Travellers heading to the Dominican Republic this winter need to practice some preventive hygiene while enjoying the sun, sand, food, and drink, integral parts of their one- or two-week vacation package.
According to a DR liaison group set up by Canadian travel insurers, 56 Canadian tourists last year reported requiring treatment for what local health care agencies and government officials said was a norovirus. Because of the transient nature of the ailment, many more who contract norovirus simply don’t report it, but suffer nonetheless.
The norovirus, or Norwalk-like virus, results in a severe stomach flu or gastroenteritis, and can lay up its victims for one to two days with nausea, vomiting, diarrhea, and cramps. The virus, which is not susceptible to treatment by antibiotics, is highly contagious and has been experienced most frequently over the past several years on cruise ships, where thousands of people are kept in close contact with each other.
Norovirus is highly contagious and can be carried in food and beverages, on surfaces such as furniture, elevator buttons, door handles, improperly sanitized cutlery or glasses, as well as by direct contact with other people. The best protection is to wash your hands frequently, avoid handshakes, use hand sanitizers whenever you can, very carefully wash any fruits or vegetables you eat, and be vigilant of the sanitation, food, and beverage services around you. Remember that ice cubes don’t work as sanitizers.
The liaison group set up by the Travel Health Insurance Association of Canada has been working to improve the way insurers and health care agencies exchange information with clinics and doctors in the Dominican Republic, with the aim of standardizing data on the availability and costs of health services for Canadian and other tourists. Part of the problem in coordinating that information, say members of the working group, is that facilities catering to tourists are growing so rapidly throughout the island.
Because of the growing tendency by health clinics and doctors in the DR to require tourists to put up individual payment guarantees (e.g., credit card imprints) before providing services, the Department of Foreign Affairs and International Trade urges all Canadian travellers to have proof of current, adequate travel health insurance on hand for immediate verification.
Another concern to travellers is the persistence of malaria, particularly in La Altagracia province at the easternmost tip of the DR, which encompasses the Punta Cana and Bavaro area resorts.
The Public Health Agency of Canada (PHAC) recommends the malaria prophylaxis vaccination and the use of personal protective measures (e.g., repellants) against mosquito bites for all rural areas of the Dominican Republic and all areas in the province of La Altagracia, including tourist resorts.
While chloroquine is the malaria drug of choice for the Dominican Republic, atovaquone / proguanil (Malarone ®), doxycycline, and mefloquine are as effective as chloroquine and readily available.
PHAC also recommends that travellers planning trips to these areas visit physicians knowledgeable in travel and tropical medicine some six to eight weeks before departure, as vaccination must be started several weeks before travel and continue after a traveller returns home.