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t m c » p u l s e | j u ly 2 0 1 9 30 standards of safety that other coun- tries do not meet. "Whatever safety systems exist in the U.S. are not going to be there in other countries," said Herbert L. DuPont, M.D., director of the Center for Infectious Diseases at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health. "There are no railings in dangerous areas where you may fall, there are breaks in the sidewalks, wires that hang at eye level. ... There are hazards all the time. We have to exercise care in a way we don't in this country and be careful and go slow—and that is preventive medicine." • • Buy travel insurance • • Between 18 and 24 percent of deaths among travelers in foreign countries are caused by injuries, compared to only 2 percent of deaths caused by infectious diseases, according to estimates from the Centers for Disease Control and Prevention (CDC). Experts hypothesize that the increased injury toll for travelers can be attributed to multiple factors— unfamiliar and risky environments, differences in language and com- munications, less stringent product safety and vehicle standards, unfamiliar rules and regulations, as well as a carefree holiday or vacation spirit leading to more risk-taking behavior. "A lot of times people travel abroad in order to do certain activ- ities, such as mountain climbing or base-jumping or parasailing," said Richina Bicette, M.D., assistant professor of emergency medicine at Baylor College of Medicine. "Those are all very dangerous activities. They look fun, but we aren't really sure what the regulations are HEALTH TIPS Z TRAVELERS J ason High, an insurance agent from Newton, Kansas, has spent his career assessing risk, but noth- ing could have prepared him for the medical journey he started in April 2017. During a seven-day cruise in the Caribbean that he won for being a top agent at his company, High and his wife, Racquel, decided to rent a moped when the ship docked on the island of Antigua. He drove and she sat behind him. "We were driving to the beach and we went from being on smaller streets to kind of a highway," High recalled. "When we got on the main road, we swerved to miss another car and we hit a curb and flew and hit a light pole that came down and hit my knee and then my femur bone went through my pelvis." Travelers from the United States may be accustomed to certain