Visit a Travel Clinic Before Going Abroad
Nearly 20 million Americans will travel abroad this year, often to exotic locales in countries with varying degrees of sanitation and standards of hygiene. It is estimated that 60 percent of overseas travelers become sick with food or water-borne illnesses. Others face more harmful diseases while on vacation, including ]]>malaria]]> and yellow fever. Despite these significant health risks, typically only 19% of Americans seek medical advice before a trip. So whether your destination is Cancun or Calcutta, it may be well worth the time to visit a travel health clinic before your departure.
The following individuals should seek medical advice before traveling abroad:
- Infants and young children, especially those aged 6-9 months (At this age, infants begin to lose immunity conferred by mother's milk; at the same time, they begin to eat more solid foods and hand-to-mouth contact increases)
- Persons infected with HIV
- Those with chronic conditions such as diabetes, cardiovascular disease, kidney disease, irritable bowel syndrome, or epilepsy
- Cancer patients undergoing chemotherapy
- Persons on prescription medications including H-2 blockers and antacids
While these individuals must take extra precautions when traveling, anyone planning a trip overseas should consider seeking medical advice from a travel clinic.
Food and Water-borne Illnesses
Food and water-borne illnesses, such as traveler’s ]]>diarrhea]]> , are the most common maladies faced during travel. Contaminated food and water can be sources of infection from Escherichia coli, bacillary dysentery, and ]]>Hepatitis A]]> —all of which can lead to severe dehydration. In general, the Centers for Disease Control and Prevention (CDC) recommends drinking only bottled water (be sure it’s a fresh bottle by checking the seal) and avoiding undercooked or raw foods (especially vegetable and fruits), dairy products, shellfish, or food that has been allowed to cool to room temperature. Based on the country you will be visiting, a travel health clinic can provide you with a complete list of CDC precautions and recommendations along with necessary antibiotics and water sanitation devices.
Depending on your destination, general health risks can range from the ]]>common cold]]> to ]]>typhoid fever]]> . Another important service of travel health clinic is vaccination against harmful infectious diseases. The World Health Organization (WHO) cites malaria as one of the most serious risks to international travelers. This potentially fatal disease, transmitted through mosquito bites, occurs in more than 100 countries—many of which are popular destinations, such as Mexico, the Caribbean, India, Egypt, and South Africa.
Also of concern are vaccine-preventable hepatitis A and ]]>B]]> , both of which can cause liver damage. An estimated 17,000 Americans become infected each year from hepatitis following an overseas trip; over 5,000 of these cases prove to be fatal. Yet, few overseas travelers seek essential inoculations or medications before they leave. A recent survey by the American Society of Travel Agents found that only 8.4 percent of respondents traveling to malaria-prone countries took the necessary precautions. The survey also found that over 50 percent of those who traveled to a country with a high risk of hepatitis A or hepatitis B were unaware of the risk and did not receive vaccinations prior to their trip.
Travel health clinics can provide you with information about the year-round health risks that exist in your destination and alert you about new outbreaks that may arise prior to your time of travel. They will also provide you with the recommended immunizations and antibiotics to safeguard against tropical and other illnesses. Of main concern are the following:
- Hepatitis A or B – Mexico, Central and South America, Africa, the Middle East, Asia, the Caribbean, eastern and southern Europe
- Malaria – Eastern Europe, Asia, Africa, the Middle East, the South Pacific, Mexico, Central America, and the Caribbean
- Traveler’s diarrhea – Latin America, Africa, Asia, and the Middle East
- Yellow fever – Africa and South America
- ]]>Cholera]]> – Southeast Asia
- Typhoid – Asia, Africa, Soviet Union
- Japanese ]]>encephalitis]]> – Southeast Asia
While some countries only recommend that visitors get vaccinated before arriving, others require vaccination as a condition of entry, and will inspect health records to verify that the necessary vaccinations have been taken. In these countries, anyone who has not been vaccinated may be quarantined until they have been, or denied entry altogether. A travel health clinic can determine the vaccination requirements for your destination, administer inoculations and provide you with the necessary documentation, such as an International Certificate of Vaccination as well as other travel health records, which can be updated before each trip.
Travel Clinic Services
Your destination, length of stay, itinerary, and previous medical history are important factors to consider when seeking travel health advice. The staffs at most travel health clinics consist of physicians and nurse practitioners with specialized degrees in infectious diseases or tropical medicine. They are qualified to develop a travel care plan customized to your individual health needs, administer vaccines and booster shots for polio or measles, mumps and rubella, and write prescriptions for antibiotics and other medications. It is important to make an appointment three to 12 weeks in advance of your trip. This will give you enough time to begin a malaria vaccine regimen if you need to (which must begin 4 weeks before departure and continue 4 weeks after your return), and for vaccinations to boost your immune system before your trip.
In general, services provided by most travel health clinics include:
- CDC and WHO information about health risks and recommendations in your area of travel
- U.S. State Department travel advisories; consulate information
- Pre-travel counseling based on destination, length of stay, and medical history, including how to care for chronic conditions while traveling
- An individualized plan of prevention and treatment, including recommendations for food and water safety, and recommendations for avoiding insect-borne diseases
- Vaccinations for influenza; hepatitis A and B; yellow fever; typhoid; polio; tetanus/diphtheria; Japanese encephalitis; measles, mumps and rubella; and rabies
- Vaccination certificates required by some countries before entry
- Antibiotics or over-the counter medications for diarrhea or prescriptions for malaria prophylaxis
- Permanent medical records listing any present illness as well as medical needs
- A list of recommended physicians or clinics abroad
- Information about traveler’s medical insurance, which provides affordable coverage for medical emergencies (also check with your current provider)
- Tests to determine whether any illnesses were acquired abroad
- Treatment of any illnesses acquired abroad
Another essential aspect of travel clinic services is post-travel care. This is particularly important for those with chronic conditions and anyone experiencing persistent health problems upon their return, including the following:
- Fever (seek immediate attention if you have traveled to an area where malaria is prevalent)
- Urinary tract or genital infections
- Skin disorders
Many hospitals and medical centers provide travel health services. The following site can provide you with a list of travel health clinics in your area: http://www.cdc.gov/travel_clinics.htm
Centers for Disease Control and Prevention
U.S. State Department
or Office of Overseas Citizens Service
World Health Organization
Aurora Health Care Travelers Clinic. Staying healthy abroad starts with healthy advice at home. Available at: http://www.aurorahealthcare.org/services/travelclinic/index.asp . Accessed July 2005.
Centers for Disease Control and Prevention. Pre-and post-travel general health recommendations. Health Information for International Travel, 2005-2006. Available at: http://www.2ncid.cdc.gov/travel/yb/utls/ybGet.asp?section=recs&obj=food-drink-risks.htm . Accessed July 2005.
Centers for Disease Control and Prevention. Malaria and Travelers. Available at: www.cdc.gov/malaria/travel/index.htm. Accessed July 2005.
Centers for Disease Control and Prevention. Vaccination Certificate Requirements for Direct Travel from the United States to Other Countries. Available at: www.cdc.gov/travel/vaccinations/cert-requirements2.htm. Accessed July 2005.
Internal Medicine Doctors for Adults. Health Care Topics: Travel Immunization. Available at: www.doctorsforadults.com/topics/dfa_travel.htm. Accessed July 2005.
MayoClinic.com. Global travel: Advance planning can prevent illness. Available at: www.mayclinic.com/invoke.cfm:id=HQ00760. Accessed July 2005.
Medical College of Wisconsin. Health Risks of Travel Range from Unusual to Mundane. Available at: http://healthlink.mcw.edu/article/1031002363.html . Accessed July 2005.
MedicalNewsService.com. American Society of Travel Agents Urge Healthy Travel for Consumers. Available at: http://www.medicalnewsservice.com/fullstory.cfm?storyID=3029&fback=yes . Accessed July 2005.
Medical University of South Carolina. Travel Clinic. Available at: http://www.muschealth.com/medical_services/specialty_listing/travelclinic/ . Accessed July 2005.
Tulane University. Clinic Keeps Travelers Fit. Available at: http://www2.tulane.edu/article_news_details.cfm?ArticleID=5752 . Accessed July 2005.
UMass Memorial Medical Center. Traveler’s Health Services. Available at: http://www.umassmemorial.org/ummhc/hospitals/med_center/services/travelers/index.cfm . Accessed July 2005.
University of Connecticut Health Center. The International Traveler’s Medical Service. Available at: http://health/uchc.edu/clinicalservices/travel/ . Accessed July 2005.
University of Maryland Medical Center. Travel Medicine. Guide for the Adventurous Traveler. Available at: http://www.umm.edu/travel/guide.htm.Accessed July 2005.
University of Texas Health Services. Travel Medicine. Available at: http://www.uth.tmc.edu/uths/travel.html . Accessed July 2005.
U.S. State Department. Medical Information for Americans Traveling Abroad. Available at: http://travel.state.gov/travel/tips/health/health_1185.html . Accessed July 2005.
Vanderbilt International Travel Clinic. Health Services You’ll Receive After You Return. Available at: http://www.vanderbilttravelclinic.com/services/after.html . Accessed July 2005.
Vanderbilt International Travel Clinic. Health Services You’ll Receive Before you travel. Available at: http://www.vanderbiltclinic.com/services/before.html . Accessed July 2005.
Last reviewed July 2005 by ]]>Rosalyn Carson-DeWitt, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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