The seasonal flu vaccine has arrived in all of our clinics. The WHO and CDC collect data from May-September and analyze the circulating influenza virus strains around the world. Since it is winter in the Southern Hemisphere, other countries are able to identify the types of influenza virus strains that are causing most of the illnesses. This information gives us a clue about what to expect for our upcoming winter and flu season.
Influenza or “the flu” is highly contagious and kills healthy children and adults every year. Each year, an average of 20,000 children under age 5 are hospitalized due to influenza complications. For travelers, getting influenza is one of the most common illnesses that occur while away from home. Crowded airplanes, trains, and buses are breeding grounds for the flu. Our clinic has seen a few cases of influenza this season already.
I always highly recommend getting the flu vaccine at least 2 weeks before the trip. All children and adults over 6 months should be getting the flu vaccine every year. It is best to get the flu vaccine EARLY in the fall season, before getting exposed to the flu. People often forget that you can get the flu ANYWHERE, and even in warm, tropical locations year-round. Getting the flu vaccine will not only provide the best protection against a miserable illness but also help to protect those around you and your community!
Every parent of a child with a serious food allergy worries when eating out at a restaurant. What happens if the chef made this dish with peanut oil? Or if the pot wasn’t cleaned thoroughly before my child’s dish was made and could be contaminated? Or if someone ate shrimp at this table recently? In my case, my daughter has a fish allergy so I avoid all sushi and seafood restaurants.
Traveling abroad when you or your child has a serious food allergy is daunting but NOT impossible. When I talk about a serious food allergy, I mean the kind that involves whole-body hives, lip or throat swelling, wheezing, vomiting, loss of consciousness, or even death. When you have this kind of food allergy or anaphylaxis, you need to be very careful of what you eat and the possible hidden exposures or “contaminants” you are in contact with. Here is a list of what you need to do if you are planning a trip:
- Take your destination’s cuisine into consideration during trip planning. Since my daughter cannot be exposed to any fish proteins, I have decided not to visit Thailand or Vietnam since fish sauce is used ubiquitously like salt in these countries. My friend’s child is allergic to dairy so going to France was not a good option for her. And if your child has a peanut allergy, I would avoid Southeast Asia. My recommendation is to be thoughtful in your trip planning as to where you want to go with a food allergy since you will likely be eating out at restaurants while you’re there.
- Research airline food allergy policies before you book your flight. The No Nut Traveler is a great website for people who have food allergies and want to fly safely on commercial airplanes. Some airlines, like Jet Blue, will create a buffer zone to keep your child safe from food allergies. Some will also make an announcement to all passengers on the flight not to eat peanuts on the flight if you or your child have a serious peanut allergy. You can also ask for early boarding so that you can wipe down the seats and tables with wet wipes before your child sits down. I would also recommend bringing a blanket to cover the seat to further protect from potential allergens. If your child has an allergic reaction to airborne nut proteins, you will want to choose an airline that does not serve nuts and will make an announcement to fellow passengers. When booking your flight and checking in at the airport, notify the agent of your food allergy and request that the gate agent/cleaning crew are also aware. Pack plenty of safe snacks/food. It pays off to be prepared at every step of your trip.
- Plan your accommodations with food allergies in mind. If your child has a serious food allergy, staying in a suite or condo with a kitchen will be more convenient and safer for you to prepare your child’s food. Staying at high-end hotels or all-inclusive resorts means that you will be eating out with every meal which will increase your risk of an allergic reaction.
- Learn some key phrases in your destination country’s language to warn others about your child’s food allergy. I’ve used the Google Translate app on my phone multiple times during my trips abroad. Figure out how to say the following: “My child is very allergic to _____. If she eats this, she may die.” It would also help to have this phrase written down in that language.
- Find out which hospitals are near your accommodations and figure out how to dial “911” in that country. If your child has a serious allergic reaction, like throat swelling or wheezing, DO NOT call the local clinic or hotel doctor. He/she will likely NOT have the necessary emergency medications or equipment to give appropriate care. It may end up delaying the right treatment for your child. It is best to get emergency care and go directly to a hospital emergency room.
- Pack at least 2 Epipens auto-injectors in your CARRY ON LUGGAGE and 2 doses of oral Benadryl (Diphenhydramine). For children under 55 pounds, they need the Epipen Jr (0.15 mg). For children over 55 pounds, they need the Epipen (0.30 mg). If you have the Auvi-Q auto-injector, please call your doctor for a prescription for the Epipen or Epipen Jr instead. ALL Auvi-Q devices were recently recalled. You can return your Auvi-Q to the company and get reimbursed by calling 1-877-319-8963. Benadryl comes in chewable tablets and single dose vials, which are more convenient to carry in your travel health kit. If you don’t know your child’s dose of Benadryl, you can ask your doctor. If you child also uses an inhaler, be sure to pack this in your carry-on luggage too.
- Know your Food Allergy and Anaphylaxis Emergency Care Plan. You can download a copy of the plan on the food allergy.org website and pack it in your travel health kit. If you have any questions about your child’s plan, review it with your child’s doctor before your trip.