Overview of travel medicine
Travel medicine as an area of health science is concerned about health preparation of travelers and management of health problems in travelers.1 Travelers do get ill or injured abroad or when they return home. The commitment of travel health is a continuum from before the traveler leaves to after the traveler returns home. According to the World Tourism Organization, approximately 26% of the 800 million international journeys in the year 2005 were for visits to friends and relatives and for religious purposes/pilgrimages.2
Morbidity and Mortality
Although infectious diarrhea and upper respiratory tract infections account for most travel-related morbidity, cardiovascular disease is the most common cause of mortality in travelers. A study of overseas fatalities among Americans revealed that cardiovascular disease was the cause of >50% of the deaths; injuries accounted for about 25% of the deaths.3
Preparation for Travel Abroad
Medical advice for patients planning trips abroad must be customized to each individual and based on the most current expert recommendations. Below are a few recommendations.4
- The risk of travelers’ diarrhea can be reduced by eating only freshly prepared, hot foods. Combination therapy with a single dose of ofloxacin plus loperamide usually provides relief from travelers’ diarrhea within 24 h.
- Using a diethyltoluamide (deet)¬ containing insect repellent and wearing permethrin-coated clothing can reduce the risk of malaria, yellow fever and other diseases contracted from insects.
- Routine immunizations such as tetanus, measles, mumps and rubella, and influenza should be updated if necessary before the patient embarks on the trip.
- Hepatitis A immunization should be administered to persons traveling to places other than Canada, Australia, New Zealand, Japan and western European countries.
- Typhoid vaccination should be considered for travelers going to developing countries.
- Yellow fever immunization is indicated for travelers going to endemic areas of South America and Africa.
- Malaria prophylaxis with chloroquine is indicated for travelers going to Mexico and Central America. Mefloquine is recommended for those traveling to areas where malaria is resistant to prophylactic treatment with chloroquine.
Learning More about Travel Medicine
Travel medicine is emerging as a distinct specialty because of ever-changing global disease patterns and increased world travel. Travel medicine recommendations are modified frequently, so up-to-date sources should always be reviewed before specific travel advice is given to patients planning trips abroad.
1.Leggat PA, Goldsmid JM. Primer of Travel Medicine. 3rd edn. Brisbane: ACTM Publications, 2002.
2.Special groups of travellers. Ch. 9. International Travel and Health. World Health Organization. 2007: 174–176. Available at: http://whqlibdoc.who.int/publications/2007/9789241580397_9_eng.pdf
3.Hargarten SW, Baker TD, Guptill K. Overseas fatalities of United States citizen travelers: an analysis of deaths related to international travel. Ann Emerg Med. 1991; 20: 622–626.
4.Dick L. Travel Medicine: Helping Patients Prepare for Trips Abroad. AAFP. 1998. Available at : http://www.aafp.org/afp/980800ap/dick.html
Written by: healthplus24.com team
Date last updated: March 10, 2015