Tjiang W, See KS Kris, Osel Clinic, Osel Group
More than 1 billion travelers worldwide cross international boundaries on an annual basis, facilitates increased health exposures in different environments, the potential spread of disease and risk for illness; However, whether associated with tourism, humanitarian efforts, globalization of industry, or migrant employment, studies suggest only a small number of travelers seek pre-travel health advice.
Travel medicine is a branch of medicine that specializes in diseases and conditions that are acquired during travel and is devoted to the health of travelers who visit foreign countries. It concerned not only with prevention of infectious diseases during travel but also with the personal safety of travelers and the avoidance of environmental risks. Travellers may encounter sudden and significant changes in altitude, humidity, temperature and exposure to a variety of infectious diseases, which can result in illness. In addition, serious health risks may arise in areas where accommodation is of poor quality, hygiene and sanitation are inadequate, medical services are not well developed and clean water is unavailable. Immunizations, preventative medications, and general precautions should be considered prior to trips to different parts of the world.
Medical Consultation Before Travel
A key goal of the pretravel visit is to define potential travel health risks. Travelers should ascertain the associated travel health information for their specific itinerary from a travel medicine clinic or medical practitioner at least 4–8 weeks before the journey.However, last-minute travellers can also benefit from a medical consultation, even as late as the day of travel. This should include general health information such as vaccine requirements, preventative medications, disease outbreaks, political environment, and medical resources.
Personal health information should be obtained and carried, including personal health status (eg, age, weight, pregnant), medications and allergies, past medical history, medical or physical limitations.
Immunizations against hepatitis A,hepatitis B, typhoid, yellow fever, meningococcal meningitis,rabies,tetanus,diphtheria,polio and others may be recommended or required for travelers to certain countries.
Preventative medications against traveler's diarrhea, malaria,tuberculosis, and other diseases may be necessary.
Precautions regarding foods, beverages, weather, insect bites, and personal hygiene are important while traveling. Patients with underlying medical diseases, such as kidney disease and diabetes, may need special arrangements in order to travel safely.
Basic Health Travel Kit
A basic medical kit will be prescribed or provided, supplemented as appropriate to meet individual needs. A medical kit is an essential item that should be carried by travelers to developing countries or where local availability of such resources remains in doubt. The kit should include standard first-aid items, simple medications for common ailments, and any items specific for that traveler.
A great resource to identify more specific information can be found online through the Diseases Related to Travelsection of Travelers' Health on the CDC Web site. However, one of the most commonly experienced illnesses related to travel is diarrhea.
Traveler's Diarrhea
By far, the most common health risk for travelers, especially those visiting developing countries, is traveler's diarrhea(TD), which can range from mildly annoying to prolonged, painful, and debilitating.
Traveler’s diarrhea, however, may occur at any time while traveling, even after returning home. The primary cause is contaminated food or water, typically found in areas with poor sanitation. Most cases are benign and resolve in 1-2 days without treatment. Traveler’s diarrhea is rarely life threatening, and infectious agents are the primary cause of traveler’s diarrhea. The natural history of traveler’s diarrhea is that 90% of cases resolve within 1 week. Because traveler’s diarrhea is usually self-limiting, oral rehydration is often the only treatment recommended.
High Risk Travelers
Health risks associated with travel are greater for certain groups of travelers, including infants and young children, pregnant women, the elderly, the disabled, the immunocompromised and those who have pre-existing health problems. Such travelers are strongly recommended to seek specialist travel health advice
All individuals planning travel should seek advice on the potential hazards in their chosen destinations and understand how best to protect their health and minimize the risk of acquiring disease. Forward planning, appropriate preventive measures and careful precautions can protect their health and minimize the risks of accident and of acquiring disease.
Although the medical profession and the travel industry can provide a great deal of help and advice, it remains the traveller’s responsibility to seek information, to understand the risks involved, and to take the necessary to protect their health while travelling.
Understanding the dynamics of travel and the interplay of healthcare will minimize the adverse effect of travel-related illnesses and concerns while maximizing enjoyment and success for the trip.
References
Herbert LD. Travel Medicine Guidelines for Physicians. Infectious Diseases in Clinical Practice.
May 2007; (15)3: 194-195. doi: 10.1097/01.idc.0000269914.72229.3e
Hill DR, et al. The Practice of Travel Medicine: Guidelines by the Infectious Diseases Society of America. Clinical Infectious Disease. Dec 2006
Nicks BA, Slapper D. Travel Medicine and Vaccination. Medscape. June 2016
Shiel WC. Medical Definition of Travel medicine. MedicineNet. Dec 2018
WHO. International Travel and Health. 2012
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