The amount of water and fluid in your body is something few people think about until there is a problem -- problems can occur with too much or too little. A basic guide for figuring the basic amount of oral fluids a person should be drinking is based on weight. A 20 kilogram (44 lbs) person should be taking in about 1500 mL per day. For those of us that weigh more than that, just add 20 mL of fluid, per day, for each additional kilogram. A person weighing 150 lbs (68 kg) should be drinking about 2.5 liters of water, providing there are no prior medical conditions that limit water intake, daily. This is more than most people I know drink, and they are not doing fun stuff like playing at the beach, hiking or exploring a new city on a hot summer day. The people that are exerting themselves in hot climates need to pay attention to how hydrated they are.

There is no easy way to say this, but one of the most effective ways of judging your hydration status is to check the toilet. How often are you urinating and what color is it? Early doctors used to taste patient's urine as part of their analysis. You can skip that part and just see if your urine is a nice, clear color or darker yellow. Darker yellow urine may mean that your are dehydrated. When somebody becomes more and more dehydrated, they begin to urinate less and less. Oh, don't try to fool yourself by thinking "I am going to pee all the time, I am fine" if you are drinking alcohol. Alcohol is a diuretic and makes you urinate more, but leaving you further dehydrated.

Continue reading It's all about the water

It's all about the water originally appeared on Gadling on Sun, 13 Jul 2008 12:00:00 EST. Please see our terms for use of feeds.

Lots of people get motion sickness. It is rumored that Christopher Columbus even had trouble with sea sickness. Fortunately, you don't have to dread that ship, car or plane trip for fear of "un-packing your breakfast" in full public view. There are a number of effective treatments and preventions for those who suffer from motion sickness -- the goal is to keep trying until you find one that works, for you!

The basic problem with motion sickness is not in the stomach, but in the discoordination of the visual signals sent by the eyes, the inner ear (responsible for balance) and the brain. The Travel and Tropical Medicine Manual cited one study involving over 20,000 passengers crossing the English Channel and the North and Irish Seas. Their data showed that motion sickness was more common in females than males and the older you were, the less likely you were to be effected. Over one-third of the passengers in the study felt symptoms of motion sickness. For the lucky ones that have never felt motion sickness, the symptoms include cold sweats, nausea and weakness.

Where to sit and Where to look

Choose a seat with the smoothest ride, if possible. Over the wings of a plane, the front seat of a car, forward facing seats and laying flat on your back are all places to help minimize motion sickness. When the "feeling of yuck" starts to creep in, try to focus on a distant object (it will be moving the least) or close your eyes. Avoid reading or focusing on objects close by -- their motion is much more obvious.

Continue reading Avoid "un-packing breakfast" due to motion sickness

Avoid "un-packing breakfast" due to motion sickness originally appeared on Gadling on Thu, 19 Jun 2008 12:00:00 EST. Please see our terms for use of feeds.

Travel health and the emerging specialty of "wilderness medicine" have obvious overlap. Dr. Paul Auerbach is one of the leaders in wilderness medicine: helping found the Wilderness Medical Society, co-author of A Field Guide to Wilderness Medicine and numerous journal articles and serving as faculty to the Stanford Fellowship in Wilderness Medicine.

His blog, Medicine for the Outdoors, is celebrating the two year anniversary. For those who haven't yet had a chance to visit, it is filled with practical information and advice for those exploring their environment and wanting to come back from the experience in good health. Travel and expedition medicine is the focus of my career and I find myself citing Dr. Auerbach's work and information, in my work. He is one of the pioneering physicians who helped elevate this field of medicine to a new and unique specialty.

A visit to his blog will allow the reader to learn about things from jellyfish stings and dislocated shoulders on the trail to malaria medications and outdoor recreation. This is truly an opportunity to read, first hand, the information from a leader in wilderness and expedition medicine. I highly recommend a visit to his blog, if you get a chance. Oh, and don't forget to congratulate him on his two-years of dispensing great advice!

Medicine for the Outdoors celebrates two year anniversary originally appeared on Gadling on Sun, 15 Jun 2008 13:00:00 EST. Please see our terms for use of feeds.

It is unfortunate that what looks good, doesn't always feel good. I think this is no more apparent than with a pair of shoes. You have a killer pair of new shoes that you've been waiting to wear on your trip and that day is finally here! New shoes on your feet, you head out for a day of sightseeing in your new city. But this is a recipe for blisters -- nothing can slow down a day of hiking, shopping or sight seeing quicker than hotspots on your feet.

Understanding how blisters form and some basic treatments just might allow you to ambulate with less pain and save that pair of shoes, as well.

If you remember from the hazy days of high school biology, the skin is made of 2 layers: a thick, inner layer (dermis) and a thin, outer layer (epidermis). As heat, caused by friction and rubbing, forms a "hotspot" on the foot, the two layers of skin begin to separate and fluid fills in this space. Moisture from sweat or water acts as a lubricant between the sock and the foot as well as softening the skin. This increases friction potential and a greater chance for a blister. This concept is key for helping to understand blister prevention.

Blisters commonly occur in areas of softer skin, that are not used to being roughed up by shoes. The shoes you wear everyday have already toughened up your feet in the areas that that specific shoe rubs. However, the new pair of shoes or the shoes you do not commonly wear will rub your feet in new,potentially soft areas. Common sense dictates that you should not wear a pair of shoes new to your feet on a day that you have a lot of walking to do. If you have the time, try wearing your shoes around for a few hours at a time with thick and comfy socks. Even if you are just walking around your house, having the shoes on your feet help decreases the chances of future blisters. That's in a perfect world, however, and I don't know about you, but I rarely visit there.

Continue reading Are the shoes worth the blisters? (and what to do if they are!)

Are the shoes worth the blisters? (and what to do if they are!) originally appeared on Gadling on Fri, 13 Jun 2008 11:00:00 EST. Please see our terms for use of feeds.

You are finally there...the perfect beach, the perfect companion and the perfect drink in your hand. This is what you've been working and waiting for. You've left the mobile phone off and are dedicated to not letting anything ruin your trip. Besides the calls from work though, sunburn can ruin a holiday pretty quick.

Basics: Your Skin and the Sun's Rays

You may remember from hazy days in high school biology that the skin has two main layers: epidermis (thin, outer layer) and the dermis (thicker, inner layer). The skin has many functions and one of them is protection from the sun. The amount of melanin in the skin can effect the skin's ability to protect against sunburn and damage from ultraviolet light, as most light skinned people can tell you. Being very light skinned, I get a "light pink" just going outside to get my mail.

This sun's ultraviolet light has three main types, UVA, UVB and UVC. People are exposed to much, much more UVA light than UVB, but it is actually UVB that is responsible for most sunlight induced erythema (sunburns). The UVC light is largely absorbed by the Earth's atmosphere. An interesting article that discusses the interplay of UVA and UVB and UVA's possible role in skin damage can be found here

Prevention

The best way to avoid getting a sunburn is to protect yourself and there are several ways to do this. Sunscreens, clothing, sunglasses and avoidance of peak sun hours (10 am to 3 pm) are all common tools in the war on sunburn. Glasses, contact lenses and sunglasses protect the eye from most UVB rays. For those of you that are "into shades" you can read a bit more about things like light transmission and distortion.

Continue reading Don't get burned on your next trip

Don't get burned on your next trip originally appeared on Gadling on Wed, 11 Jun 2008 12:00:00 EST. Please see our terms for use of feeds.

A recent post of mine seemed to briefly address the issue of the spread of infectious disease during air travel, without giving too much "meat" behind it. I thought there might be some interest in this subject and I would like to refer to an outstanding article, from the Lancet 2005; 365: 989-96, written by Mangili and Gendreau.

Clearly, the number of people who travel via air, is a staggering number with annual estimates well over 1,000,000,000 worldwide and over 600,000,000 in America, alone. Air travel is exciting and can be the most enjoyable part of the trip for some, but it also places one at risk for infectious disease.

The Cabin Environment

The spread of infection in commercial aircraft cabins is subject to several factors. The environment of the the cabin itself is perhaps the most important. The cabin, offering a pressurized environment and low humidity, requires that passengers and crew are in close proximity of each other. When parked, the fresh air is supplied via an auxilary power unit but during flight, fresh air is sent into the cabin from the engines where it is has been heated and compressed; outside air at typical cruising altitude is presumed to be sterile. Air enters the cabin from overhead, circulating downward and exiting from the floor. This is designed to help limit the spread of airborne particulate through the cabin.

Most commercial airliners use 50% re-circulated air for improved fuel performance and humidity control. This re-circulated air is filtered with a HEPA (high efficiency particulate air filter) system. Several studies have shown that standard cabin air is exchanged 15-20 times per hour compared to 12 per hour in a typical office. A survey demonstrated that most airlines use HEPA filters, although it is not a federal requirement.

Continue reading Infectious disease spread on airplanes

Infectious disease spread on airplanes originally appeared on Gadling on Thu, 05 Jun 2008 09:00:00 EST. Please see our terms for use of feeds.

Science Daily released an interesting article, based on research conducted at University of Massachusetts Amherst, that shows the low risk of air travel and bacterial illness.

Bacteria that was present in aircraft -- with exotic names like Psuedomonas, Bacillus and Staphylococcus -- are commonly found on healthy skin and not generally causative organisms of disease.

The research team sampled the air from twelve aircraft (Boeing 767) cabins with flight times of 4.5 to 6.5 hours. The samples were taken from the coach section of the plane at 6 different intervals, including boarding, climb, cruise and deplaning. As expected, the highest concentrations of bacteria was found during boarding and deplaning. When the passengers move through the plane, their activity stirs up dust and skin bacteria, releasing it into the cabin air. During the flight, the bacteria levels decreased, likely due to a decrease in activity in the cabin.

Bacteria in aircraft a low risk to travelers originally appeared on Gadling on Thu, 08 May 2008 12:30:00 EST. Please see our terms for use of feeds.

Medical News Today ran an interesting article covering the efficacy of rectally given anti-malarial medications. The purpose of using a suppository to deliver the medicine, Artemisinins, is a fairly new concept and can prove useful to prevent a life-threatening delay of intra-venous medications to combat severe forms of malaria.

The study looked at over 1000 patients and compared rectal administrations of several different medical compounds, all artemisinin derivatives. Interestingly, the article also compared these medicines with a standard treatment of quinine.

Ease of administration, portability and lack of special training for use are benefits of rectally administered medications. Delays in treatment of severe forms of malaria can result in death and travelers who are in remote locations and suffering from malaria might benefit from beginning this form of treatment, while seeking definitive medical care.

This might also serve as a reminder that the person trying to treat you for malaria in a remote area actually knows what they are doing when they are "checking down there".

Doc, I have malaria...why are you looking down there? originally appeared on Gadling on Mon, 07 Apr 2008 11:00:00 EST. Please see our terms for use of feeds.

This last weekend, I had very little time off and was in bad need of a trip and a little adventure. Knowing that I had to work this weekend, I chose to take my "vacation" to Azeroth. My decision to visit there was a great choice and I had a weekend full of adventures, looted treasure, monsters and magic. I visited several continents around Azeroth and only died a few times.

For my trip, I booked a tour with Naturally Rebellious, a guild with a lot of experience touring "noobs" around both continents. I can say that my guides were very professional, gave great service and explanations as we went, including history of the areas. They even cooked for me, secured lodgings and taught me a few things to keep me out of trouble on the journey. In fact, they had to heal me after several close calls, including a severe bear mauling, outside Astranaar.

The tour started in the beautiful city of Darnassus, the capital of the Night Elves and probably the safest city on both continents. My guides met me at the Warrior's Terrace and made sure I was properly equipped for adventures. I needed a sword, bow, armor, magical potions and some food.

Darnassus was a great city and very beautiful. Merchants and craftsmen have their shops built, alongside houses, right into the massive trees. It reminded me of the redwood forests in Northern California. There is even a large lake in the center, where I learned to fish. After a few tries, I was able to start dragging some Longjaw Mud Slappers to the shore. After a bit of preparation and the standard guide safety briefing, including waivers and something about "risk of death and if death does occur, Naturally Rebellious is required to resurrect said corpse within 5 minutes" we started. It was a little un-settling.

The trip out of Darnassus involved an animal called a Gryphon. This is basically a large flying bird, ridden like a horse. Surprisingly, they were kept in very good condition by their trainers and did not smell as bad as I expected. I learned this was to be our primary means of transport, for the tour. Darnassus is on an island, and there are boats to travel to the mainland, but the gryphon was a great way to get a "bird's eye view" of the landscape and see the area. Next stop...the Continent of Kalimdor and the port city of Auberdine.

Auberdine was my first real chance to get some adventuring in and test out my newly acquired skills. We gathered some herbs and I learned to make some potions of my own. I was fighting with the bears for a bit and had a great time. I noticed I was quickly ushered out of the city by my guides and told it was "for my own protection". Apparently, this is a favorite raiding area for the "bad guys" of the world, the vile Horde. True to form, the horde showed up and laid quite a massacre on the unprepared and those insane enough to join the fight. I would advise extreme caution in this town, due to political instability and civil unrest. Still, the town was nice and the clam chowder was superb.

Pushing on, we took the gryphons to the Barrens for a wildlife safari. Roaming around the vast, dusty plains allowed us to see some exciting animals, very up close and personal. Highlights included the Zhevra, a cross between a unicorn and a zebra and the Kodo, a very large and slow dinosaur type creature. We visited the Goblin city of Ratchet. A meal of bear steaks and blood sausage topped off the visit, before we headed down to the Shimmering Flats to watch a drag car race at Mirage Raceway. I even got an autograph and picture with the champion driver Nazz Steamboil!

Our next leg was one of the most exciting for me, because we got to take a long boat trip, from the port city of Ratchet, to the other continents of the Eastern Kindgoms. We docked in Booty Bay, a pirate and goblin town on the southern most part of the land. Fishing is the center of business in Booty Bay, unless you count piracy. After a hard day of fishing and fighting both buccaneers and angry gorillas, we stayed at the notorious Salty Sailor Tavern. This was my first experience with Junglevine Wine and we ate some very good Spotted Yellowtail and Rockscale Cod. I even entered the weekly fishing tournament and won a lucky fishing hat! If you make it by the Salty Sailor, tell Nixxrax Fillamug, the bartender, I sent you.

Our final stop was the human's capital city, Stormwind. This is Azeroth's version of New York City. Everything is here and you can learn or buy what ever you can imagine. The Trade District was bustling with people chatting, checking their mail, making trades, purchasing new gear and running from district to district, within the city. The statues lining the entrance to the city were majestic and I even enjoyed the smoky and noisy Dwarven District. No trip to Stormwind is complete without a trip to the Mage Quarter and the Wizard's Sanctum that houses the Stormwind Academy of Arcan Sciences.

With great sadness, I knew this trip to Azeroth was over. I wasn't too worried because I knew I would visit again, very soon. I made some great friends and killed a few Orcs at the same time. If this sounds like your type of fun, pick up a copy of World of Warcraft and take a trip you won't soon forget. When was the last time you got to save a princess, overthrow an empire and catch some fish all in the same day? Now that is a vacation!

My Weekend in Azeroth originally appeared on Gadling on Tue, 01 Apr 2008 14:40:00 EST. Please see our terms for use of feeds.

Sure, we've all thought about it and some of us do it often. Getting high on your holiday trip can be pretty fun, in fact. I mean really high, above 11,500 feet (3500 m). Not everything cool is on a beach at sea-level. Ruins in the Andes, trekking in the Himalayas and chasing back country powder are a few things you have to get high, to do. These trips are all "dream vacations," so why risk a problem with altitude sickness?

High altitude is considered to be 1500 - 3500 m (4950 - 11,500 ft) while very high altitude covers 3500 to 5500 m (11,500-18,050 ft). Anything above 5500 m falls into the extreme altitude category. Altitude sickness is not related to physical fitness and can have some deadly consequences, if not recognized and treated promptly.

Accute Mountain Sickness generally includes symptoms of headache, worse at night or during straining, nausea/vomiting and dizziness. The symptoms are often described as a "bad hangover".

Some conditions associated with more severe forms of altitude sickness or AMS (acute mountain sickness) include HACE (high altitude cerebral edema) and HAPE (high altitude pulmonary edema). These conditions involve swelling and fluid accumulation in the respective tissues. Swelling of the brain, as seen in HACE, can present as marked stupor and confusion. HAPE, with fluid collecting in the person's lungs, often starts as a cough followed by progressive shortness of breath.

Continue reading Getting High on Your Holiday

Getting High on Your Holiday originally appeared on Gadling on Thu, 27 Mar 2008 10:20:00 EST. Please see our terms for use of feeds.

Most people that read Gadling are travelers. After talking to a lot of my more mobile friends, I see that they got interested in travel at a young age, often from their family. Turns out, a love for travel can be genetic, and chances are you come from a long, long line of travelers.

The National Geographic Genographic Project headed by Spencer Wells looks at tracing every person's journey genetically. Wells, who has authored several books on the subject of population genetics, is interested in seeing how people have arrived at their current location. Starting from African and the "one mother theory" about 60,000 years ago, this projects looks at the spread of humans over the earth and their genetic differences and similarities acquired on the way. One can even see how close to extinction the human race was.

Fantastic stories of people crossing the land bridges between continents, trekking through deserts in Africa and sailing across oceans -- your ancestors experienced this! You can follow your personal journey, through comparison of DNA, and see where you've been and what types of genes you are carrying. I was quite surprised to see my journey. I am very light skinned and fair haired and was shocked to see that I had a lot of genetic connections to Central Asia. Looking at the pictures of people sampled from that region, I saw similar features to my grandfathers and relatives.

The coolest thing about the Genographic project is that it is "people powered." It needs your participation to work. You can purchase a kit to create your own DNA cheek swab and send in your data. Wells and his team will analyze your chromosomes and compare them with their database. This will give you a personal map and story of your journey.

This project will continue to shed light on migratory patterns and evolution of humans, as a species, for years to come. It will also hopefully show people just how similar we all are and how intertwined our paths have become.

Your Journey of 60,000 years originally appeared on Gadling on Tue, 18 Mar 2008 12:30:00 EST. Please see our terms for use of feeds.

The Hanta Virus is a little known problem of those who live and travel in the American Southwest. Unfortunately, Hanta has a reputation for killing people and should be taken seriously. A recent article discusses a case from February, 2008. Knowledge of transmission and prevention are needed to prevent a great "Indiana Jones" style adventure, visiting ghost towns, from making you very sick.

Hanta Virus first got major media attention with an outbreak in New Mexico in the early 1990's. The "Four Corners" area (Arizona, New Mexico, Utah and Colorado) was the epicenter of infectious disease and epidemiological research. This outbreak allowed researchers to determine that the disease is spread through contact with infected rodent urine and feces. Spread of Hanta between humans, directly, is not common and believed impossible.

Rodents are ubiquitous in the American Southwest and they are the primary vector for disease transmission. People especially vulnerable to this are hikers and backpackers and those who live in more rural areas. Exploration of ghost towns is a popular vacation activity and caution should be taken when doing this. These ghost towns attract the rodents and visitors to these buildings are putting themselves at potential risk through contact with animal urine and feces. However, of more than 100 reported cases, only 2 have come from hikers. The rest are from people cleaning their garages, vacation homes and other areas that include rodents excreta. Bleach solution and rubber gloves are proper protection measures, along with adequate ventilation while cleaning vacation homes or garages.

Hanta Virus symptoms include a flu-like illness with muscle aches and pains, headaches, nausea and vomiting and fatigue being common. There is no cure for Hanta Virus and care is supportive (treating the symptoms only). Worse is the Hanta Pulmonary form that classically appears after the person appears to have recovered from the initial infection. The person;s lungs fill with fluid and progression can be quite rapid, in hours in fact.

There have been 76 cases in New Mexico, since 1993, with 31 deaths.

Hanta Virus in American Southwest originally appeared on Gadling on Wed, 12 Mar 2008 17:20:00 EST. Please see our terms for use of feeds.

I was, recently, lucky enough to get an "escape weekend" from Chicago to Milwaukee, Wisconsin. On the drive to Milwaukee, along Interstate 94, I found a mecca of cheese and salami. Mars' Cheese Castle is not only an almost mandatory pit-stop for those traveling between Chicago and Milwaukee, but it is a treasure trove of tasty foods and great service. Part restaurant, bar, gourmet deli and gift shop, this is a worth the stop!

I am a big fan of wines, cheeses and various meats/salami. Mars' Cheese Castle satiated my appetites quite nicely. An easy access location allows an easy break from the Interstate and ample parking makes it tough to say "no" to a quick stop for supplies.

Wisconsin is known for great cheese and the Castle doesn't disappoint. Immediately, upon entrance, the deli counter is in view. Packed with great things, both local production and foreign, I was lost for about an hour just browsing. Of course you can get famous and fresh Wisconsin Cheese Curds, in many varieties. I was surprised, by the store's humble appearance, at the selection of imported cheeses including Gruyere, blues and goat cheeses.

Their meat section contains a nice selection of sausages and various luncheon meats. Usinger's products are prominently featured and after a few taste tests, I saw why. There are also some interesting gift ideas, such as sausages shaped like beer bottles. For something to add to your salami and cheese collection, hit their fresh bakery in the back of the store. Fresh cheese, bread, danishes, and rolls are made several times per day.

While you are busy buying foods for your picnic or to enjoy later that night, browse their gift section with some eclectic items that are uniquely "Wisconsin." The Green Bay packers logo is on every conceivable item you could imagine. Cows are another common subject and a better collection of "Brick-a-Brack" or "Chotckies" could not be found, anywhere.

What good is all this food without a little wine or beer too wash it down? While there, we managed to get a few bottles of Von Stiehl Wine, from a surprisingly good selection considering they also had beer shaped salami. Still, it is a beer brewing state and beers, beer steins and gift boxes they have a ton of.

Mars' Cheese Castle is easy to see from the highway and easy to get to. The food and beverage selection is impressive and you can get a dish towel with a smiling Wisconsin cow picture. What else can you ask for on a road trip through Wisconsin? Next time you are in southern Wisconsin, stop by and make sure you are hungry!

[See map]

Mars' Cheese Castle originally appeared on Gadling on Fri, 07 Mar 2008 15:00:00 EST. Please see our terms for use of feeds.

As the weather begins to get a little less wintery we are already beginning to discuss our summer trips. A beach trip is always a favorite. Laying on the shore with a bit of swimming and relaxation are just what's needed after a long, cold winter. But there are a few hazards that can ruin a good trip to a dive spot or beach -- best to start thinking about them now, so if there is a problem, you'll be ready to deal with it.

One of my most favorite quotes on the subject of bites and stings actually comes from WC Fields. "Always carry a flagon of whiskey in case of snakebite and furthermore always carry a small snake."

Jelly Fish are beautiful creatures to watch swim and some of the most interesting marine life. They can also cause a lot of pain and problems if you get stung. Jellyfish sting with their tentacles that contain thousands of nematocysts. Thus, a single creature can produce many, many stings.

The first priority, for a jellyfish sting victim, is to make sure they are still breathing properly and not having a severe allergic reaction. Burning at the site, numbness, nausea and swelling are all common reactions. A topical decontaminant is what is next. Get those stingers to stop causing problems! The nematocysts can generally be 'de-activated" with a solution of vinegar, rubbing alcohol or baking soda, poured over the wound. This will also help relieve the pain. Papain, found in meat tenderizer may also be helpful. Removal of the stingers can be aided by shaving the area, with a sharp razor and shaving cream. A local antibiotic/antiseptic cream can now be applied, with or without a low dose steroid cream. For those who just have to adventure in known jellyfish areas, a StingerSuit might be a good consideration. Oh, save the pee for the bathroom as it has not been proven to be of benefit and it is kind of gross.

There are a few famous jellies to know about. First is Chironex Fleckerii (Box Jellyfish), from Australia. This sting can be fatal to humans and extreme caution should be taken in waters where they live. The other bad-guy is Irukandji (Carukia Barnesi), also from Australia. This jelly is only about the size of a large coin and very deadly. Swimmers can often miss seeing them, until it is too close by to avoid.

Make sure to pay attention to life-guards and warning signs for the beaches you are visiting. The best advice is to avoid areas with abundance of jellyfish and head to another beach that is safer.

In a Jam with the Jellies originally appeared on Gadling on Wed, 05 Mar 2008 11:00:00 EST. Please see our terms for use of feeds.

The recent incident involving the woman who died mid-air has drawn attention to travelers who choose to fly when seriously ill. CNN ran an article offering advice for those who fly while sick, and to summarize, they advise against it. I consider myself a student of remote medicine and medical care with limited resources, and I am finding it difficult to think of a more remote, under-equipped location than a commercial airliner at 30,000 feet.

The CNN article discussed a company called MedAire and their advice to consider postponing flight plans when ill. The basic theory is that if someone is sick on the ground, their condition will likely be exacerbated by the cabin pressure, making them worse. MedAire reports that they receive approximately 50 in-flight calls per day from pilots with sick passengers and documented 97 on-board deaths for 2007.

Federal law requires that all US commercial airliners carry basic medical supplies including an AED (automatic external defibrillator), oxygen and a basic medical kit. The purpose of the AED is to detect a lethal cardiac arrhythmia and deliver a lifesaving shock, that hopefully converts the heart to a safe rhythm. The contents of the medical kit vary, but generally include aspirin, nitroglycerin, alcohol swabs, anti-histamines, broncho-dilators, epinephrine, dextrose, a blood pressure cuff and stethoscope, shears and IV tubing with saline fluid. The article also points out that although flight attendants have training in handling in-flight emergencies, they are not medically trained.

Perhaps the most important lesson that can be learned from this article is that a traveler is ultimately responsible for their own safety and well-being at all times. There is a tendency to take for granted the fact that most people reading this live in areas where an ambulance service and trained medical care are merely a phone call away. This is not always the case when traveling -- especially at 30,000 feet above the ground.

Some basic pre-planning for a flight should include a carry-on bag with ample supply of medications and a list of medical conditions. Loose, comfortable clothing and proper hydration cannot be stressed enough.

A very good and informative article from the Aerospace Medical Association offers some tips for healthy airline travel.

Should you postpone your travel plans when ill? originally appeared on Gadling on Thu, 28 Feb 2008 12:00:00 EST. Please see our terms for use of feeds.

The Ugandan Ministry of Health declared their outbreak of Ebola Virus officially over on Februrary 20th. If anybody have seen the movie Outbreak, they will remember the first few scenes involving the Ebola Virus. This is one of those dark, scary viruses that has crawled out of the forests and has been wreaking havoc since 1976.

Ebola Hemorrhagic Fever is spread through direct contact with body fluids of someone who is already infected with the virus. Another likely way to get this is from handling dead animals found in Central African forests. Famous for its case fatality rate of an amazing 55-90%, this is something you want to avoid. Symptoms include high fevers, rash, vomiting and diarrhea. Then it gets bad: multi-organ system failure, uncontrolled bleeding from the eyes, gums and rectum are common in the severe forms. There is no known cure.

This particular outbreak was a source of much attention, due to neighboring countries closing their borders in an attempt to contain the spread. Of interest to travelers to the area, the general traveler is not at risk for Ebola and the WHO did not issue any travel precautions to the area.

Ebola Outbreak over in Uganda originally appeared on Gadling on Mon, 25 Feb 2008 11:20:00 EST. Please see our terms for use of feeds.

The Island of Madagascar, east of Africa, has been hit pretty hard by Cyclone Ivan. Madagascar has been a popular traveler's destination due to its natural beauty and unique wildlife. The fourth largest island in the world, Madagascar is home to 5% of the world's plant and animal species.

Cyclone Ivan made landfall on the island Februrary 18th, and 28 deaths have already been confirmed. The death toll is expected to rise as rescue workers are just now beginning to gain access to the parts of the island most heavily damaged. The capital city of Antanarivo has approximately 18,000 people displaced and country wide figures estimate 300,000 effected by the storm.

A country that depends largely on tourism and agriculture, Madagascar has also been suffering with large international debt. A population of 7.5 million in 1975 (the last year they had a census), lives primarily in the rural areas out side of the capital city.

A wonderful website that discusses the variety of wildlife and vegetation on Madagascar can be found at www.WildMadagascar.org. Notable adventures on the island include surfing, wildlife tours involving the local carnivores called Fossa and Eco-travel.

Cyclone Ivan and Madagascar originally appeared on Gadling on Sat, 23 Feb 2008 10:00:00 EST. Please see our terms for use of feeds.

Passengers on a flight from San Diego to Hawaii were expecting to have a safe flight followed by, hopefully, some relaxing time in Hawaii. Instead, they were exposed to measles.

Measles is a highly contagious disease and is characterized by the famous rash that first develops on the face and head, spreading downward to the torso and arms.

The San Diego Union-Tribune reported that an 11 month old child from San Diego is under isolation at a military base until the risk of infection subsides, in 3-4 more days.

The origin of the infection believed to be from a visit to a pediatric clinic in La Jolla. San Diego County has reported 5 cases of measles, in 2008.

Travelers on the plane, as well as those at the gate, are at risk for contracting measles if not properly immunized. The MMR (measles, mumps, rubella) vaccine is commonly given to children over the age of 12 months. The 11 month old child was not able to receive the vaccine.

Any person who is believed to have been in contact with measles should visit their doctor.

Measles on a Plane originally appeared on Gadling on Thu, 14 Feb 2008 14:00:00 EST. Please see our terms for use of feeds.

A really interesting article over at Medical News Today looks at the prevalence of fake anti-malarial medications being sold, especially in China. The article is the result of a communal project involving physicians, public health workers, and Interpol participating in "Operation Jupiter" to uncover the unfortunately common practice of fake medication being sold to travelers. The original article, published in the Public Library of Science can be read here.

The anti-malarial drugs often contained no medications of benefit to malaria prevention. Worse than that were the medications that actually contained harmful substances such as banned medicines and ingredients from the street drug Ecstasy. But wait, it gets even worse! Some of the medicines sold had trace amounts of the known anti-malarial drug called Artesunate. There was just enough to pass the drug screening test, but not enough to provide any decent protection. This means that a resistance to Artesunate can build, rendering a very potent anti-malarial drug worthless.

One suspect, from the Yunnan province, is charged with selling 240,000 packs of fake Artesunate. This is an amount large enough to give false hope of protection from malaria to almost a quarter of a million people. However, only ten percent of this was able to be seized and removed from the market.

This article underscores the importance of knowing where your medication comes from. There are many reputable pharmacies worldwide, but there are also some shadier, backdoor places that have these unlicensed and harmful products. The best advice would be to get your medications from your home country or from a known and confirmed reputable place.

Make sure you get the medications you are paying for and are actually being protected from malaria.

Beware of fake malaria drugs in Asia originally appeared on Gadling on Wed, 13 Feb 2008 10:40:00 EST. Please see our terms for use of feeds.

A DVT (deep vain thrombus) is a condition that can be life threatening in travelers. You can get this from having poor blood circulation in the lower body, which leads to the blood clotting in the veins of the legs. The danger occurs if this clot finds its way to the lungs, suffocating the victim. This condition also goes by a few other names like VTE (venous thrombo-emobolism), PE (pulmonary emolism) or "economy class" syndrome" due to the cramped leg space on some airline carriers.

The veins of the legs carry blood, under low pressure, back to the heart and lungs, to be recharged with fresh oxygen. When a clot develops in these veins, it can be very large due to the increased diameter of the veins in the legs. Normal, healthy blood is made to clot and prevent somebody from bleeding to death in the event of a trauma. Blood also clots if it is not moving at its standard rate as well. A person sitting in a plane or car, for greater than 3-4 hours, is at risk for having decreased blood flow in the legs which can cause this dangerous clotting.

A sharp pain in the chest, increased heart rate and shortness of breath are all common symptoms. The DVT can occur several days after a trip and is, usually, first noticed as swelling of one leg more than another.

Travelers need to know how to maintain good blood flow in the legs, thus minimizing the risks of this deadly condition. For longer flights, trains, and drives, they key is mobility! Get up and out of your seat every hour to walk around. Visit the bathroom, walk the isle for a few paces or do some simple stretches in your chair. Some of my favorite stretches include flexing my calf muscles by raising my heels off the ground and placing my weight on the balls of my feet. Deep knee bends also work very well for stretching the muscles of the legs and increasing blood flow to the area.

Treatment for these conditions are required immediately. Medicines such as heparin or enoxaparin are commonly used. Awareness of this condition and taking steps to ensure good blood flow to the legs, during travel are the keys to prevention.

Resources: CDC Traveler's Health Yellow Book: DVT

Prevent the dangerous "economy class syndrome" originally appeared on Gadling on Tue, 12 Feb 2008 11:20:00 EST. Please see our terms for use of feeds.