by Dawn Brazell
Public Relations

If you happen to grab lunch with Joseph Cantey, M.D., or physician assistant Cameron Oswald, be sure to steer clear of certain subjects.

The infectious disease and travel medicine experts are loaded with information on how best to prepare for international travel, particularly to Third-World countries, so that you're best protected. But, they also have the rare horror story.

Take the botfly, for example.

Fortunately, it's very rare, but travelers in certain tropical regions sometimes become this insect's victim. An egg-laden female botfly will capture a mosquito and glue her eggs onto the mosquito in hopes that the eggs will find their way to a human host. When the mosquito bites a victim, the host's body heat triggers an egg to hatch, fall off and burrow in.

The larva secures itself and grows, forming a small mound beneath a person's skin.

Oswald said it's particularly unpleasant when the mounds start to move around. Fortunately, there's a relatively simple cure of suffocating it and providing antibiotic treatment. Oswald has seen only one case in his clinic.

Cameron Oswald, physician assistant, holds up the yellow vaccination card, approved by the World Health Organization, that she makes sure travelers keep up to date.

While treating illnesses acquired traveling is part of the job, a larger portion of the work of MUSC's Travel Medicine clinic is dedicated to prevention. Given the growth in the field of travel medicine, it keeps health experts busy.

International tourist arrivals grew by more than 4 percent in 2011 to hit the 980 million mark, according to the United Nations World Tourism Organization. With growth expected to continue in 2012, international tourist arrivals are on track to reach the milestone one billion mark later this year.

Cantey encourages travelers going to exotic locales to get appointments a couple of months before their trips. MUSC travel medicine experts check immunizations and consult TRAVAX, an interactive website to which the department subscribes that provides the latest travel health information for health care professionals. There is an entry on TRAVAX for every country in the world, including details on general health risks, outbreak news, immunization recommendations, malaria prevention and other infection risks and the best places to go for medical services at the destination.

"We know what's going on to the very last minute," said Cantey. "We've been trained in all these diseases and infectious diseases."

Dr. Joseph Cantey

Although there are more travel medicine vaccination centers opening, Cantey said it's important that patients seek out a center staffed by physicians with access to a subscription service such as TRAVAX. "It's far more complicated than just giving vaccines."

MUSC travel medicine experts examine patients and assess their current health status before making vaccination and other health recommendations. They also give patients packets of information based on the regions to which they are traveling as well as general educational tips, such as remembering not to rinse toothbrushes with tap water for those traveling to places with unsafe water.

Oswald said travelers will be careful not to drink the water, but then eat something that's been washed in it or rinse their toothbrushes just out of habit. They also may not know that dairy products such as cheese, yogurt, ice cream and milk may be unpasteurized in some areas. She does what she can to raise awareness so they can minimize their risks.

"People travel all the time without vaccines and malaria pills," she said. "They're taking a big risk. We want to make people more aware and minimize that risk."

Sometimes the tips are as simple as clothing choice. Cantey said tsetse flies prefer blue clothing, so they advise patients going to areas known to be a problem for that, such as Kenya, to wear light-colored clothing since insect repellants don't work. Tsetse flies cause African trypanosomiasis or sleeping sickness. It is a tropical disease caused by a parasite that is transmitted to humans by an infected tsetse fly and can be fatal if not treated.

One of the most common problems is malaria, which they've seen in cases of returning travelers. This disease is caused by a parasitic microbe spread by mosquitoes. Each year, malaria infects at least 300 million people living in tropical regions. It can cause brain damage or death if red blood cells infected with malaria parasites build up in the brain's blood vessels.

Also, parasitic worm diseases can be picked up by wading in certain waters, so they warn travelers what waters are known to be contaminated.

Travel can be a wonderful, fun adventure, especially if travelers get educated about the tricks of the travel medicine trade to protect their health. Oswald said she enjoys being a travel medicine specialist because generally patients are happy and excited to be going on fun trips.

"I live vicariously," she said smiling. Cantey agreed. Their goal for happy travelers: To keep them that way.

For more information, visit The Travel Clinic, at www.muschealth.com/travelclinic/.