Table of contents
Abstract ……………………………………………………………………… 3
Statistics ……………………………………………………………………… 4
International travel health issues ………………………………………… 4
Growth of Travel Medicine Institutions…………………………………… 6
Nature of travel advice ……………………………………………………… 6
Pre-travel Assessment ……………………………………………………… 7
Common Ailments…………………………………………………………… 10
Malaria ………………………………………………………………… 10
Travelers’ Diarrhoea………………………………………………… 11
Sexually transmitted Infections…………………………………… 11
Working Abroad……………………………………………………………… 12
Safety and Security ………………………………………………………… 12
Post-Travel Check-up ……………………………………………………… 13
Conclusion …………………………………………………………………… 13
List of references …………………………………………………………… 14
The current statistics indicates that the number of people traveling to different parts of the world is increasing. These people come from different geographical backgrounds that may be potential for complex ailments. Travel medicine is one of the disciplines which is gaining its momentum to conduct several important pre and post-travel health assessments to ensure that those travelling are free of any infections. To prevent any chances of infecting others, there has been a call to ensure that the risk assessment is carried out. Apart from pre-travel health assessment, a post-travel assessment is also conducted to ensure that the travelers are well and have acclimatized to the new environments.
The information compiled has been obtained through primary methods such as surveys and case studies. Other secondary sources of information such as the journals, newsletters and health records were also consulted for the purpose of obtaining valid and accurate data. The results obtained indicate that there has been an increase in the number of new infectious ailments from different parts of the world. This has prompted several countries to ensure elaborate, qualified and experienced experts to deal with such issues before and after the departure. The following discussion will focus on the role of travel medicine in the prevention of any uncalled for infections.
It is estimated that about 1 billion people make an annual travel to different parts of the world. This annual travels comes with a lot of advantages such as the growth of economies and the expansion of technologies and infrastructures among others. However, the health experts warn that this could be used as an avenue through which dangerous ailments could be passed. There is therefore a worldwide call for the need of travel medicine which aims at ensuring that those travelling are examined before travelling for the purpose of establishing their health history. The following statistics reinforce the need for such an undertaking
According to World Trade Highlights (2009), it is estimated that there are about twelve million departures in Australia alone. These are people coming from both the remote rural areas where there could be difficulties in accessing health facilities and vaccinations meaning that some of the travelers will need thorough scrutiny before departure.
International travel health issues
According to Steffen (2000), illness amongst the travelers currently ranges between 15% to around 55%. The discrepancy between the two percentages could be attributed to different countries’ development in the health sectors. In the developed countries, it is expected that the number of infections will be minimal due to availability and affordable comprehensive care services. Those countries also boast of having qualified and experienced medical practitioners who assist in combating deadly ailments.
On the other hand, it has been observed that the number of illnesses among those travelling from the developing countries especially in some parts of Africa is on the increase. A good example is those traveling from Sub-Saharan Africa and who are located in the tropical kind of climatic conditions. Those areas are prone to Malaria infections due to presence of mosquitoes and decreased health facilities and medicine. For that reason, it is important to administer treatment for those travelling out of such areas while at the same time offering information to those wishing to visit such locations.
It has also been observed that there is a tendency for frequent change in the status of a given ailment, the vaccine and the availability of the drugs (Steffen 2000). This is what has prompted the travel medical experts to call for up-to-date travel advice. This means that the nature of the ailment may change to the extent that one may confuse it for another ailment. One kind of disease may exhibit different signs and symptoms depending on the season, people and geographical locations. This therefore calls for the need to get the latest updates concerning ailments.
Finally, Steffen (2000) argues that travel has the greatest impact on the distribution of diseases worldwide. Though this could raise controversy, the bottom line is that there is tendency to increase infections through the travel. This is the main reason why the World Health Organizations brought to a halt the travelling of people in countries which were affected by the N1H1 infections. This was to prevent those unaffected from contracting the same ailments from the already affected. The travelers’ medical experts in different countries had great task of ensuring that they bring the pandemic to a controllable situation. The above statistics provided by the international health organizations therefore reinforces the need to promote the travel medicine initiatives for the purpose of ensuring that everyone is safe.
Growth of Travel Medicine Institutions
For the purpose of dealing with the issues of health in the travel sites, there has been a call to train experts who will undertake such responsibilities. Many countries in the world have responded by opening various institutions which are aimed at disseminating information which include and not limited to common ailments in different countries and the different climatic conditions. This is in line with the policies and the ethical code of conduct of the International Society of Travel Medicine (ISTM) which was apparently established in 1991. That body calls for the need to provide the clients with the information they need concerning their health status and also what they expect to find in their destination. On the other hand, the medical practitioners have been accorded the right to conduct medical examinations from the clients to extract information about their health status.
Nature of Travel Advice
It is the duty of the travel medicine practitioners and experts to provide adequate information to the travelling clients. The information must be up-to-date for it to apply to the current situation. It is important that the clients be explained to why such information is important to them as many may ignore. As we said above, the main reason why up-to-date information is important is because certain natures of ailments may change bringing a lot of confusion on the clients. In addition, certain types of vaccines previously administered may not work in the current situation to resistance by certain bacteria and viruses. This is because with time, such agents of diseases become immune.
The next kind of advice provided has to do with health issues. At this point, the client is let to know the kind of ailments that they will be expecting to find in their destination. Using the information collected about their health status and history, it is important that the travel medicine experts advice them accordingly. For instance, a person suffering from asthma needs to know the climatic conditions of the place of their destinations. This is for the purpose of enabling them to make wise and informed decisions concerning the kinds of clothes to carry with them. They will also be provided with the information concerning the availability of the drugs in their destinations, so that if they are not provided, they carry enough to last them for the time they will be out.
The kind of advice offered should also be individualized. This means that it should be between the person travelling and the medical expert. This is owing to the ethical issues and the right of the patients concerning the issue of confidentiality of their health status. The reason why this needs to be observed is because certain kinds of ailments may predispose the client to discrimination and victimization in the event that other people get to know their health status. For instance, people who suffer from HIV/AIDs fear to share their status with anyone due to high chances of social alienation. Some people have distorted information concerning many ailments and they use it to look down on those affected. It is therefore imperative to ensure that the information obtained from the travelers remains confidential unless in the situation where it may endanger the lives of other people.
Apart from the above, it is said that the pre-visit travel medicine consultation should take a period of time before the traveler can depart. This is because certain vaccination they are exposed to require more time to become effective. It is also important to note that certain illnesses such as HIV/AIDs may not be diagnosed if the disease is in the window period. However the information on sexuality will enable the medical practitioners to postpone the examination to a later date so that they can determine beyond doubt the status of the traveler. In addition, it is imperative to note that some people respond negatively to certain medical procedures. They might develop side effects which may deteriorate their health further. In such as case, the medical experts should consider alternative means of dealing with such complications.
Apart from the heath issues we have focused on above, it is important for the travel medicine experts to determine the risk of destination. In doing so, they need to know whether the traveler has the information about the geographical nature, climatic conditions and prevalence of the common ailments in the countries of their destination. Certain diseases are associated with certain areas and countries and thus such information will be imperative. For instance, ‘Delhi-Belly’ and Malaria are associated with the Asian and African continents respectively. People travelling for the first time in such countries will be required to come up with better logistics on how they will manage to keep their health status safe.
Apart from that, the team needs to have trusted sources of information concerning the current health issues in different regions of the world. This will ensure that the information provided to the travelers in valid and free of any biasness. There several sources of validation which have been identified and they include Worldcare organizations, Center for Disease Control (CDC) among others.
The other pre-travel assessment factor has to do with the age of the traveler. A minor for instance will pose a lot of challenge since they can not cater for themselves. On the other hand, the elderly may have frequent health complications meaning that they need to be accompanied. For that reason, it is important for the airline to stick to their policies concerning the age-limit for those wishing to travel to avoid experiencing uncalled for challenges. On matters of health, the elderly and the minor might not express themselves as expected and this may hamper the proper medical procedure. Therefore, matters of age should be an important factor in the assessment.
Medical history should not be ignored at this point. This will provide the information concerning illnesses such as Malaria, Diphtheria, asthma, diabetes, pregnancy, cholera and many others. Such history is important to ease the medical procedures taken especially if the previous diagnosis was carried out in recognized health institutions. On the same issue, it is important that the
It is also imperative to know whether the person intending to travel can actually do so. Due to some health issues the person’s wish to travel may be hampered. Some countries have very tough health regulation and rules which those wishing to visit them must meet. It is until recent that many countries have lifted the ban which denied those with HIV/AIDs and other sexually transmitted infections from travelling. However, this has been observed as a violation of people’s rights and has therefore been scrapped. However, there are genuine cases where one may be denied such a chance until further date. This is for instance in a case of pregnant woman who is about to deliver. It is important to let such a person finish that process first and then travel later. This will save the agency certain challenges that may ensue in the event that such people are allowed to travel.
There are ailments that need not be ignored where taking both the pre and post-visit assessments. Certain complications are known to pose little threat to the general public because they have been contained. However, there are those which are still prevailing even in the midst of the developments in the medical researches. For that reason, it is important to consider the malaria, travelers’ diarrhea and sexually transmitted ailments.
It is said to be one of the most common forms of diseases associated with the tropical kind of climate (Graham, 2000). It is said to affect over three million people in the world annually and consequently resulting in the death of more than two million annually. This is therefore a dangerous disease that can not be ignored. Apart from that, it is said that Australia alone records more than 600,000 malaria patients per year not forgetting 600-800 cases that are reported annually (Cossar, 2000). The information provided in the research indicates that there has not been a successful form of medication which will eradicate malaria completely. The palliative measures will therefore help those countries where the incidence of malaria is high to cope.
Endemic malaria is said to occur in about 100 countries including those in Asia, Africa, south and Central America. However, the most prone areas in the world are those that are found in the south of Sahara where thousands of children and pregnant mothers die annually. There are several issues that have been pointed out as the main reasons why malaria is on the rise. For instance, the economic strains have hampered the African countries’ efforts of fighting it (Gallus 1999). Most of the developing countries can not afford the high cost of medication and vaccinations which are associated with the control of malaria. Apart from that, they lack better housing and mosquito nets which could prevent the prevalence of the disease.
It is therefore imperative to prepare the travelers wishing to visit these areas so that they can arm themselves with the required medications and equipments. They should also be warned against visiting certain areas which are so prone to such endemic.
It has also been said to be one of the most common ailments that troubles the travelers. Millions of travelers in the world experience such embarrassing moments because of contaminations with food and water. However, it is said that the disease is mild apart from the dysentery which is characterized by fever and bloody diarrhea. Travelers moving from Australia, Canada and the United States have higher tendencies of getting the disease if they travel to some parts of Asia and Africa(DuPont, 2006). This is because the former have low risks of such ailments as compared to the later countries.
The most important thing to do is to pass information concerning the health issues on how people will avoid getting infected. For instance, people should ensure that the water they is of the required quality and avoid eating contaminated food.
Sexually transmitted infections
The research indicates that in Thailand, over 70% of the sexual workers are HIV positive. Such information is crucial to the travelers because they will be required to protect themselves if they have to engage in sexual activities (Kozarsky 2000).The information which they should be given includes the use of condom every time they have sex with strangers and avoid drinking before such an activity. It is important to note that the disease has no cure yet and therefore it is important that the travelers take care of themselves.
Apart from the information provided above, it is important that the travelers be prepared on the policies and the working conditions of various nations and especially the one they wish to visit. This is because some people will not survive in the harsh working conditions due to their state of health. The climatic conditions of certain countries may affect the life of some travelers especially those suffering from asthma. It is therefore important that the travelers learn about such information for the sake of maintaining their good health.
Safety and security
The world is experiencing deterioration in matters concerning the safety due to criminal activities which is on the rise (Tood, 2003). Certain countries are hostile to people who are considered out-groups. Such people may be discriminated on the basis of race or religious affiliations. Such prejudices may put one in a dangerous situation if they are to visit such countries. It is therefore important to avoid visiting such countries at all costs.
It is not enough to just carry out the pre-visit assessment, but it is also important to administer post-travel check-up to ensure that the people travelling are still in their normal health stratus. It is known that some people develop some complications during the freight because of the sudden change of the environment. Such people need to be given a chance after arrival to acclimatize to the new environment while still under supervision.
This is one of the new developments which were proposed in the early 80’s but have not been embraced until recently. People are encouraged to insure their health to ensure they are catered for any time they have complications. Travelling in areas prone to ailments for instance will put one at higher risk of contracting such diseases. They will therefore be assisted better if they insure their health.
The travel medicine focuses on the health of the people before and after they have reached their destinations. They conduct both pre and post-travel assessments for the purpose of establishing the health status of the travelers. Dissemination of the information is also one of the most important parts of the travel medicine agencies. Such information includes the prevalence of some ailments, the working conditions in various countries, the security measures and climatic conditions.
Not every one qualifies to travel due to given health issues and it is the work of the travel medicine bodies to ensure that such people are made to understand such a position. Therefore, such an agency should be looked at as an integral part of the travelling agencies as it serves to maintain the health status of the travelers. It should be embraced by all the countries to prevent nay chances of unwanted infections.
Baker TD, Hargarten SW, Guptill KS. The uncounted dead — American civilians dying
overseas. Public Health Rep 1992; 107: 155-159.
Bannister et al (2004) “The role of standby emergency medication for falciparum
Malaria: current opinion” in the Book of Readings for this module
Centers for Disease Control and Prevention (2004). Cruise Ships and Air Travel.
CCH Australia (1994) CCH Occupational Health and Safety Glossary. Sydney; CCH
Cossar JH, Walker E, Reid D, et al (2004). Computerised advice on malaria prevention
and immunisation. BMJ 1986; 296: 358.
Cossar JH, Walker E, Reid D, et al (1986). Computerised advice on malaria prevention
and immunisation. BMJ 296: 358. ACTM Publications, 100-112.
DeGorord et al (2003) “Diving emergencies” in the Book of Readings for this module.
DuPont (2006) “Travellers’ diarrhea” and Thielman et al (2004) “Acute Infectious
Diarrhoea” in the Book of Readings for this module.
Fradin et al (2002) “Comparative efficacy of insect repellents against mosquito bites” in
the Book of Readings for this module.
Gallus AS, Goghlan DC (2002). Travel and venous thrombosis. Curr Opin Pulm Med
2002; 8: 372-378
Gallus AS, Goghlan DC (2002).. Travel and venous thrombosis. Curr Opin Pulm Med
Gamble et al (2002) “Aid workers, expatriates and travel” in the Book of Readings for
Gendreau et al (2002) “Responding to medical events during commercial flights” in the
Book of Readings for this module
Graham H, Putland J, Leggat P (2005). Ch. 8: Air travel for people with special needs.
Graham H, Putland J, Leggat P (2000). Ch. 8: Air travel for people with special needs.
Hargarten SW. (1994) Injury Prevention: A crucial aspect of travel medicine. Journal of
Travel Medicine. 1(1):48-50
Hill DR, Behrens RH. A survey of travel clinics throughout the world. J Travel Med
Hill DR, Behrens RH. A survey of travel clinics throughout the world. J Travel Med
Kozarsky PE, Freedman(2004)., eds, Travel Medicine, Mosby-Elsevier Science, 2004,
Leggat PA, Goldsmid JM (2002). eds. Primer of travel medicine. 3rd ed. Brisbane:
Leggat PA, Goldsmid JM (2002) eds. Primer of travel medicine. 3rd ed. Brisbane:
ACTM Publications, 100-112.
Leggat et al (2004) “Travellers’ diarrhoea: Health advice for travellers” in the Book of
Readings for this module.
Mendis et al (2002) “Air travel and venous thromboembolism” in the Book of Readings
for this module.
Murdoch (2003) “High Altitude Illness” in the Book of Readings for this module.
Nicholson et al (2003) “The airline passenger: current medical issues” AND Cheng
“Screening Passenger fitness to fly and medical kits onboard commercial aircraft” in the Book of Readings for this module and Chapter 6 of the textbook
Richens (2006) “STIs and HIV among travellers”, Rogstad (2004) “STIs acquired on
holiday”, and Schuhwerk et al (2006) “HIV and travel” in the Book of Readings for
Somer Kniestedt RA, Steffen R.(2003). Travel health insurance: indicator of serious
travel health risks. J Travel Med 10:185-189,
Steffen R (2004). Epidemiology: morbidity and mortality in travelers. in Keystone JS,
Tood (2003) Health and safety in hostile environments and Venkatesh et al
(2003) Bioterrorism-a new challenge for public health in your Book of Readings
for this module.
Teichmann et al (2007) “International Aeromedical Evacuation” in the Book of Readings
for this module.
Usherwood V, Usherwood TP (1989). Survey of general practitioners’ advice for
travellers to Turkey. J R Coll Gen Pract 39: 148-150,