The shot doc

Decatur physician specializes in getting travelers ready to face health hazards of international trips

By Paul Huggins
http://www.decaturdaily.com

The hymn “He’s Got the Whole World in His Hands� may come to mind to local churches planning short-term mission trips to remote parts of Africa or South America this summer.

But before they board their plane, many probably will visit Decatur General Hospital’s Dr. Scott Harris, who has treatments for the whole world’s infectious diseases in his hands.

“It would be very unusual to find a family doctor who has the immunizations we carry,� said Harris, whom some clients refer to as “the shot doc.�

That’s because Harris is a travel doctor specialist, and he’s the only one in North Alabama. That puts him in high demand as the number of international travelers grows significantly every year, and especially this time of year, as people prepare for vacations and mission trips.

About 800 million people will travel out of their home countries this year, he said, and that number will surpass 1 billion in five years.

Most of his patients are business travelers, followed, in order, by tourists, missionaries and expatriates returning to their home countries.

A lot of businessmen go to China and India, Dr. Harris said, and he has seen a growing number of parents going to China to adopt a child. Tourists typically go to Europe, but he finds others ranging from those cruising to the Caribbean to mountain climbers headed for Africa. Many short-term missionaries are visiting the Caribbean and South America with a growing number heading to eastern Africa, he said.

A pre-travel consultation to Harris includes a risk assessment, advice to reduce exposure to those risks, immunizations, medications and advice for self-treatment.

“It’s very subtle on what medicines you take, depending on which part of the country you’re traveling to,� he said.

Harris recommends hepatitis A vaccine for almost all people traveling to places other than Canada, Japan or Western Europe. Depending on location, other immunizations may include typhoid, rabies or polio.

Muslims heading to Saudi Arabia often need meningitis vaccines, and he noted a few countries in South America and Africa require visitors to show proof of having received the yellow fever vaccine before issuing visas.

Although there is no vaccine against malaria, common in more than 100 countries and contracted by more than 100 American travelers annually, there are oral medications for preventing it that Dr. Harris said he regularly prescribes.

That included 22 members of Southside Baptist Church, who went to the jungles of Belize for nine days in March.

“It was wonderful to just be able to go one time and get all your shots,� said Berry Terry, Southside director of missions. “Of course, it also gave us a comfort level for him to sit down and talk with us.

“My wife and I went together and he consulted with us for about an hour. The shots didn’t take but a few minutes,� he said.

Travel medicine started becoming a specialty about 10 years ago, Harris said, coinciding with increased international travelers. He has training and certificates from two travel medicine boards, but he said doctors currently don’t have to be certified in travel medicine to practice the specialty.

Harris said specializing in travel medicine was a natural extension of his main specialty of treating infectious diseases. In addition, he loves to travel abroad and has taken a number of medical mission trips.

Being an international traveler, he said, makes him better qualified to understand and explain what his patients will need to be safe. He added that besides medical advice, he will offer tips on dealing with jet lag, altitude sickness, local customs and even how to obtain medical care overseas.

The biggest mistake pre-travelers make is not checking on health risks, Harris said. There are popular resort areas such as Cancun where hepatitis A is common, and he noted one in 300 unvaccinated people who visit infected areas will contract it.

The most common mistake travelers make once they get abroad is getting careless with food and drink, and ending up with stomach problems, such as traveler’s diarrhea, commonly called Montezuma’s revenge or Delhi belly. It strikes more than 50 percent of visitors to developing countries and more than 80 percent in high-risk countries.

On occasion, Harris said, he has received calls from people in foreign lands who needed medical attention, and he was able to search his database for a doctor in their vicinity who had treated travelers previously.

That same database has helped him contact doctors in remote parts of the world to get details on undocumented health risks.

“There was this one time I sent out a request on the Internet,� he said, “and a short time later I got a text message back from a doctor in Zimbabwe, which included a map of where the risk areas were for hepatitis A.�

Planning overseas travel?

Unless you’re heading to Western Europe, you’ll probably need some type of vaccinations to protect against infectious diseases. Here’s a basic list of shots and oral medications Dr. Scott Harris of Decatur General Hospital recommends for some international destinations:

# Paris – Nothing beyond routine immunizations, such as diphtheria, pertussis, tetanus, measles, mumps, rubella, chickenpox and polio.

# Hong Kong – Routine shots and perhaps hepatitis A vaccine.

# Sofia, Bulgaria – Routine shots and definitely hepatitis A.

# Cancun, Mexico – Routine shots and definitely hepatitis A; there is no malaria in Cancun but overnight trips to other parts of the Yucatán might require malaria prophylaxis.

# Belize – Routine shots, hepatitis A, occasionally typhoid vaccine depending on the anticipated itinerary and usually malaria prophylaxis (some parts of the country are malaria-free).

# Calcutta, India – Routine shots, hepatitis A, typhoid, occasionally rabies, rarely Japanese encephalitis virus vaccine and always malaria prophylaxis.

# Lagos, Nigeria – Routine shots, hepatitis A, typhoid, yellow fever, often meningococcal vaccine and always malaria prophylaxis.
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