Dominican Republic Health Precautions

(Travelers') Diarrhea
Many people on vacation suffer from travelers' diarrhea. It is sometimes caused by a change in temperature or the oil used in food preparation, and sometimes it may be bacteria, viruses or parasite contaminated water or food.

The symptoms usually start with abdominal cramps, nausea and vomiting, a slight temperature increase and a loose stool which seems endless. With the associated dehydration, often drinking water alone is not sufficient and a mineral supplement may be required. As with all unknown illness, more care is often required for small children and the elderly. Ensure that you have travel medical insurance and visit your hotel doctor after 12 hours of symptoms. They will monitor your situation and give you electrolytes, a hydrating IV or an anti-biotic if necessary. Don't self diagnose since you won't know if you're treating an infection or not, and using an unnecessary antibiotic can lead to other physical symptoms and conditions caused by the eradication of the good bacteria our bodies need to keep us healthy.

You can reduce the risk of travelers' diarrhea by following some simple tips:

• Wash your hands regularly; particularly after each trip to the washroom, each handshake, before and after every meal, after being in the pool and ocean and after handling money;
• Do not drink the tap water or use it for brushing your teeth and avoid licking your lips in the shower as well. Bottled water is readily available (ensure that the seal is unbroken). All ice and water provided by the hotel is safe.
• Eat only freshly prepared meat, fish, rice and seafood, served very hot or extremely cold as that item requires. As with ice and water served at the hotel, you are fine eating all fruit and vegetables served at the hotel.
• If you get diarrhea, continue eating and drinking to allow the irritant to pass through the body. Loperamide (Imodium) can be used if traveling or away from a toilet but should not be used merely to accommodate the inconvenience of diarrhea. Do not use Imodium if there is any sign of blood or in children less than 10 years old, or for longer than 24 hours. The doctor will guide you, and if your condition warrants contrary action, you will be so advised.



Malaria
Malaria is the most serious infectious disease that you can catch as a visitor to the Dominican Republic. Malaria is caused by the transfer of a parasite from human to human transmitted by a bite of the anopheles (mosquito). Malaria occurs throughout the year at the border with Haiti, but also occurs occasionally after heavy rains elsewhere on the island where standing water increases the incidence of mosquito breeding.




The malarial mosquito is most likely to bite between sunset and sunrise. Repellents can be applied to the skin and to the seams of clothing where the mosquito may be trapped against the skin. Diethyltoluamide, better known as DEET, is your best protection.




When visiting the high-risk areas, one can consider the use of anti-malaria prophylaxis (taking medication which is a precaution against catching malaria).





Malarone is the newest and most-prescribed malaria prophylaxis for travelers. It is used both to prevent malaria and to treat. The medicine is available through your family doctor.




There are many insect repellents containing DEET, in the form of gels, sprays, and creams, which can easily be ordered online if you cannot purchase them in local stores. Look for concentrations of DEET to as high as 50% if you don't suffer a contrary reaction to it.




Sunburn
Don't underestimate the strength of the sun, for when that happens you'll be like so many tourists who find sunburn and sunstroke the reason for making a visit to a Caribbean doctor. Both conditions can lead to very serious symptoms and side effects which can easily ruin your vacation. Look for signs of exhaustion, shivering, fever and blisters as effects of sunstroke and excessive burning.




Doctors, Medical Clinics and Hospitals
The resorts usually have an on-site doctor and clinic, or one with which an arrangement for service is in place. They will assist with immediate medical attention and refer you to a hospital or clinic if blood tests, x-rays or casting is required. The doctor, who will speak and understand at least a working level of English, can escort you in the ambulance or cab to a private hospital/clinic which is preferred over the public institutions for speed of care, with facilities and medical knowledge comparable to hospitals found worldwide. Speak with the doctor immediately upon arrival at the hotel if a member of your party has a life-threatening allergy or physiological condition. Should a situation present at some point during your vacation, you will then have the preliminary introduction out of the way and the doctor will be ready to attend on the matter instantly.




Medical Insurance
It is very important that all vacationers have full travel medical coverage since a broken bone might cost thousands of dollars and should you suffer something like gall stones or an accident requiring air evacuation, it could cost tens of thousands of dollars. You can buy insurance through your tour operator, your bank, independent insurance companies, or online travel insurance companies. You are usually expected to contact a toll free number at the head office of your insurer, either before seeing the doctor for the first time or immediately after. Some of the companies will fax a form to the doctor and you can fill it out there and then getting the appropriate signatures and often waiving your requirement to pay up front and the insurance company will take care of the charges directly. Most companies will ask that you submit receipts for all expenses that you incur and you will fill out a questionnaire once you are home and be reimbursed after a claims adjuster has reviewed the paperwork. You can and should visit the hotel doctor in case of diarrhea lasting longer than 24 hours, any skin irritations from contact with Caribbean land or water plants or animals, difficulty breathing, skin inflammation or rashes, excessive dizziness or weeping wounds.




Pharmacy and Medicines for Sale
The shops at your hotel may sell - at an inflated price - pain and fever relievers, anti-diarrheals (Imodium), upset stomach and constipation relief, wound disinfectant, sterile dressings, tweezers, condoms, insect repellent, anti-itch lotion, anti-histamine and sunscreen.

If you're taking any course of drugs/medications, it is advisable to carry with you a list of prescriptions with the names of medications and their purposes. If a Dominican doctor wants to prescribe you anything extra, they will want to know what other treatments you are taking. It may also be needed at border control to prove that any drugs you are transporting are for personal use. The Dominican authorities take a very strict stand on drugs. Bring your prescriptions in their original bottles with your name and the name of the drug clearly visible.




Vaccinations
Vaccination recommendations should be based on your health and consultation with your doctor. Though not updated with any regularity, you can check here for guidance. Doctors in certain world countries tend to prescribe some vaccinations with more frequency than the doctors in other countries so there is no general consistency. Some of the recommended vaccinations are for diseases or ailments that many can acquire while at home and are only suggested for travel in general and not particularly for travel to the Dominican Republic. Those include Hepatitis A and Hepatitis B, Tetanus, Diphtheria, Pertussis, Polio and Measles/Rubella. For travel to the Caribbean, a Typhoid immunity is recommended, though the chance of contracting the disease on your vacation is unlikely. The best protections against Dengue and Malaria are long sleeves, staying indoors, sleeping with windows closed, insect repellant with DEET ranging from 30% to 50% in proportion or picaridin in 7% to 15% concentrations. Oil of Lemon Eucalyptus, Tea Tree Oil and cinnamon oil are also natural insect repellents.