Racing abroad this summer?

as more people seek out international running events or book adventure vacations abroad, it's worth exploring guidelines for active international travel.

Before you leave the country, ask your doctor or a travel medicine specialist which vaccinations are appropriate for your destination. Some of these may include: hepatitis A and B, influenza, Japanese B encephalitis, meningitis, polio, rabies, tetanus, diphtheria, typhoid, varicella, yellow fever pneumococcal, measles, mumps and rubella. If you'll be traveling in the tropics, ask your doctor about chemoprophylaxis for malaria. Also pack insect repellent with at least 25% DEET listed in the ingredients.

To plan correctly for vigorous physical activity on your trip abroad, you'll want to take precautions to minimize jet lag. Crossing three or more time zones disrupts circadian rhythm and the sleep-wake cycle. Sleep well the night before departure. Drink plenty of water during the flight since cabin pressure can cause dehydration. Immediately after take-off, set your watch to the destination time zone. A sleep mask and earplugs will likely come in very handy on a long overseas flight. If you're competing in a race, allow a minimum of one day of recovery for each time zone you crossed.

Once you've arrived, if you're prone to motion sickness avoid travel on rural roads or onboard a ship; it can wreak havoc. You can minimize the likelihood of a bout by eating a light meal not less than three hours before you travel, focusing on the horizon during the trip and sitting in the front seat of a car or the middle of a ship. Try to limit head movement by leaning against a firm surface. Avoid reading and try to get plenty of fresh air. There are transdermal patches with few side effects that may serve you well.

You can avoid altitude sickness, which affects people regardless of fitness level, by ascending slowly. Some physicians recommend acclimatizing at 5,000 feet before going to 8,000 or 10,000 feet. Undoubtedly, you should acclimatize for at least two or three days at 10,000 feet, then allow two days for every additional 3,280 feet.

To avoid insect or other bites, apply DEET, check your bedding and shoes regularly before use, and wear water shoes in the ocean. Always avoid swimming in stagnant fresh water, and if you're packing SCUBA gear, be sure to follow established recommendations on air travel after diving.

To avoid heat illness, always wear sunscreen and drink plenty of fluids, regardless of whether you're training or racing. Pack a hat and sunglasses and wear light-colored, loose clothing. For more information on getting the most out of your trip abroad, visit www.cdc.gov/travel or www.tripprep.com.

(Phys. & Sportsmed. 2003, Vol. 31, No. 10, pp. 27-35)