Cholera in the Dominican Republic. Dengue fever in the Caribbean. Measles in Ukraine.
With summer travel season here, so are new warnings about health hazards in many exotic destinations. Granted, I'm probably more paranoid than the average middle-aged traveler, having been a bone-marrow transplant patient with a weakened immune system. And my idea of adventure travel is anywhere without a Four Seasons hotel. But in developing countries-and even in many developed ones-many travelers over 50 face special concerns, especially if they have chronic health conditions or take medications such as steroids that suppress the immune system.
"We see a lot of people who, after retirement, want to take the trek of a lifetime in Nepal, but it isn't the same as going to Kansas City, and a lot of them don't realize this," says Phyllis Kozarsky, an infectious-disease expert at Emory University and travel health consultant for the Centers for Disease Control and Prevention, both in Atlanta. Many popular areas lack basic medical care, let alone easy access to a local drugstore.
埃默里大学（Emory University）传染病研究专家、美国疾病控制和预防中心（Centers for Disease Control and Prevention）旅行健康顾问科扎斯基（Phyllis Kozarsky）说，我们看到很多人在退休后想去尼泊尔徒步，但这跟去堪萨斯城可不一样，而他们很多人都意识不到这一点。埃默里大学和疾控中心均位于亚特兰大。很多热门地区都缺乏基本的医疗保健设施，更别说方便地在当地药店买到药了。
See Your Doctor
Four to six weeks before foreign travel, it's wise to visit a doctor for recommended vaccines and cautionary medications such as malaria pills and a prescription antibiotic in the event of a bad stomach bug. But it is also important to pack mosquito repellent and other precautions for outdoor activities in areas where malaria, yellow fever and other insect-borne diseases abound─and to stock up on other important items.
"I walk through the aisles of my local pharmacy and carry the things I'd like to have with me in the event of a minor illness," such as pain relievers and anti-diarrhea medication, says Dr. Kozarsky.
The CDC travel health website has a regularly updated list of health risks and vaccination recommendations and requirements for specific countries. Some clinics use a software program, Travax, which tracks disease risk data. Paul McKinney, developer of the program and medical director of the travel clinic at the University of Louisville in Kentucky, says it also helps identify vaccine requirements for travelers who may be going from one foreign country to another. For example, travelers going to India from the U.S. don't require a yellow-fever vaccination, but if they are first visiting countries where yellow fever is endemic, India may require them to be vaccinated.
疾控中心旅行健康网站列出了具体国家的健康风险和建议接种的疫苗及要求清单，并且会定期更新。有些诊所会用Travax软件程序，它能够跟踪疾病风险数据。该软件的开发者、肯塔基州路易斯维尔大学（University of Louisville in Kentucky）旅行诊所主任医师麦金尼（Paul McKinney）说，该软件还能帮助确认在国外不同国家间旅行者的疫苗要求。例如从美国到印度的旅行者不需要接种黄热病疫苗，但如果他们要先去黄热病多发的国家，印度可能会要求他们接种疫苗。
Live vaccines such as the one for yellow fever can be risky for those over 60 or 65, Dr. McKinney warns, because of a higher likelihood of side effects. Patients taking steroids, which lower resistance to viral infection of any kind, are also less likely to have a good response to a vaccine.
It's also important to be up-to-date on routine vaccinations such as flu and tetanus before leaving the U.S. A shingles vaccine for those over 65 can reduce the chance of being struck with a painful and debilitating case of the virus, which is related to childhood chickenpox. Measles are also a growing concern in Europe, Dr. Kozarsky says. If you're unsure whether you had measles or a childhood vaccination for it, a blood test can determine if there are antibodies to the disease.
Travelers also need to be careful about organisms that can penetrate the skin while swimming, or bacteria found in drinking water-as well as raw foods such as salad and fresh fruit.
In Case of Emergency…
For the worst-case scenario, it is also a good idea to consider an emergency medical evacuation program. Before a trip to Russia last year, Marvin Freedman, a retired Justice Department investigator and avid world traveler, bought a membership from MedjetAssist, on the recommendations of some fellow travelers. He admits he was skeptical it could deliver as promised: evacuation to the hospital of his choosing for the $260 plan.
While poking around historic towns in the Golden Ring area outside Moscow, Mr. Freedman picked up a bug that worsened by the time he got to St. Petersburg. Admitted to a hospital there, he was pumped full of antibiotics by doctors who diagnosed a bacterial infection. But he wasn't getting better. After a few days he placed a call to MedjetAssist, where he was connected to doctors at the University of Pittsburgh Medical Center who determined he needed to be brought home.
在游览莫斯科郊外金环地区（Golden Ring）的古镇时，弗里德曼感染了一种疾病，在他到圣彼得堡时病情开始恶化。他住进了当地的一所医院，医生诊断他是细菌感染，给他注射了抗生素。但他并没有好转。几天后，他打电话给MedjetAssist，联系上了匹兹堡大学医学中心（University of Pittsburgh Medical Center）的医生，他们认为他需要被送回美国。
The next morning, a Lear Jet with a flight doctor and a nurse arrived to take him on the first leg of a long journey back to Wisconsin. Doctors there determined it was in fact a viral infection-which doesn't respond to antibiotics-and discontinued the drugs. After making a full recovery, Mr. Freedman says he is undaunted from globe-trotting and already has a journey to India in the planning stages.