I think I’ll take a break this week from the outline and share some pieces of information that I acquired while working that helped me with the exam. 

• Chicken pox seems to be common especially in British travelers.  I mentioned this to the lady sitting next to me at the travel medicine review course and she laughed and told me that when she was a child she also got chicken pox while visiting Disney (she was from Canada though).  Consider the fact that a lot of other countries do not vaccinate for chicken pox like we do in the US so it is more common among travelers from those countries.  I don’t know that it is exam relevant but we would actually bring an information handout for the family as well as for the hotel giving cleaning suggestions for after the family left.  Disney’s hotels were fantastic about bringing coloring sheets and things to entertain kids that had to stay in their rooms because they were contagious.

• In Haiti, Cuba, Mexico and a lot of other countries antibiotics are available over the counter so it really was surprising to travelers from these countries that they would need to see a provider to obtain them here.  Additionally, a trend that I’ve noticed is that the longer people are travelling for the less tolerant they seem to be of differences from their home country.  Travelers that would come on vacation for a week understood that they couldn’t get their antibiotics without seeing a provider but people like my migrant workers who were here for months at a time were much more frustrated by it.  It also may have something to do with medical literacy but it’s just a trend that I noticed.

• British folks don’t tend to drive long distances.  I remember one family was going to visit a museum in my town and I mentioned that was where I was from and they were shocked because it was 2 hours away.  It didn’t bother me because I would go work for a weekend at a time but they couldn’t imagine regularly driving 2 hours to get to work. 

• I did a lot of urine dips out of those glass cups in hotels.  It’s always in the back of my mind when traveling that I wonder if they washed them well.

• Steroids are available over the counter in Brazil and it was shocking to my patients that they couldn’t get them without seeing a provider in the US.  In general, my patients from Brazil would always have called their PCP at home and gotten a recommendation on what to get (that was always spot on) but they couldn’t get it over the counter in the US.  Those were some of the smoothest visits because they already knew what they needed.

• In many other countries rapid flu and strep tests are not done commonly.  Patients would gather around and film on their phones to share with relatives when the lines showed up that they had something.  I found that fascinating. 

• This is true for nontravelers as well, but a lot of times people will say “I have a UTI” but they don’t at all and it’s vaginal discharge or an STD.  It’s also common for me to hear “I have a sinus infection” but it’s allergies or a cold that hasn’t settled in the sinuses.  Especially with those two self diagnoses I’ve found it really pays to dig into symptoms early on. 

• British folks would always give me their children’s weight in stones which was the absolute bane of my existence trying to weight based dose their antibiotics.    

• People from northern countries do not think to apply (or reapply) sunscreen when they go out.  Some of the worst burns I’ve seen were in travelers whose skin was not acclimated to the Florida sun.  That rapidly ruins a vacation especially in some cases as it was every single family member who was burned.