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出门不生病,你需要做到这些

更新时间:2016-3-2 8:52:02 来源:纽约时报中文网 作者:佚名

Staying Healthy While Traveling the Globe
出门不生病,你需要做到这些

On a recent trip to Tanzania with four grandsons, my most important task (beside protecting them from the jaws of a lion or leopard) was to keep them, and myself, in good health. It would not have been much fun to be stuck in a tent next to the commode or flattened on a cot while the rest of the gang viewed a dazzling array of wild animals from the safety of a Land Rover.

最近,我带着四个孙子到坦桑尼亚旅行。行程中,我最重要的任务(除了从狮子或豹子的利爪下保护他们之外)就是保障他们和我自己的身体健康。当别的游客都乘坐路虎安全地欣赏各色各样的野生动物之时,你却被困在带座椅式便桶的帐篷里甚至卧床不起,肯定不是什么愉快的经历。

Although I came prepared for the worst, I did everything I could to make our trip the best. And I’m happy to report, no one got sick and we all had a great time.

虽然也要准备好去应对可能发生的最糟糕的事件,但我首先是竭尽所能地想让我们能享受一场美好的旅行。现在,我可以很高兴地报告大家,我们当中没有一个人生病,每个人都玩得很开心。

When I described the steps I took to friends and physicians, they urged me to write about them. So here goes, along with a host of other helpful travel hints from well-informed professional sources.

我向朋友和医生们说起我所采取的措施,他们都力劝我把它们写下来。所以,我们这就开始吧,以下内容中还包含我从其他见多识广的专业人士处得到的许多有用的旅行注意事项。

No. 1: I reminded my grandsons daily, any water you drink or use to brush your teeth must come from a sealed bottle that you open. Ice wasn’t an issue in the bush, but that too should be prepared from bottled water. When you take a shower or swim in a pool, keep your mouth shut. (This warning was particularly pertinent for one grandson who always sings in the shower.)

第一:我每天都提醒我的孙子,只有自己亲手启封的密封瓶装水才可以饮用或用于刷牙。在丛林中不存在冰的问题,但要用冰的话,也应该利用瓶装水制备。洗澡或在游泳池中游泳时要保持闭嘴。(这条警告特别适用于我一个喜欢在淋浴时唱歌的孙子。)

No. 2: Before every meal, we each chewed one pink tablet of bismuth subsalicylate (sold as Pepto-Bismol and various store brands).

第二:每次吃饭前,我们每人都要咀嚼一片粉色的次水杨酸铋片(商品名为Pepto-Bismol或其他品名不等)。

I have used this preventive since first reading about it in 1980 in The Journal of the American Medical Association in a study led by Dr. Herbert L. DuPont, an infectious disease and travel medicine specialist at the University of Texas, Houston. The study described how using these tablets greatly reduced the risk of traveler’s diarrhea among American students traveling to Mexico. In a subsequent study published in 1987, Dr. DuPont and colleagues reported that two tablets chewed four times a day reduced the risk of developing diarrhea by 65 percent. (Each tablet contained the standard dose, 262 milligrams of bismuth subsalicylate.)

自从我第一次读到这一点后,我就一直在采取这一预防措施。那还是1980年《美国医学协会杂志》(Journal of the American Medical Association)上德克萨斯大学(University of Texas,位于休斯顿)的传染病和旅行医学专家赫伯特·L·杜邦(Herbert L. DuPont)博士领导的一项研究。它介绍了在到墨西哥旅行的美国学生中,使用这些药片如何大大降低了旅行者的腹泻风险。在1987年发表的一项后续研究中,杜邦博士及其同事报告说,每天四次、每次咀嚼两片该药片可将腹泻风险减少65%(每片含标准剂量的次水杨酸铋,即262毫克)。

I have relied on these tablets, albeit in a lesser dose because I’m a lot smaller than average, during trips to Vietnam, Thailand, Peru, Indonesia, India and Nepal, and never got sick despite eating salads and peeled fruit, which one is warned to avoid. In fact, in India and Nepal, my traveling companion, who also took the tablets, and I were the only ones who stayed healthy even though the others in our group assiduously avoided those no-no foods and we did not.

在赴越南、泰国、秘鲁、印度尼西亚、印度和尼泊尔的旅行期间,我一直依赖这些药片(虽然使用的剂量较小,因为我的体型远小于普通人)。尽管我食用了沙拉和去皮的水果(有人警告我提示要避免食用此类食物),也从来没有生过病。事实上,在印度和尼泊尔,我和一位坚持服用这些药片的旅伴是我们那个旅行团中唯一保持健康的人——哪怕其他人都竭力不去碰那些禁忌食物,而我们并没有忌口。

So for the five of us going to Tanzania, I packed 15 tablets for each day of our trip — and no one experienced the slightest gastrointestinal upset. That wasn’t the case, though, for most of the others on our itinerary. However, if you choose to try this preventive, I suggest you check first with your doctor and perhaps consider using Dr. DuPont’s larger dosage.

因此,为了我们五人的坦桑尼亚之行,我按照每天15片的剂量准备了药片,结果,没有一个人出现过丝毫的肠胃不适。同行的其他人却大多没有这么幸运。不过,要是你选择尝试这种预防措施,我还是建议你先去拜访一下医生,或考虑使用杜邦博士推荐的较大剂量。

Without a preventive, which is no guarantee against food-borne illness, stick to “safe food” that is cooked and served hot, and fruits and vegetables you have washed in bottled water and peeled yourself. Never eat undercooked foods — eggs, meat, fish or poultry — or any food sold by street vendors.

预防性用药并不能保证你不会感染食源性疾病,而在没有预防性用药的情况下,你应该只吃那些“安全食品”,即煮熟并趁热食用的食品,以及你自己去皮、用瓶装水洗净的水果和蔬菜。绝对不要食用没煮熟的鸡蛋、肉、鱼或禽肉等或街头摊贩出售的任何食品。

Reduce your exposure to germs by washing your hands often, and always before eating. A hand sanitizer with at least 60 percent alcohol can be used if soap and water are unavailable.

经常洗手,尤其是在进食前,以减少你对病菌的暴露。如果没有肥皂和水,也可以使用至少含60%酒精的洗手液。

I took no chances, especially since I was responsible for four children. I had an emergency supply of Lomotil (for digestive problems) and azithromycin (Zithromax Z-pak, for infections) just in case.

我不会抱着侥幸心理去冒任何险,当我要为四个孩子的安全负责时尤其如此。我备有应急的地芬诺酯(Lomotil,治疗消化问题)和阿奇霉素(治疗感染)以防万一。

No. 3 (really No. 1 chronologically): I made sure we were all up-to-date on routine vaccines — measles-mumps-rubella, varicella (chickenpox), diphtheria-tetanus-pertussis, polio and an annual flu shot — and added two (for hepatitis A and typhoid) that the Centers for Disease Control and Prevention recommends for travelers to Tanzania. You can review recommendations for other destinations on the C.D.C. website at cdc.gov/travel. We also each filled prescriptions for generic Malarone (atovaquone proguanil) to prevent malaria, and I checked daily to be sure the boys remembered to take it.

第三(如果按时间顺序排列,其实这应该是第一点):我确保大家都接种了最新的常规疫苗:麻疹-腮腺炎-风疹、水痘、白喉-破伤风-百日咳、脊髓灰质炎和每年的流感疫苗,还补充接种了美国疾病控制和预防中心(Centers for Disease Control and Prevention, C.D.C.)建议到坦桑尼亚旅游的游客接种的两种疫苗:甲肝和伤寒。您可以从C.D.C.的网站cdc.gov/travel上查看针对其他目的地的建议。我还让医生为我们每个人都处方了足量的阿托伐醌/氯胍来预防疟疾,并每天检查孩子们有没有按时服药。

I also packed an ample supply of sunscreen, insect repellent with 20 percent or more of DEET, and a first-aid kit of hydrocortisone cream, antibiotic ointment and a variety of bandages, though happily the latter two were never needed. For one grandson prone to motion sickness, I took some meclizine as well.

我还准备了充足的防晒霜、至少含20%DEET(避蚊胺)的驱昆虫剂以及一个包含氢化可的松软膏、抗生素软膏和各种绷带的急救包,不过我们很高兴后两者从来没派上过用场。有一个孙子容易晕车,所以我也带了些美克洛嗪。

As the oldest traveler in the group (and the shortest now that my youngest grandson, at age 11, has passed me), I am acutely aware of the risk of blood clots when flying long distances. I always book an aisle seat so I can get up every hour or so and walk around for a minute. It also helps to move your legs and flex your ankles frequently. You might also wear graduated compression stockings on very long trips. Similar precautions apply to long car or train trips.

作为旅行团中最年长的成员(也是最矮的一个,因为我最小的孙子[11岁]已经超过了我),我对长途飞行中的血栓风险有深刻的认识。我总是预订靠过道的座位,这样我就可以每隔一小时左右站起来走动一会儿。这样的安排还有助于经常活动双腿和屈伸脚踝。你也可以在长途旅行时穿着预防下肢静脉曲张的弹力袜。类似的预防措施也适用于长途的汽车或火车旅行。

Although the risk of clots is generally very small, they can be life-threatening. At greatest risk are people over 40, those who are obese or pregnant or have limited mobility (for example, because of a leg cast) or who have a personal or family history of clots. Estrogen-containing medications also raise the risk; I usually take one of those, raloxifene, prescribed to protect my bones. But it can increase the risk of a clot, so I stop taking three days before a plane trip of four or more hours. For more information, check the C.D.C. advisory on blood clots and travel, and talk to your doctor.

虽然一般而言,血栓风险很小,但它们可能会危及生命。40岁以上、肥胖、怀孕或行动不便(比如一条腿打了石膏)以及有血栓病史或家族史的人风险最大。含有雌激素的药物也会增加血栓风险。我平时会服用一种此类药物——雷洛昔芬来保护我的骨骼,但既然它可能增加血栓风险,我会在至少四小时的飞行前三天停止服用该药物。欲了解更多信息,请查看C.D.C.关于血栓和旅行的建议,并咨询你的医生。

Even when traveling alone, I always purchase travel health and medical evacuation insurance because, well, you never know. People on my various trips have broken bones or become seriously ill and had to return home mid-trip. Two men died while snorkeling on separate trips of mine.

即使是在独自旅行的时候,我也总是会购买旅游健康与医疗保险,毕竟——你知道——世事难料。在我的各种旅行经历中,就见过有人因骨折或生了重病而不得不中途打道回府。在我独自旅行的时候,也遇上过2次男子在浮潜时死亡的案例。

Consider carrying a card that lists your blood type, any chronic illnesses or serious allergies and the generic names of prescription medicines you take. Bring some extra doses in case of travel delays.

请考虑携带一张卡片,列出你的血型、慢性疾病或严重过敏史,以及你正使用的处方药的通用名。请适当多带一些药物,以防行程延误。

Other worthy precautions: To avoid nasty parasitic diseases like schistosomiasis, do not swim or wade in fresh water in developing countries or wherever the sanitation is poor. Pools should be chlorinated. However adorable an animal (domestic or wild) may be, keep your distance. Do not touch or feed any animal you don’t know. Some carry rabies. Should you get bitten or scratched by an animal, wash the wound immediately with soap and clean water and, if at all possible, get to a doctor quickly.

其他值得注意的事项:为了避免血吸虫病等严重的寄生虫病,请不要在发展中国家或任何卫生条件差的地方的淡水中游泳或涉水。游泳池应经过加氯消毒。无论动物(家养或野生)有多可爱,都请保持距离。请勿触摸或饲喂你不认识的任何动物。有些动物可能携带狂犬病病毒。万一被动物咬伤或抓伤,应立即用肥皂和清水清洗伤口,如果可能的话,尽快去看医生。

If you expect to be at a high altitude (8,000 feet or higher), consult your doctor about medicine to prevent altitude sickness, which can take more than the starch out of a person. I was glad I did when traveling to Cusco, Peru (11,154 feet) and climbing in the Sacred Valley of the Incas (9,000 feet). The recommended preventive is acetazolamide (generic version of Diamox).

如果你计划前往高海拔(8000英尺[约合2348米]或更高),请咨询医生如何用药预防高原反应——万一发生高原反应,可就不单单是让人垂头丧气这么简单了。我很庆幸我在前往秘鲁的库斯科市(11154英尺[约合3400米])以及攀爬印加圣谷(Sacred Valley of the Incas,9000英尺[约合2743米])时做了这些预防措施。推荐的预防药物是乙酰唑胺。

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