Whether your trip is for business or pleasure, you will benefit by taking some relatively simple steps to reduce health risks and to thereby make your trip more safe and enjoyable.

Over the past several months we have been bombarded with newscast alarms about

Ebola and, more recently, about MERS (Middle East Respiratory Syndrome). A few years ago there were similar alarms about SARS (Severe Acute Respiratory Syndrome) All of these diseases are highly fatal.  And here are no vaccines to protect you from any of them.   

Could these fearsome viral diseases impact your travel plans? 

Very briefly, until Autumn, (when influenza is likely to again rear its ugly head) takingvsensible precautions against acquiring any of these diseases is fairly straightforward. Ebola (the most frightful of these three) has come under almost complete control in West Africa, and it has not caused any cases in the Near East or in Asia. 

SARS did trigger relatively world-wide cases in 2002 and 2003, but there have not been any cases of SARS anywhere in the world since 2004.  So, of the three worst offendersvonly MERS remains a concern for persons travelling to the Middle East or the Far East.

MERS is still active in many of the countries of the Middle East (countries like Saudi Arabia, Kuwait, Lebanon, Iraq, Iran, Qatar, Oman, Yemen, Jordan, Syria and the United Arab Emirates).  And the case fatality rate in the region ranges from 30-40 percent.  There has been no complete control of this epidemic in these countries, so you should take maximum precautions if your travel plans take you to any of these destinations.  [There have been no reported cases in Israel.]

More recently, there has been an outbreak of MERS in South Korea which was triggered by the return (from Saudi Arabia) of an infected elderly Korean man.  The disease spread rapidly at first, and as of two weeks ago, there had been 120 confirmed cases there.   The South Korean authorities acted promptly. They quarantined over 6,500 persons, and closed thousands of schools.  With their actions, new cases have greatly slowed and the fatality rate there has never exceeded thirteen per cent.  It is likely that South Korea will be able to issue an “all clear” within the next few weeks.  With one very minor (and fully controlled) exception, the outbreak in South Korea has not spread to any other countries in Asia. 

Here are the tips:

• If you are in poor health, an infant, quite elderly, or your immune system is compromised from chemotherapy, or HIV, or for any reason, don’t make the trip.
• See your primary health care professional and get all your regular “shots” up to date.v(None of these will affect MERS directly, but they may help you avoid othervinfections that could weaken you and make you more susceptible to MERS.)
• Carry (and use) alcohol wipes wherever you go. 
• Your Mom told you not to “pick you nose” She was right!  That goes also for rubbing your eyes and putting your fingers in your mouth.  (Well, these things are actually O.K. in the privacy of your room, but only when preceded and followed by thoroughly washing your hands—Don’t tell your Mom I said so).
• Wash your hands several times a day (with an alcohol wipe follow-up).
• Carry many surgical masks with you. I recommend wearing one AFTER being seated, when on any air flights in the region.  (Airplane flights are probably the mostvhazardous locations you will find yourself in).  People (some coughing and sneezing) are generally really packed in, and the air is commonly re-circulated with less than adequate filtration.  Also carry cough drops which you can use yourself or offer to anyone seated near you who can’t control a cough.  The offer of a surgical mask to such a person will often also be appreciated.  Remember, your surgical mask should be of a light color and should be worn ONLY after taking your seat.  (Dark masks often have very different connotations for members of the flight crew.)  
• Don’t get into a spitting match with a camel !

This last rule deserves some explanation. There is strong evidence that the virus which causes MERS (MERS CoV) is quite commonly carried in camels where is causes little, if any symptoms.  There isn’t very good evidence yet for the direct transmission of MERS from camels to humans, but just to be on the safe side, it’s probably a good idea to “Keep out of spitting distance.”

Bruce Merchant, M.D., is a research physician in the immunology and pathology of human tumors and infectious diseases. He also holds a doctorate in Immunopathology from the University of Chicago. He is also involved with two separate clinical studies, one that involves the use of convalescent immune plasma (from Ebola survivors) and another employing a number of new pharmaceuticals, which are to be critically tested in Ebola patients in West Africa. He is the author of the new book: Moonkind: Survivors of Ebola. Learn more about Dr. Merchant at www.moonkindbook.com