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Parts of the country have already been teased by winter's icy fingers, prompting many Canadians to start planning escapes to warmer climes. Of course, no one plans a bout of travellers' diarrhea, hepatitis A, typhoid fever or malaria, but with one of these diseases affecting as many as half of all travellers to some southern destinations, new drugs and prevention techniques can be the key to an enjoyable beach holiday.

If last season is any indication, more than a million of us will flee the cold for a week or two of sunshine and warmth in the tropics or subtropics, mostly at resorts in Mexico or the Caribbean. According to a recent survey from Léger Marketing, a Montreal-based independent research firm, Canadians tend to splurge on their vacations, with one-third spending an average of $2,000 to $3,000.

But this money could go down the drain (pardon the expression). Travellers' diarrhea (TD), hepatitis A and typhoid fever — as well as the resurgent malaria bug — are significant causes of vacation ruination in destinations such as Mexico and the Dominican Republic, says David Colby, an associate professor of medicine and microbiology at the University of Western Ontario. “TD remains the most common illness,” Colby says. “It's not fatal, but who wants to spend three days of their vacation on the toilet?”

The most common cause of TD is food or liquid contaminated with a bacteria called enterotoxigenic E. coli. As many as 50 per cent of travellers to Mexico will get diarrhea of varying severity and, while the risk varies from island to island, the rate in the Caribbean as a whole is 15 to 20 per cent, according to Toronto General Hospital's Centre for Travel and Tropical Medicine.

A recent study by the centre indicated that more than 95 per cent of Canadian travellers make a food faux pas, such as eating raw vegetables or drinking iced beverages, within 72 hours of landing at their destination. Léger Marketing, meanwhile, found that 40 per cent of those surveyed this summer have personally experienced TD, and three-quarters knew someone who has experienced it.

Most travellers to the tropics or subtropics know that you have to boil it, peel it, cook it or forget it, Colby says, adding that this advice is easier to remember than to follow. “People who come to me after experiencing TD can often remember the exact moment they were probably infected. They remember eating salad and thinking, ‘What the heck, it's not going to happen to me this time at this resort.' “ A new oral vaccine against TD, called Dukoral, is widely available but not yet widely used, perhaps because of the cost (two courses of the vaccine cost about $75). According to Dukoral's manufacturer, 60-per-cent protection against diarrhea starts about a week after taking the final dose. A booster dose three months later is recommended if a traveller is still at risk. People going on business trips and short vacations should consider using the drug, Colby says.

Travellers should also protect themselves against hepatitis A and be up to date with their tetanus shots, “because you never know when you'll step on a rusty nail,” Colby says, adding that a new injected drug called Vivaxim for the first time combines vaccines against both hepatitis A and typhoid fever.

Another threat is hepatitis B, mostly endangering those who have sexual contact and those who receive injections while abroad. Twinrix, a combined vaccine for both hepatitis A and B, administered over the course of six months, is said by health professionals to offer virtually lifetime protection. Vaccines are also available for yellow fever and polio.

“I've had travel agents tell me some of their clients are needle-phobes,” Colby says. “Some travellers would rather change destinations than get a required shot. The trouble is, not that much is actually required, and people get mixed up about what is required and what they should do to stay healthy.”

Other health risks, cited by Canadian infectious-disease specialists such as Jay Keystone and Mark Wise, include mosquito-borne dengue fever and malaria. Travellers to malarial zones such as Haiti, the eastern part of the Dominican Republic, as well as rural areas of Asia and Mexico, should prepare with DEET-based insect repellent and consider malaria pills. Less common hazards are hookworms usually picked up by barefoot strollers (especially in Jamaica); “snail fever,” which can be caught while swimming in fresh water; and rabies from animal bites.

While travellers should consult local travel clinics before southern vacations, Colby warns that they should make appointments five or six weeks in advance. “Clinics become incredibly busy in the winter, especially in December and January. Last-minute visits are difficult to accommodate.”

There are some dangers you can't be vaccinated against: The most common cause of death for Canadian travellers is a motor-vehicle accident.