New York
City Health
Ambulance:
911
Police: 911
Fire: 911
See your doctor at
least 4-6 weeks before your trip to allow time for shots to take
effect (as Appropriate for Age)
Rabies - Rabies, if you might be
exposed to wild or domestic animals through your work or recreation.
Hepatitis B - Hepatitis B if you
might be exposed to blood (for example, health-care workers), or if
you engage in other high risk behaviors. Hepatitis B vaccine is now
recommended for all infants and children ages 11-12 years who did
not complete the series as infants.
Booster Shots - Travelers should
be fully immunized against tetanus and diphtheria. Individuals who
have previously received vaccination may require booster doses. In
the United States, proof of immunization against diphtheria,
measles, poliomyelitis, and rubella is now universally required for
entry into school. In addition, the school entry requirements of
most states include immunization against tetanus (49 states),
pertussis (44 states), mumps (46 states), and hepatitis B (26
states). Haemophilus influenzae type b (Hib) vaccine is not required
for school entry but is required in 49 states for attendance in day
care facilities.
Updated On: 4/14/00
Source: US Department of State, US Centers
for Disease Control, Health Canada-Laboratory Centre for Disease
Control, and Dr. Eliot Heher
Ehrlichiosis - Travelers should
be fully immunized against tetanus and diphtheria. Individuals who
have previously received vaccination may require booster doses. In
the United States, proof of immunization against diphtheria,
measles, poliomyelitis, and rubella is now universally required for
entry into school. In addition, the school entry requirements of
most states include immunization against tetanus (49 states),
pertussis (44 states), mumps (46 states), and hepatitis B (26
states). Haemophilus influenzae type b (Hib) vaccine is not required
for school entry but is required in 49 states for attendance in day
care facilities. Use Tick Precautions (long pants, insect
repellants, avoid wooded areas); potentially serious but sensitive
to doxycycline
Lyme Disease - Travelers should
be fully immunized against tetanus and diphtheria. Individuals who
have previously received vaccination may require booster doses. In
the United States, proof of immunization against diphtheria,
measles, poliomyelitis, and rubella is now universally required for
entry into school. In addition, the school entry requirements of
most states include immunization against tetanus (49 states),
pertussis (44 states), mumps (46 states), and hepatitis B (26
states). Haemophilus influenzae type b (Hib) vaccine is not required
for school entry but is required in 49 states for attendance in day
care facilities. Use Tick Precautions (long pants, tick repellants,
avoid tick habitat, check for ticks daily). New vaccine is available
but may only be effective in North America.
Rabies - Travelers should be
fully immunized against tetanus and diphtheria. Individuals who have
previously received vaccination may require booster doses. In the
United States, proof of immunization against diphtheria, measles,
poliomyelitis, and rubella is now universally required for entry
into school. In addition, the school entry requirements of most
states include immunization against tetanus (49 states), pertussis
(44 states), mumps (46 states), and hepatitis B (26 states).
Haemophilus influenzae type b (Hib) vaccine is not required for
school entry but is required in 49 states for attendance in day care
facilities. Avoid contact with raccoons, foxes, skunks, groundhogs
and bats
Swimming & Boating Accidents
- Travelers should be fully immunized against tetanus and
diphtheria. Individuals who have previously received vaccination may
require booster doses. In the United States, proof of immunization
against diphtheria, measles, poliomyelitis, and rubella is now
universally required for entry into school. In addition, the school
entry requirements of most states include immunization against
tetanus (49 states), pertussis (44 states), mumps (46 states), and
hepatitis B (26 states). Haemophilus influenzae type b (Hib) vaccine
is not required for school entry but is required in 49 states for
attendance in day care facilities. Use common sense; don't use
alcoholic beverages when swimming or boating; never swim or boat
alone; never dive headfirst into an unknown body of water. Wear a
Personal Flotation Device (PFD); Watch weather and tide reports.
Food & Water Borne Illness -
Travelers should be fully immunized against tetanus and diphtheria.
Individuals who have previously received vaccination may require
booster doses. In the United States, proof of immunization against
diphtheria, measles, poliomyelitis, and rubella is now universally
required for entry into school. In addition, the school entry
requirements of most states include immunization against tetanus (49
states), pertussis (44 states), mumps (46 states), and hepatitis B
(26 states). Haemophilus influenzae type b (Hib) vaccine is not
required for school entry but is required in 49 states for
attendance in day care facilities. Use good personal hygiene. Eat
only from reputable restaurants. Cook meats and wash vegetables and
fruits thoroughly. Water filtration or boiling is more likely to be
effective against Giardia cysts than iodine or chlorine; seek
medical attention for persistent diarrhea after travel
Encephalitis - Travelers should
be fully immunized against tetanus and diphtheria. Individuals who
have previously received vaccination may require booster doses. In
the United States, proof of immunization against diphtheria,
measles, poliomyelitis, and rubella is now universally required for
entry into school. In addition, the school entry requirements of
most states include immunization against tetanus (49 states),
pertussis (44 states), mumps (46 states), and hepatitis B (26
states). Haemophilus influenzae type b (Hib) vaccine is not required
for school entry but is required in 49 states for attendance in day
care facilities. Use mosquito precautions as follows: wear clothing
that reduces the amount of exposed skin and use insect repellant on
exposed skin. DEET-containing compounds are most effective but
should be used cautiously--products with his concentrations of DEET
should not be used at all in children or infants.
Encephalitis - Travelers should
be fully immunized against tetanus and diphtheria. Individuals who
have previously received vaccination may require booster doses. In
the United States, proof of immunization against diphtheria,
measles, poliomyelitis, and rubella is now universally required for
entry into school. In addition, the school entry requirements of
most states include immunization against tetanus (49 states),
pertussis (44 states), mumps (46 states), and hepatitis B (26
states). Haemophilus influenzae type b (Hib) vaccine is not required
for school entry but is required in 49 states for attendance in day
care facilities. Use mosquito precautions as follows: wear clothing
that reduces the amount of exposed skin and use insect repellant on
exposed skin. DEET-containing compounds are most effective but
should be used cautiously--products with his concentrations of DEET
should not be used at all in children or infants.
Venomous Snakes - Travelers
should be fully immunized against tetanus and diphtheria.
Individuals who have previously received vaccination may require
booster doses. In the United States, proof of immunization against
diphtheria, measles, poliomyelitis, and rubella is now universally
required for entry into school. In addition, the school entry
requirements of most states include immunization against tetanus (49
states), pertussis (44 states), mumps (46 states), and hepatitis B
(26 states). Haemophilus influenzae type b (Hib) vaccine is not
required for school entry but is required in 49 states for
attendance in day care facilities. Follow local recommendations;
Leave snakes alone; Stay out of tall grass; wear thick leather
boots, and remain on hiking paths as much as possible. If bitten
wash the bite with soap and water, immobilize the bitten area and
get medical help as soon as possible.
Rocky Mountain Spotted Fever -
Travelers should be fully immunized against tetanus and diphtheria.
Individuals who have previously received vaccination may require
booster doses. In the United States, proof of immunization against
diphtheria, measles, poliomyelitis, and rubella is now universally
required for entry into school. In addition, the school entry
requirements of most states include immunization against tetanus (49
states), pertussis (44 states), mumps (46 states), and hepatitis B
(26 states). Haemophilus influenzae type b (Hib) vaccine is not
required for school entry but is required in 49 states for
attendance in day care facilities. Use Tick Precautions (long pants,
tick repellants, avoid tick habitat, check for ticks daily).
Motor Vehicle Accidents and other injuries
- Travelers should be fully immunized against tetanus and
diphtheria. Individuals who have previously received vaccination may
require booster doses. In the United States, proof of immunization
against diphtheria, measles, poliomyelitis, and rubella is now
universally required for entry into school. In addition, the school
entry requirements of most states include immunization against
tetanus (49 states), pertussis (44 states), mumps (46 states), and
hepatitis B (26 states). Haemophilus influenzae type b (Hib) vaccine
is not required for school entry but is required in 49 states for
attendance in day care facilities. Drive defensively and avoid night
driving; Wear safety belts; don't drink alcohol and drive; if
possible avoid motorcycle and motorbike travel
Hurricanes - Travelers should be
fully immunized against tetanus and diphtheria. Individuals who have
previously received vaccination may require booster doses. In the
United States, proof of immunization against diphtheria, measles,
poliomyelitis, and rubella is now universally required for entry
into school. In addition, the school entry requirements of most
states include immunization against tetanus (49 states), pertussis
(44 states), mumps (46 states), and hepatitis B (26 states).
Haemophilus influenzae type b (Hib) vaccine is not required for
school entry but is required in 49 states for attendance in day care
facilities. Follow local weather forecasts and act accordingly
Updated On: 10/12/01
Animal Borne Diseases - Certain
diseases occasionally occur, such as plague, rabies in wildlife,
including bats, Rocky Mountain spotted fever, tularemia, and
arthropod-borne (mosquito-borne) encephalitis. Recently,
rodent-borne hantavirus has been identified, predominantly in the
western states of the United States.
Lyme Disease - Lyme disease is
endemic in the northeastern United States, Mid-Atlantic, and the
upper Midwest and the southwestern provinces of Canada. Occasional
cases have been reported from the Pacific Northwest.
Foodborne Diseases - Foodborne
diseases (e.g. salmonellosis) occur and the incidence has increased
in some regions in recent years.
Environmental Hazards - Other
hazards include poisonous snakes and extreme temperatures. In the
north, very low temperatures may occur in winter while high
temperatures occur in the south, especially the desert southwest.
Motor Vehicle Crashes - Motor
vehicle crashes are a leading cause of injury among travelers. Walk
and drive defensively. Avoid nighttime travel if possible and always
use seat belts.
| General
Health Information |
Updated On: 2/13/02
Source: Prof. Marshall W. Raffel
Both the private and public sectors provide very high quality
medical care in the United States. However, it is important for
visitors and students to the United States to have some type of
health insurance to cover the costs of medical care they may need.
Costs for doctor and hospital care can be very high without
insurance to help pay for those costs. Insurance policies differ,
however, in terms of the services covered, which doctors and
hospitals can be used, whether or not deductibles have to be met,
and co-payments the patient may have to make. Insured persons should
therefore make every effort to understand fully the terms and
conditions of the policies they choose.
Access to doctor services and hospital is fairly simple. College and
university students can almost always have prompt access at their
school's health center, and be referred, if necessary, for
specialist and hospital care. Others, including students whose
colleges may have limited medical services, should call a doctor's
office for an appointment, being careful to know if their insurance
policy covers primary care services and, if so, whether or not that
particular doctor's services will be covered. If a doctor in the
community is not available for an emergency, one should go to the
nearest general (acute care) hospital. Most general hospitals today
have medically staffed emergency rooms. How much one will have to
pay for such care will vary depending on the type of insurance one
has, and the location of the hospital. Costs vary throughout the
country, being much higher in the larger cities than in smaller
towns and rural areas. In most instances insurance policies require
a substantial patient co-payment for emergency room care unless the
patient is also admitted for bed care. In nearly all parts of the
country one may call for an ambulance by dialing 911 on the
telephone.
General (acute care) hospitals are owned and operated by a variety
of organizations. Most are not-for-profit and run by community
agencies and church groups. City and county governments run some,
and some are run by for-profit organizations. Regardless of who owns
and operates them, they all are expected to earn their budgets from
insurance and patient payments. Government run hospitals, often
frequented by the poor, usually have tax monies appropriated to
cover losses.
The majority of Americans have some type of insurance to cover most
of the costs of medical care. Typically they make some co-payments
for visits to the doctor, hospital emergency room, for drugs, and
for other items. The extent of insurance coverage, and the range of
co-payments, will vary with the type of insurance policy. Most
insured Americans today are enrolled in insurance plans that are
known as managed care plans. These plans require that patients see a
primary care doctor initially. Primary care is provided by family
physicians (specialists in general practice) as well as by
specialists in internal medicine, pediatricians, and
obstetricians/gynecologists. Most managed care insurance plans
require their enrollees to have a referral from a primary care
doctor to see other specialists. The most popular managed care
programs are the Health Maintenance Organizations (HMOs) whose
enrollees typically pay lower co-payments and receive some
preventive care.
Most Americans get their health insurance coverage through their
place of employment, though many buy their insurance directly.
Retired people and some disabled persons have their insurance
provided by the federal government through a program know as
Medicare. Many low income and unemployed people are eligible for
insurance through a government program known as Medicaid. Since both
the federal and state governments finance Medicaid, some states call
their Medicaid program by some other name; for example, MediCal in
California and Medical Assistance in New York. People covered by
Medicaid, however, often have difficulty seeing doctors in the
community because Medicaid's fee schedule is low and some doctors
try to avoid those patients. When this situation occurs, the
Medicaid patient must use the hospital emergency room.
A rather large number of people (an estimated 43 million people -
16% of the population) have no health insurance. These people are
able to receive care at the emergency rooms of most hospitals. If
they are unable to pay for that care, the hospital simply has to
assume the costs. Hospitals, by law, must provide a certain amount
of free care each year.
Most doctors practice in groups with other doctors although some
still practice by themselves, particularly in smaller communities.
For medical care Americans typically call their doctor (or the
medical group in which the doctor practices) for an appointment. If
the condition is very painful or seems to be an acute illness, they
are usually seen the same or next day. For more routine care the
patient may have to wait longer. When contacting their primary care
doctor for an emergency, many doctors will advise that they go
directly to the hospital emergency room, which will typically
require a significant patient co-payment.
Most doctors have offices in the community and have the privilege of
admitting and treating their patients in the local hospital. A
growing number of doctors, however, have their offices in or near
the hospital. Some large hospitals, particularly university medical
school hospitals and others in large cities, have doctors on full
time salaries within the hospital, and most of these hospitals also
have clinics for primary care.
To become a medical doctor in the United States one must complete 8
years of post-secondary school education: 4 years in pre-medical
studies at a college or university followed by 4 years of medical
school. On successful completion of medical school, the degree of
Doctor of Medicine (MD) or Doctor of Osteopathy (DO) is awarded.
There are 143 accredited medical schools in the U.S. today: 124 MD
schools and 19 DO schools. The more widely known schools are the
ones that grant the MD degree and their graduates represent
approximately 95% of the doctors in practice today. The degrees, MD
and DO, are essentially the same, and graduates of both types of
schools can be fully licensed to practice medicine in all of the
states. The graduates must in addition, however, pass a national
test and complete a period of supervised post-graduate training in
order to be licensed by the state government to practice medicine in
the state where they wish to work. Doctors who have been trained in
the United States and Canada usually have no difficulty in moving to
other states to practice medicine.
Most doctors in the United States, including those providing primary
care, are specialists. After completion of medical school they
undertake 3 or more years of specialist training and are tested by
an appropriate national specialty board. When approved by the
national specialty board they are known as board certified in that
specialty. In addition, every board certified specialist must
regularly take additional approved training courses either to retain
their specialty certification or to retain their state government
license to practice medicine. Every specialty organization now also
requires a periodic retesting of their members. Thus, one can have
reasonable assurance that a medical doctor today, whether an MD or
DO, is well trained and competent to provide quality care within
their specialty.
Specialty boards and other groups are also developing clinical
guidelines, or treatment protocols, to guide doctors in the
treatment of specific conditions. These guidelines enable doctors to
utilize the most recent information to treat their patients
effectively and efficiently. The very latest technological
equipment, moreover, is widely available.
Quality care is assured also in other ways. Hospitals are inspected
regularly and licensed by the state governments. In addition,
hospitals are inspected and accredited by a nongovernmental
organization: the Joint Commission on Accreditation of HealthCare
Organizations (JCAHO). Most insurance companies will not pay for
care in hospitals that are not licensed and accredited.
Pharmacies are
recognizable by a caduceus (winged staff with two serpents twined
around it) or a mortar and pestle displayed outside or within the
store window.
In general, pharmacies in the United States are very reliable. That
is, they dispense the proper medications and the drugs themselves
are of a high quality. Pharmacies can be used for all of you
prescription and over-the-counter drug needs. Pharmacists cannot
distribute prescription medications without authorization from a
doctor. The pharmacists themselves are trained professionals with
degrees in their field.
Regular business hours for pharmacies are 8 a.m.-10 p.m. Monday
through Saturday and 9 a.m.-9 p.m. on Sundays with some pharmacies
staying open 24 hours a day 7 days a week. A listing of local
pharmacies open outside of regular business hours can be found
through consulting your hotel concierge, local newspaper or phone
books. There are several well-known chains of pharmacies in the
United States that are reliable, these include CVS and Rite Aide.
Over the counter medications can also be found in a variety of
places, including grocery stores and hotels.
Regardless of the pharmacy situation in any country, it is always
advisable to bring enough medication to last through your trip. Be
sure to carry it with you rather than trusting it to checked luggage
(many frequent travelers bring a double supply of medication and
pack each in different bags). It is also advisable to carry extra
prescription sheets written by your doctor (with the generic names)
in case you need refills during you trip and to show at customs as
proof of the medication?s identity and necessity. Always remember to
check the expiration dates on all medications, whether they are from
home or abroad. Depending on where you are traveling, you may also
want to carry an anti-diarrheal medication and/or ask you physician
for an appropriate anti-diarrheal prescription, as a precautionary
measure.
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