Healthy Honeymooning 101

By Marlene R. Fedin

With proper preparation the world is yours.

Sure, you'll stand by your spouse in sickness and in health. But let's just try to avoid the "sickness" part on your honeymoon. Here's how to reduce the risks.

Anticipating the taste of exotic cocktails and cuisines in remote getaways. What could possibly ruin this vision of paradise?

Can you say "Malaria"? Or, DVT, West Nile virus, SARS, Norwalk virus, Hepatitis C, Montezuma's Revenge, sports accident or medical emergency? The bad news: There's a litany of health risks almost anywhere you go. The good news: With advance planning, you can identify and prevent -- or minimize -- your personal risk, whether mundane (sunburn and diarrhea) or exotic (snakebites and infectious disease.

Here's what you can do to ensure that your dream trip doesn't turn into a nightmare.

Before You Book Your Trip

Consider Your Health: Travelers with asthma or respiratory problems may want to avoid high-altitude locations or those with heavy smog and pollution.

Find Out If a Ship's Fit to Sail: Check a ship's sanitation records and inspection scores at the CDC's Vessel Sanitation Program Web page (http://www.cdc.gov/nceh/vsp/default.htm). If you're prone to motion sickness, opt for a cabin that's towards the middle of the ship, as close to the waterline as possible and don't forget to pack an anti-nausea remedy. Be especially careful about personal hygiene. (It's now acceptable to bow rather than shake hands, a custom adopted after recent viral outbreaks.) Check the ship's medical provisions and emergency transport services.

Time Your Flights to Minimize Fatigue, Jet Lag, and Stress: Avoid rushing from your reception to the airport. If you've scheduled both a transcontinental and a transoceanic flight, break up your trip and spend a day on the ground at each leg of the trip.

Identify Destination-Specific Risks: Don't select a destination without first researching its health risks. The Travel Health (http://www.cdc.gov/travel/) section of the CDC (Centers for Disease Control) web site provides updated information on local health conditions, including diseases, outbreaks, precautions and required vaccinations and immunizations. (Phone: 877-394-8747; fax: 888-232-3299) The WHO's (World Health Organization) International Travel and Health Section (http://www.who.int/ith/chapter01_04.html) is another invaluable planning resource.

Take Preventitive Action

Consult a Travel-Medicine Specialist: They can schedule needed immunizations, provide necessary certificates of vaccination (required by some countries), prescribe pre-trip medications and offer preventive strategies and remedies for jet lag.

Search the International Society of Travel Medicine's (http://www.istm.org/) Travel Clinic Directory of U.S. and global providers to locate a physician or clinic (often found at major airports).

Get Your Shots: Allow enough time (several weeks or more) to get recommended shots and take prescribed medications. Many doctors suggest that all travelers update their tetanus/diphtheria shot and get a Hepatitis A shot.

Schedule a Checkup: If you have a chronic condition or current or recurring health problem, are planning a trip to a less-developed area or are taking an extended trip, get a physical and dental checkup a few weeks before you leave. Request prescriptions such as a broad-spectrum antibiotic to treat recurrent infections but don't take a prophylactic antibiotic to prevent intestinal problems.

Boost Your Immune System: A healthy immune system is your best defense against potential health risks. So resist the temptation to sleep less, skip workouts and eat erratically in the weeks before you're wedding. Travel Healthy: A Handy Guidebook for Health-Conscious Travelers by Lalitha Thomas (Hohm Press, 2002) $9.95 offers immune-building strategies.

Check Your Health Insurance: Are you covered for treatment outside your home state? Anywhere in the U.S.? Abroad? For emergency evacuation services? Carefully review your policy to avoid expensive surprises.

FYI: Some medical facilities outside the U.S. don't take insurance and require full payment, in cash, at time of care.

Purchase Pre-Paid Travel-Health Services: Evacuation via private air ambulance is expensive and usually not covered by health insurance. Short-term travel-health insurance that includes emergency evacuation and access to a network of vetted, English-speaking physicians is a must for adventure travelers and global honeymooners.

Pack These!

Take copies of prescriptions (including glasses and/or contact lenses and birth control pills or devices) and a note from your doctor stating why you need them. Keep medications in original containers and place in your carry-on bag. If you're taking a narcotic, tranquilizer or an amphetamine, make sure it's legal to bring it into the country.

Pack a kit based on your specific health needs as well as your travel itinerary, activities and the local climate and special health risks. Include over-the-counter products, which may not be available at your destination, for treating recurrent or likely problems.

Fast access to personal medical data is critical even in non-emergency situations. To facilitate accurate diagnosis and treatment, each of you should carry a typed card or sheet of paper with the following information:

• Medical History At a minimum, include: date of birth; blood type; food and drug allergies; pre-existing health conditions and past hospitalizations; recent or recurring health problems and surgeries, including oral or facial surgery; any speech, hearing, visual, memory, or other physical condition that may not be obvious to an observer; whether you wear glasses or contact lenses; the location of any implanted medical device (shunt, diabetic pump, etc.); a list of over-the-counter and prescription drugs (and the condition for which they've been prescribed) and any herbs, vitamins, or supplements you are now taking; list of immunizations by type and date; and any special concerns or considerations you have regarding medical treatment.

If you're trying to conceive or there is any possibility that you may be pregnant (even if you don't know it), flag this on your data.

• Medical Caregivers (Physician names, specialty, medical practice and/or hospital affiliations, and cell phone, emergency service and pager numbers; note who has your medical records)
• Personal Emergency Contacts (Indicate who is authorized to make medical decisions for you -- as a back-up to your new spouse who may also be hurt, injured, or otherwise unavailable to make such decisions)

It's everything you need to know in a carry-on size book.

On the Road

Practice Good Hygiene: Avoid touching shared surfaces and keep your hands away from your eyes, mouth, and nose. Wash your hands frequently and use antibacterial wipes or an alcohol-based hand gel.

Don't Forget to Take Your Meds: Time changes can make it easy to miss a day. Stay on schedule by following your at-home routine (adjusting for the local time difference). A watch alarm set to home time can help keep you on track. Consult your doctor about time-sensitive medications and dosages.

Prepare for Flights:

• Book business or first class seats for long trips.
• Avoid blood clots (DVT): Walk around every hour or so. At your seat, change positions, move your feet around, stretch, do ankle rolls. Don't cross your legs. Wear compression socks and ask your doctor about special drugs to prevent blood clots.
• Stay hydrated: Drink a glass of water every hour and avoid alcoholic and caffeinated beverages.
• Wear loose, comfortable clothing.
• Try to sleep or nap on long or overnight flights.
• Bring your own healthy snacks and don't skip meals.

Drive Safely

• Take frequent breaks; stretch your legs and walk around.
• Check medications to be sure they won't affect your ability to see or drive.
• Don't drive when you're tired or have been drinking.
• Observe local laws, especially speed limits.
• If you're riding a motorbike or cycle for the first time, get instructions and take a test drive before going long distances.

At Your Destination

Curb Your Enthusiasm for Risky Food and Drinks: Avoid foods from street vendors and other hygiene-challenged venues. Drink only bottled, boiled, or carbonated water or drinks in cans or bottles. But beware locally bottled products: They may contain local freshwater, which may harbor unsafe organisms. Avoid tap water, fountain drinks and ice cubes. Consider packing water-purification tablets or a filtering device for questionable areas.

Don't Enter the Honeymoon Olympics: You're more vulnerable to accidents and injuries when you're tired and stressed. Dial down your schedule for the first day or two. If you're not physically fit, don't schedule numerous -- or very strenuous -- activities. Make sure you know -- and comply with -- any special health or safety precautions before you begin a sports or fitness activity. Get instructions in the proper use of special equipment. To avoid heat stroke and heat exhaustion, don't schedule strenuous or prolonged physical activity during the hottest parts of the day.

Protect Yourself From the Elements -- and Insects: Wear protective clothing (especially from dusk to dawn, prime mosquito "snack" time). Use sunscreen and insect repellants and limit sun exposure.

Keep Your Hands Off the Animals: You'll avoid bites, infections and disease.

Be Careful Where You Swim: Heed beach warnings. Avoid freshwater-filled pools, rivers, lakes, and even the seas, especially if you have open cuts or abrasions. They may contain harmful, infection-causing organisms.

When You Return

Some health problems take days or even weeks to manifest. (Malaria, for example, can flare up weeks after exposure.) If you have any health problems within a month or two of your honeymoon, alert your doctor to your itinerary.