food or water contaminated by the feces of an infected person is where the cholera bacterium is usually found. The bacterium can also live in rivers and coastal waters. The disease is most common in places with poor water treatment and sanitation. Cholera has been eliminated in industrialized countries with modern sewage and good water treatment.

If you’re traveling to an underdeveloped country, you should protect yourself against cholera. According to the World Health organization, the following regions have experienced recent cholera outbreaks:

• Haiti
• Dominican Republic
• Central and West Africa
• Pacific Islands

How Can I Protect Myself Against Cholera?

In Canada, you can protect yourself against cholera by getting vaccinated.

Dukoral is an oral vaccine available for adults and children 2 years of age and older. The vaccine is given in 2 doses, 1 to 6 weeks apart. It can take up to two weeks for a person to have full protection.

The vaccine is not routinely given, as the disease is not a high risk within Canada. Travelers should consult a travel health specialist about the risk of cholera at their destination.

As with every vaccination, standard prevention from the illness should be continued. Follow these steps to avoid coming in contact with cholera bacteria:

• Drink Clean – Only drink bottled, boiled, or chemically treated water. Never drink tap water or get a drink with ice cubes in it. Do not consume fountain drinks either. Bottled or canned carbonated drinks are safe.
• Sanitize Wise – Wash your hands with soap and clean water, often. It is especially important to do so before you eat or prepare a meal and after you use the bathroom. If no soap is available, use an alcohol-based hand cleaner with at least 60% alcohol. Remember to use bottled, boiled, or chemically treated water to brush your teeth, wash dishes, prepare food, and make ice.
• Eat Safe – Only eat foods that are freshly cooked and served hot. Never eat raw or undercooked meats, seafood, or unpeeled fruits and vegetables. Those are great reservoirs for the cholera bacterium.

If you are planning to travel and are unsure of your risk of cholera, a Passport Health travel specialist can help. Dukoral vaccines are available on-site at your local Passport Health clinic. Schedule your appointment today by calling or booking online now.

Has bathroom-duty ever kept you from having a good time? Share your comments below, on Facebook, or via Twitter.

With more reported cases in the United States and Canada, the Zika virus has been gaining an immense amount of publicity. The World Health Organization (WHO) declared an international health emergency over the spread of the virus and is taking steps to stop Zika spread.

Experts are warning people to not attend the Rio Olympics, as well as visiting popular destinations like Disney World.

What Is the Zika Virus?

The Zika virus spreads to people through the bite of an infected Aedes mosquito. But, it is can also spread through sex.

Zika may have some longterm effects. The virus can infect the fetus of a pregnant woman, and causes devastating birth defects. These defects include microcephaly, a condition in which a baby is born with a small head and severe brain damage. Other birth defects include: blindness, deafness, seizures, and other congenital defects.

Most victims of Zika only have mild symptoms if any. These symptoms include fever, rash, joint pain, muscle pain, and headaches.

Many people infected with Zika don’t get sick enough to go to the hospital, and many cases are unknown. The virus remains in the blood of an infected person for about a week. For pregnant woman, this may cause devastating consequences.

How Is Zika Treated?

Diagnosing Zika requires a few different tests. This itself is challenging and burdensome.

“Imagine you have a busy practice where there’s pressure to do a high turnover”, said Dr. Peter Hotez, dean of the National School of Tropical Medicine. “You’re not going to be able to test everyone with a rash and fever for Zika.”

There are many other sicknesses which can cause these symptoms. Few people experiencing them will be concerned enough to visit a doctor.

There is currently no medicine to treat the Zika virus. There is also no known vaccination to prevent it.

How Threatened Are We by Zika?

Pregnant women should take the most precautions. Expecting women should not travel regions with the Zika virus. Most of these countries are in the Caribbean and Latin America.

The Aedes mosquito which carries the virus is typically only found along the Gulf Coast and in Florida. But, tropical medicine experts are warning people of the potential spread. The regions most likely to be affected are southern states and southwestern states.

There are now over 800 cases of Zika in the United States, 265 are pregnant women. Most cases were contracted overseas, but some were through sex while in the US.

Some athletes are deciding to skip this year’s Summer Olympics in Rio de Janeiro where Zika has been common.

“Even though the risk of infection from the Zika virus is considered low, it is a risk nonetheless and a risk I am unwilling to take,” said Rory McIlroy, ranked No. 4 in the world for golf.

Golfers Rickie Fowler and Jason Day are also uncertain of their plans to attend the Olympics.

How Can I Protect Myself from Zika?

Although there is no vaccine for the Zika virus, there are ways to prevent yourself from acquiring the illness.

• Avoid travel to an area where Zika is common
• Take steps to prevent mosquito bites such as wearing long sleeves, using insect repellent, and sleeping with bed nets
• Take steps to prevent getting Zika sexually by using condoms
• See a doctor or healthcare provider if you have any concerns

All Passport Health clinics offer a variety of insect repellents.

Have you ever had a frightening experience with mosquitos? Share in the comments below, on Facebook, or via Twitter.

Traveling across time zones can seem like literal time travel. At some point during trip planning, you’ve probably considered ‘losing time’ or ‘gaining time’. If a plane crossed a time zone or two flying a few hundred miles, it could land just 30 minutes after departure. But our internal clocks adjust slowly and we suffer temporary periods of jet lag.

[Read more…]

Nut allergies, especially tree nuts, are a common allergy found in children and adults. This can cause stress for many people travelling to foreign places. You may not know what kinds of foods you will be eating and how they’re prepared. Plus, many travellers may be in an unfamiliar region where quality healthcare isn’t available.

But, this stress doesn’t have to consume you before and during your trip. A nut allergy shouldn’t disrupt your travel plans. Check out these five ways to enjoy your adventures despite having an allergy.

Know your symptoms

Itchy throat? Hives? Nausea? Swelling of the tongue? Sound familiar?

A variety of symptoms reflect an allergic reaction to nuts. Knowing your first symptom can help to identify and treat an allergy right away. The longer you wait, the worse it can get.

This will also help you pinpoint the foods that caused the reaction, so you know what foods -or ingredients- to avoid.

Not only should you be aware of these symptoms, but so should your travelling companions.

Carry an epinephrine injection

Known as an EpiPen, Auvi-Q or Adrenaclick, these injections are emergency treatment for any life-threatening allergic reaction.

Make sure you and your companions known when and how to use your epinephrine injection. If used incorrectly, it could actually cause more harm.

Meet with your doctor first to discuss any medical information associated with epinephrine injections.

Find your “safe” foods

Research the types of cuisine that are typical in the country you will be travelling. This includes finding out the ingredients that go into those foods. For example, many common pastries may contain nuts as a non-visible ingredient.

Write down and save the names of foods that do contain the nuts you are allergic to. Remember some foods may be prepared in some type of nut oil. You will also want to write down foods that do not contain nuts. This way, you will know what to ask for in a food situation should you not recognize any of the other foods.

But, what if you want to try foods that you didn’t stumble across in your research? You may be unsure of whether a certain dish has nuts. Look no further than the next tip.

Prepare for the language barrier

Often, restaurants will provide the ingredients of a dish underneath its name. Just knowing the word for “nuts” (or anything in that family) in the regional language can help.

If you’re lucky, these ingredients will be in English. Many restaurants abroad are aware of the language barrier tourists face and are prepared.

If the ingredients aren’t written in English, or written out at all, learn the key words you will need when asking. A few examples follow:

Language	Word For Nut	Language	Word for Nut
Spanish	nuez	Hindi	akharot
French	écrou	Arabic	bandaq
Portugese	noz	Bengali	bādāma
Chinese	jiānguǒ	Russian	orekh
Thai	thạ̀w	Italian	noce

When looking up how to say these phrases, pay close attention to the accent. Correct pronunciation will help whoever you are talking to understands what you are saying and avoid miscommunication.

Develop a healthcare plan

This is one of the most important tips to keep in mind as you prepare to travel abroad. The last thing you want is for a nut allergy to go wrong and not knowing how to tackle it in a quick and timely manner. There are ways to prevent this.

Talk to your doctor at home to fill any necessary prescriptions that would be helpful abroad. Ask him to write a prescription just in case you need to refill medicine in a pharmacy in your destination.

Look up pharmacies and doctors in the area you are travelling to. See if they will be able to provide you with the services you may need in the case of an emergency.

Finally, you can put all your worries at ease knowing you have done all you need to do and enjoy your trip. Safe travels!

To learn more about vaccinations or other travel medicine needs, see our main travel medicine page. Passport Health’s travel health specialists are available to help you safely plan your trip. Book today by calling or schedule online now.

Are you a traveller with food allergies? Let us know what has worked best for you in the comments below, on Facebook or via Twitter.

By Johanna Read, TravelEater.net

Montezuma’s revenge. Delhi belly. La turista. The trots. Traveller’s diarrhea. Whatever you call it, getting sick when you travel is one of the last things you want. Luckily there are many ways to avoid it.

But first, you need to assess your own risk tolerance. If you are pregnant, have a weakened immune system, are elderly, or feeding kids under the age of six, you’ll want to be extra careful. If it is your first visit abroad and your first exposure to non-Canadian microbes, you’ll also want to be more cautious. But the average person can take sensible risks in deciding what, where, when and how to eat while traveling abroad.

Which Is Safer: Street Food or the Hotel Buffet?

Eating street food is one of the best ways to get to know a culture. Would you be surprised to learn it is often safer than the buffet at your westernized hotel?

A lot of street food is cooked to order, coming off the grill or out of the wok directly to you. Unlike at a restaurant, you can see how clean the food prep area is, watch how long your dish sits before you get it, and make sure the cook isn’t putting your cooked chicken back on the plate that held the raw meat.

While the Public Health Agency of Canada recommends taking additional precautions with street food, go ahead and eat it. But, choose your street food carefully. Pick a busy food stall that has a steady flow of customers, preferably locals, and preferably parents with kids — they won’t go to a seller who makes kids’ sensitive stomachs sick. If the seller doesn’t use disposable plates and cutlery, look carefully to see how these are cleaned before they’re used by the next customer. Wipe them down with hand sanitizer if needed.

While they may be tempting to the budget traveller, avoid the fill-your-plate-for-a-set-price buffet type streets stalls, especially later in the day. While there’s usually a fascinating collection of homemade dishes, you have no idea how long the food has been sitting around letting bacteria grow. And these buffet stalls have the same problems as hotel buffets — your fellow travellers.

Even at the nicest hotels and restaurants, buffets are a food safety risk. While the higher quality places do a good job of keeping food at proper temperatures and replacing dishes often, it’s your fellow travellers who are the big concern. Even if they washed their hands when they arrived at the restaurant, since then they’ve licked their fingers, wiped their noses, scratched their heads, and coughed into their hands. Then they put their dirty hands all over the serving spoons and tongs, and then leave the handles touching the food.

If you can’t avoid a buffet, take food from the back of the tray rather than the front. It’s much less likely to be touched by the dirty handles of the utensils or perhaps a stray finger. When you put the utensils down, put them on a side plate, or at least keep the handles as far away from the food as possible. Or grab a clean fork and spoon and use them rather than the communal serving utensils.

Foods to Avoid

Choose your foods carefully. You know not to eat raw or undercooked foods, and to choose fruits and vegetables that are cooked, or that you peel or wash yourself.

But did you know that one of the most belly-trouble inducing foods is meat wrapped in pastry? Whether it’s a samosa, Aussie pie, curry puff, or bierock, these meat packages often sit around for hours slowly cooling. This makes them the perfect site for microbes to multiply. If you eat them, make sure they’re very hot (not warm) all the way through.

Watch the Hands

Be wary of places where the food server wears plastic gloves. These gloves tend to be dirtier than hands, because a person will wash their hands when they start to feel sticky and dirty. They don’t notice when their gloves get this way.

Money is filthy. Don’t eat at a place where the same person takes your money, gives you change and then prepares your food, unless you see them wash their hands in between.

Watch out for straws. Some servers will put your straw in your iced coffee or smoothie for you, and put their dirty fingers right on the spot where you put your lips. Sometimes drinking directly from the glass is cleaner.

Added Protection

Often the bugs that make you sick aren’t in your food at all. You’re more likely to have disease-causing microbes on your hands than in the food you’re eating. You’ve been touching door knobs, handrails, tables and chairs, your phone and camera all day. Before and after you eat, wash your hands with soap and warm water or with a hand sanitizer that contains at least 60% alcohol. Similarly, break the habit of touching your face and you’ll prevent germs causing stomach problems as well as colds and flus from entering your system.

For added protection, take the Dukoral vaccine at least two weeks before you travel. This drinkable vaccine protects you for up to three months against E.coli and for up to two years against cholera.

Johanna Read is a Canadian freelance writer and photographer specializing in travel, food and responsible tourism. She writes for a variety of print and digital publications to promote unique destinations and experiences and encourage sustainable travel. In one year Johanna visited six continents, but since then has only been able to hit five annually (not yet getting back to Australia, with Antarctica still eluding her).

Follow Johanna on Instagram and on Twitter. Links to all her travel stories are at TravelEater.net.