Medical tips for year-end travelers

If you're traveling overseas for the holidays or in the new year, there are some things you don't want to bring back with you — like mumps, which has cropped up in Scotland; measles, which is circulating in Germany; and mosquito-borne diseases that are spreading in certain Latin American countries, the Caribbean and even Hawaii, where more than 150 people have been diagnosed with dengue fever on the big island.

The good news is that, as of the end of 2015, no countries had an "avoid non-essential travel" notice from the Centers for Disease Control and Prevention. Such notices are reserved for the most serious health emergencies: Ebola, SARS, travel in the days following major earthquakes.

We interviewed Dr. Gary Brunette, branch chief of Travelers' Health at the Centers for Disease Control, to see what travelers should (and shouldn't) be worrying about this season. Are there any vaccines I need if I'm headed abroad this winter? It's a little late in the game to catch up on vaccines for Christmas travel — it can take 4 to 6 weeks for a vaccine to take effect. But it's not too early to start thinking about it for 2016 journeys. The first step is to find out whether you are properly vaccinated against any disease that's appearing in your destination, even if it's just one case. So that would include polio if you're off to Guinea, Laos, Madagascar, Nigeria or Ukraine; measles if you're headed to Germany, the Democratic Republic of the Congo, Ethiopia or Kyrgyzstan; and mumps if you're going to be in Scotland.

If you're going to a country where polio has been reported, the Centers for Disease Control and Prevention recommends asking your physician to check to see if your health records show that you've received the full course of polio vaccines. If not, start the shots; if yes, the CDC still recommends a single lifetime booster shot before you go.

For mumps and measles, if your records don't show you've been vaccinated, you should have a blood test to check for antibodies that would indicate you've had either the vaccine or the disease. If the answer is no vaccine, no indication of disease, then get the vaccine. There's very little, though not zero, risk from the vaccines. To learn more, go to the CDC website or ask your doctor. The CDC's travel directory is the best place to find out if there are other required or recommended vaccines for your destination. The site is organized by country and gives extensive health information. Some countries require proof of certain vaccines in order to visit, such as the yellow fever vaccine you'll need to visit many African countries. But also check the CDC site for recommended, even if not required, vaccines. The CDC recommends getting the yellow fever vaccine if you are traveling to some countries in South America including Argentina, Colombia, Peru and Venezuela. For China, the CDC recommends shots against hepatitis A and typhoid, to avoid getting sick from contaminated food.

And if you haven't yet had this year's flu shot, it's not too late to stick out your arm. Similar strains circulate throughout the world and flu season isn't over until spring.

Note: Insurance isn't likely to cover the costs of vaccines not normally recommended for the U.S. But you can submit the bills for reimbursement if your employer offers a pretax flexible spending account for medical expenses. What should I expect about airport screenings for health-related issues?

Airport personnel in Guinea, Liberia and Sierra Leone are still screening passengers for Ebola by taking temperatures and asking about symptoms such as fever and vomiting as well as contact in the previous 21 days with people who were recently sick with the disease. While the outbreak has largely ended, some cases have popped up. Any indication of exposure or illness could find you staying in the country for another three weeks or in need of medical evacuation since commercial airlines won't take you on board. Expect similar screenings when you get back to the U.S. if you've traveled to those countries. If other disease outbreaks occur that trigger screening, expect to see signs posted when you enter passport control.

I hear a lot about mosquito-borne diseases in Latin America these days. Any words of advice? Dengue fever and chikungunya are just two of the viruses spread by mosquitoes. They're cropping up in Latin America. And dengue, like so many of us, has discovered Hawaii as a destination spot. In recent months, Zika virus, has been circulating in some countries in the Americas and Caribbean, including Brazil.

There is no vaccine or medicine to prevent dengue, chikungunya, or Zika virus infections, but travelers can protect themselves by taking measures to prevent mosquito bites. The CDC recommends using a product that has 20 percent or more DEET, the most common active ingredient in insect repellents. The products will work for several hours, then need reapplying. Deet product names include Off!, Cutter, Sawyer and Ultrathon. Bonus: Ticks might avoid biting you as well.

No product is guaranteed, as any mosquito-bitten human will tell you. Applying sunscreen before repellent is one helpful strategy because you need to have the repellent as the first line of defense against the bugs. And being the underlayer doesn't take away the sunscreen's effectiveness.

CDC offers lots of information on best practices for applying insect repellent, mosquito protection and avoiding bug bites of all kinds, including the sub-Saharan tsetse fly. MERS popped up in Korea this year. Should I be worries about it? The CDC isn't recommending that travelers change their plans because of MERS (Middle East Respiratory Syndrome).

Cases of MERS have primarily been found in the Arabian Peninsula. though a few people from those regions, and some of their close contacts, were diagnosed with MERS after reaching another country. Most instances of person-to-person spread have occurred in health care workers and other close contacts (such as family members and caregivers) of people sick with MERS.

Airplanes are a hotbed for pathogens. What's the latest word about precautions for fliers? Brunette advises travelers (and, really, everyone) to wash hands frequently and thoroughly or use an alcohol-based hand sanitizer containing 60 percent or more alcohol — especially after using the toilet and before preparing or eating food. And cover your nose and mouth when coughing or sneezing. Airline passengers should be wary of their trays. A study earlier this year by travel cost calculator Travel Math fingered an airplane's tray table as the most contaminated surface on board. The solution: small packets of antibacterial wipes. Copyright 2019 NPR. To see more, visit https://www.npr.org.