Caribbean Triple Health Threat for 2016: How to Be Safe Down South

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For travelers heading south, Dr Stuart Rose provides tips on avoiding three ailments.

Travelers considering heading south for the winter in 2016 face a triple threat of diseases, according to the Center for Disease Control.

Dr. Stuart Rose, who runs a travel clinic and online store ( ) in Northampton, Massachusetts, said that the Zika virus (transmitted by daytime-biting mosquitoes) was first found to be a serious threat after thousands of babies were born in Brazil with abnormally small brains.

Most cases of Zika are relatively mild, but can cause devastating effects on a fetus, especially when infection occurs in the first trimester. There is no vaccine.

The disease is now appearing in other countries in the region; Mexico has just reported its first case.

Other viral diseases transmitted by the same daytime biting mosquitoes include dengue fever and chikungunya fever. They are widespread throughout the Caribbean and Central and South America, but cause more serious illness, often called break bone fever because of severe muscle and joint pain. Recovery can be prolonged and dengue is occasionally fatal.

In all three diseases, the mosquitoes bite during the daytime, unlike the mosquitoes that transmit malaria, that only bite in the evening and at night. Warnings in the media that advise people to sleep under mosquito nets to prevent Zika are misleading, because of the fact that these bugs bite during the daytime. In addition, the usual advice to wear long-sleeve shirts and pants is often impractical during the day in warm climates, highlighting the need to apply generous amount of DEET to exposed skin.

Dr Rose advises travelers heading south this winter to bring along a mosquito repellent containing at least 30 percent DEET. DEET, still the gold standard, is a safe product and is often under-applied, due to fears about “DEET toxicity” which has never been proven (Don’t get in your eyes or mouth however; it can be irritating).

Due to fears about DEET’s toxicity, studies have revealed that the product is safe, even if used on young children. The application of a DEET repellent is the key to avoiding these health threats found so far in El Salvador, Guatemala, Honduras, Panama, Brazil, Puerto Rico, and Mexico in 2016.

Visiting a travel clinic to get your shots and preventive medicines and where a travel medicine expert can review your travel plans and assess your travel risks as well as their prevention or treatment is a sensible start to any journey.

With his own travel clinic in Northampton Massachusetts, Dr. Stuart Rose administers all specialized travel vaccines (such as typhoid) and prescribes medications, but he also reviews, in detail, his patients’ itinerary and counsels them about how to best prevent insect bites, avoid unsafe food and water, and what to do if they get sick or injured “I also tell all of my patients, ‘Wear your seatbelt’–if there is one!’—highlighting the fact that injuries account for most “excess mortality” in travelers, especially in lesser-developed countries where poor road conditions and substandard medical care are most likely.

Dr. Rose also reminds his patients of some of the most important travel med tips: keep a small, personalized medical kit with you to treat minor problems; carry a cell phone to contact your physician back home for advice if you get sick; anticipate your medication needs before you leave; get all of your shots; wear your seatbelt and buy a medical evacuation policy, just to name a few.

For additional information on the latest warnings and updates about staying healthy while traveling, contact Dr. Stuart Rose at 413-584-9254, or email rose(at)

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Max Hartshorne
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