In 2000, 35 percent of international travel by U.S. residents was work-related. Each year, 7 million to 8 million Americans travel to countries where malaria is present; in 1998, 636 travelers returned infected with the disease.
"Companies need to be aware that when employees travel, they need to make them safe," says Joyce Almasy, R.N., of Passport Health, a national travel health company that consults with traveling employees. "OSHA has recently gotten into the picture and issued a tech bulletin regarding the safety and health of employees and international travel."
Almasy says there is no one way to stay safe and healthy while out of the country. Different destinations require different precautions and medications, but with a little education, travelers can familiarize themselves with what infectious diseases they may be exposed to.
There are specific threats for employees traveling to underdeveloped and tropical countries.
"The three to watch out for are Hepatitis A, which is transmitted through food and water; typhoid, also transmitted through food and water; and malaria ... transferred by mosquitoes," says Almasy. "We do encourage a personal first aid kit with what you use when you get ill -- decongestants, topical antibiotics, antacids. Whatever you use at home," take with you, she says, because buying medication in another country can be problematic. "It could have a different name, or be hard to come by."
Know your blood type, and if you're traveling to underdeveloped countries, to bring a wound kit with, among other things, a sterile syringe.
"I've heard stories of people getting sick in these countries, and they are sent out to buy a syringe from a street vendor," says Almasy.
Depending on the length of the trip, some businesses provide employees with supplemental travel insurance that covers hospitalization and medical transportation.
"Many people don't know this, but Medicare doesn't cover anything overseas," she says.
The optimal situation, however, is not to get sick in the first place, and Almasy has some suggestions for staying healthy.
* "No. 1, wash your hands in soap and water often," she says.
* "Only drink bottled water ... and beware of ice cubes."
Also beware of water bottles without a seal, and use bottled water when brushing your teeth and washing your hands before changing your contact lenses.
* "If you can't boil, cook or peel it, don't eat or drink it," says Almasy.
Lettuce is a good example of a food that is prone to harbor disease because it can be grown in contaminated soil. Avoid anything unpasteurized, undercooked or from a street vendor.
* Don't go barefoot, and get a tetanus shot. Don't swim in fresh water, unchlorinated lakes, pools or rivers.
* Make sure all prescriptions, including those for the trip like anti-malaria drugs, are with you at all times. In some cases, it's wise to have an antibiotic prescribed before the trip, but don't take it unless needed.
Employers and employees should take Centers for Disease Control warnings to heart and follow medical instruction.
"We are spoiled, when you think of how many diseases we have eradicated," Almasy says. How to reach: Passport Health, (216) 591-9380 or www.passporthealthusa.com
Most dangerous places
There are some places best avoided by American travelers right now. The U.S. State Department has issued travel warnings for the following countries.
* Liberia -- Rebels are engaged in clashes with government troops in a number of areas throughout the country. The president of Liberia has called for the resignation of his cabinet, which may lead to further instability.
* Yemen -- The security threat to all American citizens in Yemen remains high due to credible reports that terrorists have planned attacks against U.S. interests in Yemen.
* Kenya -- Terrorist actions may include suicide operations, bombings or kidnappings. U.S. citizens should be aware of the risk of indiscriminate attacks on civilian targets in public places, including tourist sites.
* Saudi Arabia -- This travel warning is being updated to inform U.S. citizens that the Department of State has ordered the departure of all non-emergency personnel and family members from the U.S. embassy and consulates in Saudi Arabia.
* Iran -- Tensions generated by the situation in Iraq have increased the potential threat to U.S. citizens and interests abroad posed by those who oppose U.S. policy. Some elements of the Iranian government and population remain hostile to the United States.