Whether you’re going spelunking or on a religious pilgrimage, a pre-travel consultation may help keep you healthy abroad.
Nearly a quarter of US residents have had a medical issue while abroad, and the issue is prevalent enough that it can influence where travelers choose their vacation destinations. However, many patients and healthcare providers are unaware that travel medicine specialists—like those at HealthPartners in Minnesota—can give destination-specific vaccinations that may be harder to find elsewhere. Those medical professionals can also advise on medical entry requirements.
“We ask people where they’re going, the specific timing of the travel—like, how long is it going to be—what they’re going to be doing while they’re there. So assessing their risks and having discussions with them about their degree of concern for certain infectious diseases that we may choose to vaccinate or not against,” Malini DeSilva, a research investigator and travel and tropical medicine physician at HealthPartners, told Healthcare Brew.
Travel medicine—a discipline that brings together public health, tropical medicine, infectious diseases, epidemiology, and even occupational medicine—requires primary care or infectious disease doctors to undergo additional training and certification through organizations such as the International Society of Travel Medicine or the American Society of Tropical Medicine and Hygiene.
With that additional training, travel medicine specialists can review a patient’s medical history and determine what specific health risks they may encounter while abroad. For example, immunocompromised travelers, who make up 1%–2% of all patients at US travel medicine clinics per the Centers for Disease Control and Prevention, may need to develop a customized plan in case of illness. That might include taking extra precautions regarding food and water depending on their destination.
Vaccination destination
A patient may choose to see their primary care provider for a pre-travel consultation if there isn’t a travel medicine clinic in their area, but these clinics often carry vaccinations that other providers may not have, DeSilva said. For example, patients heading to certain countries in South America and Africa are required to be vaccinated against yellow fever, and these shots are only available at licensed yellow fever vaccination centers, such as travel clinics.
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Many travel-related vaccinations, however, are not covered by most insurances.
Itinerary review
A pre-travel consultation can help ensure patients meet all the guidelines to enter their destination.
Providers use a travel medicine resource called Travax to keep up-to-date on entry requirements for different countries and review country-specific medical advisories. The tool was particularly helpful when testing and quarantine restrictions were in constant flux during the Covid-19 pandemic, DeSilva said.
“I would always pull [Travax] up in the clinic office visit to see what was actually happening when I was recommending things to patients, knowing that if they were leaving in two weeks, in a month, everything might change,” DeSilva said.
They can also alert patients if their medications are banned in their travel destination, Myhanh Nguyen, department chair of travel medicine at Sutter Health’s Palo Alto Medical Foundation, told Healthcare Brew.
For example, common ADHD medications such as Adderall are illegal in Japan—even with a valid US prescription—and patients have to petition Japan’s Ministry of Health to bring the drugs into the country.
Travel medicine specialists also review a patient’s itinerary to learn about factors like accommodations and reason for the trip, Nguyen said.
“Do you work with animals? Do you cycle with your motorbike? Are you there [to] help with a disaster? Are you there skydiving or scuba diving? Are you climbing Mount Everest?” Nguyen asked. “These [questions] really help us […] cater to a traveler’s personal situation.”
The pre-travel consultation may pay off: Travelers who had done a pre-travel consultation reported shorter hospital stays for traveler’s diarrhea compared to those who did not, researchers from a 2018 Mayo Clinic study found.
Travel medicine specialists can also advise patients to take care of health items that may get overlooked or bother them during their trip, such as seeing an orthopedist to get a cortisone shot for knee pain, Nguyen said.
“There’s a lot [more] that goes into a pre-travel consultation than just talking about vaccines or diseases. We look at the holistic view of the patient,” Nguyen said.