Healthy advice for the traveller

news: Healthy advice for the traveller

I mean, how many people have you heard of who have gone down to South Poole for their summer holidays, as opposed to going to Spain, Portugal or Greece? Or, there are those choosing the latest hotspots of Turkey and the former Yugoslav republics, or the increasingly popular South American and SE Asian subcontinents. To add to this, the World Health Organisation (WHO) predicts that travel to all these more exotic destinations will increase 80 per cent by 2010!

According to a recent survey by the Association of British Travel Associations (ABTA), the cost of travel has fallen by more than one third since 1994! In 2003, there were 21 million package holidays sold in the UK, with more than 36 million people travelling abroad. The destinations are becoming as wide ranging as our wildest dreams can take us, but herein lies the problem.

Our ever increasing adventurousness and almost bloodthirsty quests for the ultimate, extreme travel experience are starting to have a big health impact. Not just on travellers (30 – 50 per cent of travellers get ill or injured during their trip), but the general public as well, as we start spreading and importing more and more exotic illnesses upon our return from such holiday destinations.

The same ABTA study showed that, in 2003, around 1,100 Britons came back from their holidays with malaria, while 180 had typhoid and one in 330 travellers came back with hepatitis A. You might say to yourself that these are not terribly high numbers, but both typhoid and hepatitis A are seriously communicable diseases.

Worse, until the diagnosis is made, that particular ill person is potentially infecting others in his/her community. What is even more tragic is the fact that both of these diseases are perfectly preventable through a very simple vaccination programme.

So, what stops these people from protecting themselves and others? More than half of annual travellers do not even seek any form of travel related health advice, even if they are travelling to medium to high risk areas (i.e. areas of moderate to high risk of contracting communicable diseases such as malaria, traveller’s diarrhoea or hepatitis A).

Sixty-seven per cent do not get advice at all and 24 per cent get advice less than two weeks before departure. The reasons for this are quite varied. Some people just couldn’t be bothered with the sometimes lengthy and costly procedure of having multiple vaccinations before departure. Some are simply not aware of the risks involved in travelling to a certain destination, or think that the risks are too low to bother with any kind of prevention. They may well have travelled to that destination before and, as in any other relationship, familiarity (with risk) breeds contempt for preventative measures. Some have even stated that their acute needle phobia has stopped them from seeking any vaccination before travel. But, what is most worrying is the fact that a vast majority of travellers have simply been wrongly advised.

The greater percentage of misinformation came, unfortunately, from travel agents (35 per cent), with friends and family coming in at 26 per cent, magazine information at six per cent, and nurses at three per cent. What is really scary is the 28 per cent of wrongly informed travellers who sought advice from GPs! Hence the need for a specialised field like travel medicine.

Travel medicine has not as yet become a bona fide medical speciality but is fast becoming recognised as a distinct clinical and academic interdisciplinary speciality, as more and more of us travel both for business and pleasure.

GPs are not obliged to keep up with the latest recommended vaccination and prevention schedules for travellers (such as for malaria and traveller’s diarrhoea), hence more and more specialised travel clinics are opening up all over the UK. These are often run by specifically trained nurses and/or doctors, who now have several academic programmes available to them to further their knowledge (right up to a Master’s degree) in travel medicine, as well as all the online back-up from the WHO and Centers for Disease Control and Prevention (CDC).

Unfortunately, the rest of Europe is not as up to speed and official travel clinics are still few and far between, with the only official advice centres being part of the state controlled yellow fever vaccination centres.

So, what can you as a future traveller do? The general premise is that, if you are going to countries outside of Europe, North America, Australia and New Zealand, regardless of whether it is your first time visit or a trip to visit friends and relatives, you should seek some kind of travel health advice from a trained professional, at least eight weeks prior to departure.

I would, however, add to this that, even before a trip to Europe or the US, some advice should be sought, due to the constantly changing epidemic scenarios. West Nile Fever is still prevalent along the eastern seaboard of the US, and borreliosis (tick-borne encephalitis) in the woodland areas of Germany, Austria and Switzerland, not to mention the ever more frightening reports of positive Bird Flu cases. After all, it is better to be safe than sorry.

Dr Jo

General Practitioner

Assistante Director

Luzdoc IMS