But exotic locales can also open the door to exotic -- and not so exotic but equally serious -- diseases. From high profile maladies to illnesses which may sound so “yesterday,” the wise traveler’s best defense is a good offense.

“Our clients are seeking exotic locales to explore,” notes Kimberly Wilson Wetty, co-president of Valerie Wilson Travel, Inc. a leader in luxury travel based in New York City. Top destinations include Costa Rica, India, Egypt, Jordan, and Africa. “The next generation of travelers is more adventurous. They’re looking for unique experiences and are willing to go off the beaten track to find them.”

Avian influenza is still garnering media attention and alarming travelers. Yet, only 194 cases of avian flu in humans in nine countries have been reported since 2003 according to The World Health Organization. “It is important to recognize that contracting bird flu by humans is not easy. There is no evidence to suggest that the virus can be spread from person to person in an epidemic fashion.

Infections generally require substantial exposure, usually handling, of infected birds,” explains David S. Perlin, Ph.D., President and Scientific Director, PHRI and Professor of Microbiology and Molecular Genetics, NJMS-UMDNJ, Public Health Research Institute at the International Center for Public Health.

Concern about SARS ran equally high, but there have been no new reported cases since 2004. Miles J. Varn, M.D., PinnacleCare Medical Director, notes, “The less sensationalized diseases are far more likely to affect you, in particular, food-, water-, and insect-borne illnesses.”

Off the beaten track

If you are traveling outside urban centers in the U.S., Canada, Europe and Asia, Dr. Varn recommends precautions against Lyme Disease. The Centers for Disease Control and Prevention (CDC) reports that cases of Lyme Disease in the U.S. grew to nearly 20,000 in 2004. If left untreated, health consequences include facial palsy, meningitis, muscle and joint pain, heart palpitations, and neurological problems. Most cases can be cured with early antibiotic treatment, yet many people suffer ongoing symptoms.

Lyme Disease prevention is not just for campers. When traveling in wooded or grassy areas abroad, cover yourself with clothing, use an insect repellent with DEET on skin (in lower concentrations for children), treat your clothing with permethrin, check yourself and your children for ticks daily, remove ticks completely and monitor bite areas for infection continually.

Gastrointestinal illness is not easy to manage in tourist-friendly locales. Now imagine remote areas of Asia, the Middle East, Africa, and Central and South America, the world’s highest-risk regions, where 30 to 60% of travelers come down with the condition. Prepare for excursions with supplies of bottled water and packaged snacks when available foods, such as vegetables and fruits, may have been washed in local water. In luxury hotels in these regions, food-borne illnesses are rare, yet back-up medical planning is wise.

Yesterday’s news?

Are you aware that many diseases which have been essentially wiped out in the U.S. still present a threat overseas? For travel to Nigeria, India, Pakistan, Afghanistan, Angola, Cameroon, Chad, Ethiopia, Eritrea, Indonesia, Mali, Nepal, Somalia, Sudan, Yemen, Bangladesh, and Egypt, cases of Polio are on the rise. Children should be vaccinated before travel to these areas and adults should receive another dose of inactivated poliovirus vaccine.

For travel to the Ukraine, the Russian Federation, Belarus, Spain, Greece, and Kenya, Measles are a growing health threat, with a recent increase in cases reported. Check with your pediatrician to learn what immunizations are appropriate for your child’s age. In addition, check your own health records to ensure you were properly immunized.

New risks require new routines

Newly-popular, less civilized destinations require greater caution, yet according to Brigham and Women’s Hospital, one of PinnacleCare’s Centers of Excellence, only 19% of Americans seek pre-travel medical advice. Four health routines should become as commonplace as sharing your itinerary with your office and family.

Being prepared before you travel is essential. That preparation is easier to accomplish and more thorough for PinnacleCare members who have access to the personal support of an Advocate and more. Consider the situation of a member traveling abroad.

The family’s PinnacleCare Advocate reports, “A new Member advised me that the family would be leaving for Puerto Rico in three days for a week long vacation. There were multiple health concerns and two key issues, children with severe food allergies and a sister 5 months pregnant with placenta previa. By 5 pm the day after the member called, we gave her a detailed report including two general practice physicians, a high risk ob/gyn, a pediatric neurologist, and a pediatrician in Puerto Rico. We also included the private cell phone number for a high-ranking director at Pavia Health Corporation, who lives 2 miles from the hotel and agreed to be available to the family as needed.”

PinnacleCare Advocates also ensure the availability of increasingly important back-up plans for members and their families, including medical air evacuations and an international medical insurance letter of guarantee. Hospitals in locales off-the-tourist-track often require full payment before treatment, even in emergencies, so this letter can literally be a life-saver.

A pre-travel check-up is another must for exotic or extended trips. You need vaccinations and immunization boosters, a check for any undiagnosed health problems, advice on how to manage existing conditions while traveling and an adequate supply of your regular medications. Remember to keep medications in original containers to avoid customs problems, and carry them on-flight to prevent checked baggage loss.

The Mayo Clinic, a PinnacleCare Center of Excellence, advises travelers to carry a signed, dated physician document outlining health history and medication listing. PinnacleCare Members have an additional advantage: complete electronic records transmittable to medical providers anywhere in the world if they become ill or injured.

Sound like a lot? Not for PinnacleCare members. “Without such support, many overwhelmed travelers just take their chances,” sighs Kimberly Wilson Wetty. “I wish all of our clients had PinnacleCare.”