One of the most important items in your luggage is something that, with luck, you'll never have to use: a basic medical kit to handle common illnesses and emergencies.
Whether it's a two-week holiday in Paris or a three-month trek through South America, a smart traveler goes prepared. The contents of a first-aid kit might vary depending on destination, length of stay and your own medical history, but even for relatively mundane trips, it makes sense to pack some supplies to relieve symptoms and take care of minor scrapes when you're far from home.
"People tend to leave without giving any consideration to 'what if?' So having the foresight to give some attention to medical planning is a very important first step," said Dr. Eric L. Weiss, director of Stanford Travel Medicine and an assistant professor of emergency medicine and infectious disease at Stanford University.
In a study published recently in the Journal of Travel Medicine, researchers asked employees of the Coca-Cola Co. who travel to rate the usefulness of items the company issues in its standard medical kit. Tops on the list were analgesics such as aspirin, ibuprofen or acetaminophen. Next were drugs for gastrointestinal problems, such as Imodium (loperamide), Pepto Bismol (bismuth subsalicylate) and items for wounds, such as adhesive bandages.
Those are among the items Weiss recommends for a basic medical kit. Also on his list are a decongestant, cough suppressant, antacid, stool softener and duct tape. The latter, it turns out, is great for the prevention or early treatment of blisters. You don't have to a bring a whole roll -- just wrap a tongue depressor or stick with a foot or two of the adhesive.
While all these items are readily available in developed countries, bringing them along means you won't have to venture out into an unfamiliar city at 2 a.m., jet-lagged and ill, looking for supplies.
If the trip is very long or to a country where health care is less developed, consider taking along some prescription medications like painkillers and antibiotics.
Ciprofloxacin (Cipro) is probably the most frequently prescribed drug for overseas travelers, because it is effective against bacterial infections in the gastrointestinal system, urinary tract and upper respira-tory tract. It's important to remember that drugs like Imodium block diarrhea but do nothing to kill the bug that caused it; for that you need to take Cipro or some other antibiotic.
Another common antibiotic is azithromycin (Zithromax), which is good for skin, ear and dental infections and strep throat.
"If you're going to pick one, I'd pick Cipro," Weiss said. "If you're going to pick two, I'd take Cipro and Zithromax."
Weiss also likes to provide travelers with a prescription for a small amount of Vicodin or Tylenol with codeine -- strong painkillers with the added benefit of cough suppressant and anti-diarrheal action. But they are controlled substances, so it's important to keep them in their original container with your name on it to avoid being hassled or stopped at border crossings.
If you have sensitive air passages and are traveling to an area of the world where air quality is poor, it is also advisable to pick up an inhaler with anti-asthma medication.
For trips to remote areas or places where water quality is questionable, water purification supplies such as a filter and / or iodine or chlorine tablets makes sense. And, of course, if you're heading to tropical regions where diseases like malaria, yellow fever or Japanese encephalitis are concerns, you should check with your doctor or consult the Centers for Disease Control and Prevention's Web page at www.cdc.gov / travel for specific recommendations.
Another topic to consider is sexual health. Weiss recommends carrying condoms or other pregnancy protection if there is any chance you'll be having sex during the trip. And women might want to think about bringing along a dose of emergency contraception (the "morning after" pill), which has recently become available.
Finally, consider your individual medical needs. Any chronic medical condition -- from migraines and asthma to diabetes and heart disease -- means not only taking scheduled medications but having supplies on hand to deal with an acute attack.
Weiss said those and any other important medical supplies should be carried onto the plane, not packed in checked luggage. It's a good idea, too, to have your travel partner carry a separate emergency supply of any essential medicines you take, such as insulin.
Women and air travel
Though many pregnant women forgo air travel in their third trimester, most can safely travel by air up to their 36th week of gestation, according to the American College of Obstetricians and Gynecolo-gists.
Last year, ACOG issued a new advisory about the question, which is often asked of doctors. It says travel is not recommended for any pregnant woman with medical or obstetric complications, such as preeclampsia (pregnancy-induced hypertension), poorly controlled diabetes or sickle-cell disease. The group also advises pregnant women to avoid air travel if they are at significant risk for premature labor or placental abnormalities.
Another concern is the formation of blood clots in the legs -- what some have dubbed economy-class syndrome. The risk goes up on longer flights, and pregnancy is a risk factor in general for blood clots. So it's especially important to stretch your legs and walk around, or wear support hose.
The association also warns that environmental conditions in the cabin, such as low humidity and changes in air pressure, can affect women with weakened cardiovascular systems.