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    Those traveling internationally will have many questions. Should I get any special vaccinations? Will I need antibiotics for this trip? As the director of the Travelers Clinic at 69���� Health, Stuart Cohen knows how a health problem — from diarrhea to an exotic disease — can derail an international trip. He and other doctors at the clinic help people prepare for safe and healthy travel in countries around the world and in circumstances from luxury vacations to humanitarian work. “Prevention is better than cure,” said Cohen, who is also chief of the Division of Infectious Diseases for the health system and director of Epidemiology and Infection Prevention for its medical center in Sacramento. Cohen offers his best advice for those who have the good kind of travel bug.

Before you go

• Start your planning early. Certain vaccines take about two weeks to be fully effective, and some need multiple doses.
• Visit the of the Centers for Disease Control and Prevention for general tips as well as alerts and advice specific to countries and types of travel.
• See your primary care provider or use the services of a travel clinic. The offers a in the United States and more than 90 other countries. Like 69����, and also have such clinics. (69���� also offers related services for students and employees traveling on university business.)
• Think about the circumstances of the trip. Will you be in a developing country? Staying in an urban or rural environment? Participating in adventure activities? Discuss these plans with your doctor and review your ongoing health conditions as well as your history of vaccinations and certain illnesses, like measles.
• Consider your whole itinerary. For example, a country may require a certain vaccination based on where you’ve been — even if the country you’ve just come from didn’t. “The last thing you want is to have them turn you away or tell you they’ll give you the vaccine,” Cohen said.

What to take with you

What you carry with you can help hedge against health issues on your trip, Cohen said. For example, take the drugs you need. Not only can picking up medications be inconvenient while traveling, but you could end up with drugs that may be ineffective, if not harmful. “There is a big market in counterfeit medications in some developing nations,” Cohen said. For ongoing health conditions, he recommends taking enough of your medications to support an unexpected delay in return. In addition to providing recommended vaccinations, clinics and health care providers can provide antibiotics or prophylaxis specific to the risks you may encounter on your itinerary. One of the most dreaded problems is traveler’s diarrhea, commonly caused by food or drink infected with E. coli bacteria and sometimes by parasites and norovirus. Cohen noted that sometimes your experience in a developing country can come down to the quality of public sanitation including the water supply and sewage system. He recommends carrying an over-the-counter antidiarrheal and, for a more serious case, antibiotics prescribed by your doctor. Pack a first-aid kit, too. And don’t neglect the basics — including ibuprofen, a topical disinfectant and bandages — because cuts and scrapes can happen anywhere. Cohen stressed that health preparations are important for more than exotic destinations. He is especially concerned for those who are returning to their home country to visit friends and family. “They don’t really think they’re at risk,” he said. “But when they go back, there are going to be different risks.”