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Find out where the dental care items will be stored and what supplies will be available. What will be provided and what will have to be transported? Ask about laundry service availability. This will influence the amount of clothing to pack. If mosquitoes are a known problem, it is prudent to take insect repellent and mosquito nets with you and to wear clothing that covers as much skin as possible. In areas with a Zika outbreak, the CDC recommends using an EPA-registered insect repellant specifically containing DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol; the directions on the labeling should be followed.

Food, Water and Supplies

Assure that facilities are available for safe food storage, preparation, cooking and refrigeration. Plan meals accordingly. Assure the availability of potable water and, if necessary, take filters and tablets with you to treat water.

Gastrointestinal infections are the most frequent cause of illness on missions. The Centers for Disease Control and Prevention (CDC) does not currently recommend prophylactic antibiotics to prevent travelers’ diarrhea for most patients. In addition, prophylactic antibiotics do not offer any protection against nonbacterial pathogens. The primary nonmicrobial agent studied as a prophylactic against TD is bismuth subsalicylate (BSS), the active ingredient in Pepto-Bismol. Before taking Pepto-Bismol check the contraindications on the labeling. Taking over-the-counter medicines for gastric distress and diarrhea (loperamide) may be helpful. A single dose of a fluoroquinolone such as ciprofloxacin or levofloxacin is recommended for the empiric treatment of bacterial diarrhea (CDC/Yellow Book/Travelers’ Diarrhea). In areas where antimicrobial resistance to fluoroquinolones is increasing, an alternative is azithromycin. Remember to replenish fluids and electrolytes lost during TD. Many larger healthcare facilities have travel clinics that offer advice.