So you’ve decided to take a trip out of the country, possibly even to the developing world. While there will be plenty of new sights to see and experiences to seek out, a bad virus can ruin everything. Even worse, some germs that you can pick up may be deadly or life-changing. So before you fly, make sure to take precautions to keep you and your travel-mates healthy.

Block Those Germs

In 2007, a groundbreaking study captured the importance of protecting yourself from germs while traveling by air. The study, conducted by Charles P. Gerba, Professor of Environmental Microbiology at the University of Arizona, examined the tray tables and bathrooms in an airplane. It found that four out of every six trays swabbed contained MRSA (methicillin-resistant Staphylococcus aureus), and one out of six contained norovirus (a stomach virus). Not only that, but 30% of sinks, flush handles, and faucet handles in the bathrooms had E. coli bacteria, which can be responsible for stomach illnesses.

But it’s not just air travel that can put you at risk. Hotel TV remotes, doorknobs, and other often-touched items can spread germs from traveler to traveler. Luckily, there are tips you can use to protect yourself from these germs. According to the CDC, N95 face masks filter out 95% of harmful particles and can prevent 90% of infections in the air. Battery-operated air filters can also be hung around the neck to clean the air a traveler is breathing. You can use sanitary wipes to clean off commonly-touched surfaces, such as airline tray tables and hotel remotes, and you can even purchase cover slips for airline seats so you’ll know you’re sitting on a clean surface.

But more important than any of these preventative measures is the one that is often overlooked: good old fashioned soap and water. Nothing protects you from viruses like washing your hands thoroughly before touching your face or any food. Sanitary wipes and Purell are great for blocking bacteria, but use them only when regular handwashing is not an option. Experts say washing with soap and water is first choice, especially if you have visible dirt on your hands. Sanitizer can't cut through that grime. Hand sanitizer is great for when you can't get to soap and water, and it's actually more effective at eliminating germs because it kills them rather than just removing them.

Do Away With Diarrhea

Traveler’s diarrhea can put a huge damper on any trip, and it’s especially likely when you’re headed to a third-world country. Taking basic precautions can help keep you on the road and out of the restroom. For example, you can take a tablet of bismuth subsalicylate before each meal prophylactically. If you’re in a country with water that may trouble your stomach, make sure to avoid any tap water, including in activities like brushing your teeth or washing a fruit. And remember: ice cubes are just tap water in frozen form.

And if you’re especially nervous about getting traveler’s diarrhea, ask your doctor about Rifaximin (brand name: Xifaxin), an antibiotic that releases directly into the colon rather than systemically into the bloodstream. Because of antibiotic overuse, certain bacteria have become resistant to even the most powerful antibiotics available today. Antibiotic resistance is a widespread problem, and one that the Centers for Disease Control and Prevention (CDC) calls "one of the world's most pressing public health problems." Generally, antibiotics are carried in the bloodstream, so antibiotic overuse could affect the body's ability to fight disease. However, because Xifaxin is released into the colon, you avoid the issues of antibiotic overuse. With your doctor’s approval, you can take Xifaxin as a preventative measure either before trip or after you return. Note that it is quite pricey, but potentially worth the investment if you’re traveling to India, parts of China, South America, or other areas that have a high potential for traveler’s diarrhea. 

Snub the Bugs

With Zika featuring prominently in the news, insect repellent has become more and more common even at home. When traveling to a third-world country, however, avoiding insect stings can be even more essential. It can prevent not only Zika, but also malaria, dengue, and other insect-borne diseases.

Insect repellent containing DEET can go a long way towards preventing insect bites. For ease of application, you may want to bring along a small pack of insect-repellent wipes. For a more permanent and stronger option, you can spray your clothes with permethrin to make them permanently repellent.

As additional protection, wear long sleeves and pants to minimize skin exposure. If heat is a problem, opt for clothing that is lightweight and light in color, or invest in moisture-wicking clothes to help you keep both cool and covered.

Planning on sleeping outside? Invest in a mosquito bed. If you’ll be in areas that are severely infested, consider using a mosquito head net.

Other Tips

Besides these basics, there are other steps you can take to stay healthy while on the road, in the air, or in a foreign country. Make sure that you and your traveling companions follow these important guidelines to stay safe while you’re away.

• Before you leave, make sure you’re up to date on all vaccines, including MMR, Varicella, TDP, Hep B, and influenza. Check the CDC’s website for other info about vaccines and other precautions specific to your travel destination.
• Eat healthy and exercise. Keeping up your immune system can help fight off any germs that you do encounter while out of the country.
• Make sure all foods are cooked thoroughly. The cooking process will kill any viruses or bacteria.
• Don’t buy medicines in developing countries. While their local counterparts may be relatively safe, you’ll want to contact your doctor to make sure that the specific type of medicine you’re considering does not contain toxic or impure ingredients.
• Take altitude into consideration when trip planning. Young children, as well as people with heart or lung problems, should consult a health care professional before visiting locations at more than 3,000 feet above sea level. Even healthy travelers should rest on the first day at a high altitude to allow their bodies time to adjust. Your doctor may suggest medication to avoid altitude sickness.
• Avoid freshwater ponds in South America, Africa, or Asia. These bodies of water can be infested with a parasite that causes schistosomiasis, a chronic disease. Instead, stick to chlorinated pools and salt water.
• Move around on the plane. Staying still on a long flight can put you at risk of developing blood clots in your legs.

So no matter where you’re headed, take the proper precautions. Your care will go a long way towards making sure that your trip is memorable for all of the right reasons – and none of the wrong ones.