University of Maryland Traveler's Clinic offers important travel tips is to be prepared for what may lie ahead.

Food and water are two of the most important considerations while travelling. The problem is that most water and much of the food is contaminated with various parasites, bacteria, and viruses. What to do?

Avoid raw, uncooked foods-salads, salsa, fruit, raw shellfish, dairy products, and foods off vendor stands. Eat only foods that are hot and cooked, dry foods like bread, or food you can peel like bananas, oranges, etc. Do not drink the water; instead drink sodas, bottled water (particularly carbonated; also make sure the bottle is uncapped in front of you and drink it with a straw), hot tea, coffee, beer or wine. Avoid ice cubes. Use bottled water to brush your teeth or dentures and use only your own cleaning solutions to clean contact lenses.

It is possible to purify water. You can boil it for 3 minutes at a rolling boil or add iodine based purification tablets (Potable Aqua or Polar Pure). Also, in combination with the tablets, you can filter the water. A low cost filter on the market is called Pentapure Travel cup water purifier. It costs about $22.00. Other filters are also available at camping stores like REI or Hudson Trail Outfitters. The filter used with the tablets will give you excellent protection. Also, you can boil water with an immersion coil provided you have an electric outlet (you may need an electrical converter in many countries).

Sometimes you will hear people discuss taking prophylactic antibiotics (Doxcycline, Bactrim, Cipro or Noroxin) to prevent traveler's diarrhea. This is generally not recommended because of possible development of resistant bacteria, increased sensitivity to the sun (you could get a horrible sunburn), intestinal side effects, allergies, or vaginal yeast infections in women. It is better to be meticulous with the food and water, and wash your hands. You can take Imodium AD and ciproflaxacin tablets twice a day for 1-3 days for relief of diarrhea, but the most important treatment for diarrhea is to drink lots of fluids so you don't get dehydrated. If you develop bloody diarrhea see a doctor.

Do not think that because you have received all your immunizations that you are fully protected against diseases transmitted by contaminated food and water. There are many infections for which there are no vaccines available at present; so it is important to follow these guidelines.

The sun can be a killer. Most people tend to travel in hot, humid, tropical, or dry dessert climates, and have a tendency to underestimate the power of the sun, subsequent dehydration, and sun stroke.

Do wear a hat! Wear sun screen. Most important - drink a lot of safe liquids like bottled or boiled water. Don't wait until you get thirsty; by that time you are already dehydrated.

Vaccinations? Yes, indeed! Start 3 to 12 weeks ahead of time depending on your itinerary. Everyone should have had a diphtheria tetanus booster in the last ten years and two doses of measles vaccine. Polio vaccine (injectable or oral) is recommended for people traveling in areas outside of the western hemisphere, western Europe, Japan, Australia, and New Zealand. The hepatitis A vaccine or gamma globulin should be given to people traveling to third world countries, Eastern Europe, particularly the former Soviet states, and Greece. A typhoid vaccine (injectable or oral) is recommended for travel to any third world country including the former Soviet Union. In some individuals, the flu vaccine and pneumovax (against pneumococcal pneumonia) is also helpful.

Other vaccines depend on your itinerary. Yellow fever is present in Africa and South America, and will be needed for travel there. Meningococcal meningitis is a problem in large parts of Africa, Nepal, and parts of India; a vaccine is available. Japanese encephalitis is present throughout most of Asia and anyone going on a prolonged trip (over 3 weeks in rural areas) is advised to get vaccinated (this is a series of three shots over a one month period). Cholera is a problem in most third world countries but the vaccine is not very effective; it causes sore arms and fever, and it is no longer required at most border crossings. For these reasons, cholera vaccine is no longer available.

For people who are doing field research or staying in a country for many months, it is advised to get a hepatitis B vaccine and in some cases a rabies vaccine (to help protect against animal bites). Both of these vaccines are a series of three shots.

Remember, it's better to get your injections here; once overseas, needles may not be clean. Also, keep your immunization records with you.

Mosquitoes and other insects carry a variety of diseases like malaria, dengue fever, Japanese encephalitis, etc., so it's important to avoid them. Take mosquito repellent with you and use it. The active ingredient in repellent is DEET. You do not need a 100% concentration to be effective; 30% is just fine. Sawyer's Insect Repellent and Ultrathon are long-acting repellents that provide protection for 8-24 hours even after you get wet. It is also possible now to get a combination repellent and sun block. It is marketed under the brand name Repel. A good mosquito repellent for children is Skedaddle, which you can get in a drug store. You might need repeat applications. Don't wear perfume, after-shaves etc. Wear light colored clothing with long sleeves and long pants particularly in the evening. Avon's Skin-So-Soft is particularly good for those no-see-ums. Get permethrin sprays (permanone) to spray on clothes, beds, walls, windows, and mosquito nets. Lighting mosquito coils also helps ward off insects. Sleep in screened rooms or under mosquito nets. (If you use a mosquito net, drop it and tuck it around the bed in late afternoon, so when you get ready to sleep, you won't have mosquitoes inside the net). It is possible to buy a portable mosquito net (weighs 5 lbs., fits single or double beds) from IAMAT, 417 Center Street, Lewiston, NY 14092, telephone number: 716-754-4883. Another source for mosquito nets is Travel Medicine, Inc., 369 Pleasant Street, Northampton, MA 01060, telephone number: 800-872-8633.

Almost everyone has heard about malaria pills (there are actually several). The main one has always been chloroquine, taken once a week. In some parts of the world particularly in Central America, the Middle East, and some parts of China, this is still effective. However, much of the malaria in the world has become increasingly resistant to chloroquine and also to Fansidar, which was a mainstay back-up drug for a while. Now the recommendations are to use new drugs, mefloquine (Lariam), taken once a week, or Malarone, used daily. If that's not possible, use daily doxycycline (a derivative of tetracycline). Like all medications, there can be side effects, contraindications, and reactions with other medications. Discuss this clearly with your doctor. Remember - it is important to continue these medications after you return home.

Schistosomiasis is a disease caused by a parasite that lives in tiny snails in fresh water streams and lakes throughout much of Africa, South America, Asia, the Caribbean, and the Middle East (the whole Nile River is infected for instance). The problem is when you come in contact with the water, the parasite enters through your skin and can cause severe problems in the lungs, liver, intestines, bladder, and so on. This tends to be a chronic disease, and although there is a reasonably good treatment, it's best to avoid it in the first place. Don't go swimming or wading in any fresh water streams or lakes (sea water is okay). If you have to deal with such water, wear boots, gloves, etc. If you need to use the water for bathing or cooking, either boil it or chemically treat it first. Should you happen to come in contact with the water by accident, vigorously rub your skin with a towel as soon as you get out and if you have rubbing alcohol, apply it to your skin. It will reduce the risk of infection considerably.

As for shoes, take comfortable broken-in walking shoes (and wear them). Do not go barefoot. Many worms, leeches, parasites, and bacteria live in the soil. You can pick them up by walking barefoot. Also, take some sandals or sneakers that you don't mind getting wet so you can wear them walking on the beaches. Many beaches, particularly in Asia and South Pacific, have problems with jelly fish, stinging coral, poisonous rock fish, sea nettles, etc. on the shore. Getting stung by them is an exceeding unpleasant and painful experience.

Romance is just not what it used to be. In fact, it can be down right dangerous to your health these days. Herpes, chlamydia, hepatitis B, AIDS, drug resistant gonorrhea, etc. exist in every country. If you're going to have sex, you should use condoms all the time, or don't have sex. Don't even think of having sex with prostitutes; the rate of HIV infection in that population is astronomical!

Because animals are not normally kept as pets in third world countries, they are usually running around wild and are not vaccinated against rabies, so do not pet or play with these animals. If you are bitten, you're in for a lot of shots. Individuals who are going to be living in these areas for long periods of time, would be well advised to get pre-rabies exposure vaccinations (a series of three). Also if you do get bitten, wash the wound with soap and water- it will markedly reduce the risk of infection.

Travelling in mountain areas is becoming quite popular. Ideally you should ascend to high altitudes slowly and acclimate to the height first. However, many people will fly into mountainous areas and start trekking or skiing immediately. People can develop acute mountain sickness, resulting in headache, nausea, vomiting, insomnia, fatigue, and increased respiration and heart rate. These symptoms will usually go away with rest, lots of fluid (not alcohol), and a high carbohydrate diet. Diamox is a medication that can be useful in treating this, and can in fact be helpful in prevention if started 2-3 days before going to a higher altitude.

If the situation gets worse, people can also get fluid in their lungs or swelling in the brain. The best treatment is to get to a lower altitude as quickly as possible.

The most common health problem while travelling is not malaria, etc.- it's accidents! Accidents involving motor vehicles are the most frequent, followed by water sports, climbing, and assaults. So please, wear your seat belts and helmets, and watch where you're going and what you're doing.

When you are going into a remote area, ask the locals about any problems- snakes, scorpions, sharks, water conditions, etc. It's better to be forewarned.

If possible, avoid getting injections overseas. Sometimes you can get clean, disposable needles and sometimes you can't. There is a considerable risk of AIDS, hepatitis B, etc. People who are traveling extensively may want to take a kit of syringes and needles with them. Sources of first aid kits with syringes and needles are: Travel Medicine, Inc., 369 Pleasant Street, Northampton, MA 01060 (800-872-8633) and Chinook Medical Gear, 120 Rock Point Dr., Unit C, Durango, CO 81301 (800-766-1365). Also, ask your own physician.

If you are pregnant, have any heart, lung or intestinal problems, are diabetic, have epilepsy, or have any condition that affects your immune system, make sure you discuss this with your doctor and travel clinic ahead of time. You may need to make some special provisions before you travel. You may need to make some special provisions before you travel. And remember, always wear your medical alert bracelet.

If you wear glasses or contact lenses, consider bringing an extra pair, and bring all contact lens solutions. Bring all prescription medicines with you in originally labeled containers and have copies of your prescriptions. Useful items to take are: sun screen, Q-tips, band aids, antiseptic cream, safety pins, rubber bands, Swiss army knife (if you have one), and mosquito repellent.

Other useful items to consider are: Advil or Tylenol, cold tablets, cortisone cream, antifungal cream (tinactin or lotrimin) for the tropics, tampons, condoms, Benadryl (or something similar) for allergies. Pepto Bismol or Imodium AD for diarrhea. If appropriate for your trip, remember to pack malaria tablets, water purification tablets, diamox for mountain sickness, motion sickness tablets or special Trans Derm Scop ear patches, and antibiotics. Also remember medical kits with sterile needs if you need them.

While it's important to keep these warnings and do's and don'ts in mind, do remember to have fun and enjoy. You'll have a great time.

Source: University of Maryland Medicine