As a travel medicine nurse for Foxhall Immunizations I consult with patients daily on what recommendations there are for traveling abroad. Research shows us that less than half of the world’s travelers actually seek travel advice. Ideally, a traveler should seek advice 4-6 weeks prior to traveling but the realistic time tends to be 2 weeks prior to a trip which is still beneficial. The goal in travel and in travel medicine is to skillfully manage risks that a traveler may face.
The pre-travel consult consist of an evaluation of the routine vaccinations given in the past by a primary care provider, preventive and self-treatment medications and management of chronic illness while abroad. This includes malaria prophylaxis, self treatment of traveler’s diarrhea, motion sickness, and altitude illness. Insect-borne illness such as malaria, dengue, yellow fever, japanese encephalitis and chikungunya all warrant a discussion about the best insect repellents to prevent bites. The CDC recommends a deet product with 30-35% deet or a picardin product at 20%. Most travelers should carry with them over the counter medications for diarrhea, body aches and fevers and usually a topical antibiotic for skin abrasions such as Neosporin. Most diarrheas can be managed with lomotil or pepto bismol, but in some cases they need a broad spectrum antibiotic such as Cipro or Azithromycin to self treat the symptoms of a diarrheal bacterial infection.
Most vaccines are “not required” for entry into a country except Yellow Fever and Meningitis. All routine vaccines such as tetanus (Tdap), Hepatitis A or B, MMR (measles, mumps, rubella),chickenpox, polio, influenza and pneumonia should be updated by the primary care provider or the travel medicine clinic. Measles and now Mumps are infectious diseases that are on the rise in the developed and under developed worlds. Frequent travelers, even those limited to the U.S., should have an MMR booster or have their antibody titers checked by their physician. Specific travel vaccines that are determined by length of stay and country related are Yellow Fever, Typhoid, Cholera, Japanese Encephalitis, and Rabies. Short-stay travelers to tourists’ areas not in Yellow Fever zones, typically need an updated Tetanus, Hepatitis A and typhoid. Food and water borne illnesses are the largest risk for all travelers.
In this massively global and mobile society, preventative health should be the focus on protecting the population from vaccine-preventable diseases and educating our patients on the “risks” (the possibility of harm) during the course of a planned trip.
A very useful website for travelers is the official CDC (Center for Disease Control) website: http://wwwnc.cdc.gov/travel/