Photo by Aaron Schmidt

Half Moon Caye, Belize. Photo by Aaron Schmidt

Planning a foreign paddling excursion? As you’re digging into guidebooks, scrolling through online forums, and losing sleep over all the paddling possibilities on Google Earth, don’t forget to prepare for health issues before you leave. Getting the recommended vaccinations is always a good idea, but it’s also important to be ready for problems that may arise out on the water. We caught up with Dr. Chris Tonozzi, a globe-trotting paddler and family doctor who recently set up an online "travel medicine" business where he helps people get ready for travel to exotic locales. Drawing from lessons learned on past paddling trips and his professional experience, he has these tips for paddlers heading from temperate zones to the tropics.

Mosquito protection. It can be hard to tell how much mosquito exposure you'll have on your trip. But if you're paddling, you're going to be around water, so it's better to be safe than sorry. Mosquitoes are public enemy number one these days since they are the vector for malaria, Zika, Dengue and other nasties. Since we don't have other methods for preventing the latter two, mosquito avoidance matters. DEET repellent makes most of us a little uneasy as we've seen it melt plastic when spilled, but it's certainly the most compact thing you can find. Remember, the higher the concentration, the less often you need to apply it. Another great option is to cover up with clothing. Light clothing can be treated with long-lasting permethrin to make it more mosquito repellent. Also consider a head net. I use one to organize clothing in my bag, which means I always have one along if it's needed.

For bites, rashes and itches take along a steroid cream. It can't be beat for helping most skin problems resolve more quickly and giving some immediate relief from itching. Hydrocortisone 1% is available over-the-counter, and works OK, but something stronger that you can get by prescription is more compact, and gives better relief with less frequent application. Just don't overuse it as it can affect the pigment in your skin in rare instances.

Sun protection. You may be asking, "How many times do I have to hear this one?" But it deserves some special attention when you've been huddled indoors or under ski gear for the winter and suddenly show up in the blazing tropical sun. Even in the tropics, you may be under a paddle jacket most of the trip, but consider something bombproof to protect areas like the back of your hands. Since sunscreen will wear off quickly, consider a "physical barrier," like a glove. The fingerless paddling gloves I've tried haven't impressed me, as they soak up water and remain annoyingly squishy all day. Look for a pair of gloves that don't have as much bulk to hold water. Also, check out the fishing glove options that are available today. Consider a light hat with flaps to cover ears and neck (or a wide brim, if you've got room to spare), if there are times when you can go without a helmet.

Leo Tonozzi scouts a waterfall in Mexico. Photo courtesy Chris Tonozzi

Leo Tonozzi scouts a waterfall in Mexico. Photo courtesy Chris Tonozzi

Anti-fungal cream. Another nice addition to the first aid kit while traveling in moist environments. Fungal infections are responsible for athlete's foot, vaginal infections, jock itch and the like, and are much more likely when you're sitting in the water and hanging out in humid places. Anti-fungal creams are over-the-counter (clotrimazole, miconazole, etc.). A luxurious option is an anti-fungal foot powder to put on at the end of the day.

Acclimate to heat. If you're jetting directly to a hot climate, there is increasing research that supports the idea that if you spend 30-60 minutes per day exercising at 100 degrees F for 5-10 days before you go, you'll be more comfortable when you arrive in the tropics. Consider a Bikram yoga class or exercise sessions in a not-so-hot sauna as part of your prep.

— Chris Tonozzi is a family doctor and avid paddler who lives in Western Colorado. He offers an online travel consultation (a video chat visit with a doctor to order medicines or vaccinations) at, available for Colorado residents only at this time.

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