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Travel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers.
Globalization and travel
Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global epidemiology of health risks to the traveler, vaccinology, malaria prevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries.Supercourse on Travel Medicine
Mortality and morbidity
Mortality studies indicate that the cardiovascular disease accounts for most deaths during travel (50-70%), while injury and accident follow (~25%). Infectious disease accounts for about 2.8-4% of deaths during/from travel. Morbidity studies suggest that about half of the people from a developed country that stay one month in a developing country will get sick.Supercourse on Travel Medicine Traveler's diarrhea is the most common problem encountered.
Disciplines
The field of travel medicine encompasses a wide variety of disciplines including epidemiology, infectious disease, public health, tropical medicine, high altitude physiology, travel related obstetrics, psychiatry, occupational medicine, military and migration medicine, and environmental health.
Special itineraries and activities include cruise ship travel, diving, mass gatherings (e.g. the Hajj), and wilderness/remote regions travel.
Focus
Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself.WHO Travel Information Also, the CDC publishes valuable and up-to-date information. (see external links). Key areas to consider are vaccination and the six I’s:
- Insects: repellents, nets, medication
- Ingestions: safety of water, food
- Indiscretion: HIV, sexually transmitted disease
- Injuries: accident avoidance, personal safety
- Immersion: schistosomiasis
- Insurance: coverage and services during travel, access to care
Specific disease problems
Yellow fever is endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps. CDC re: Yellow Fever
Meningococcal meningitis is endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to Mecca. Detailed information is available on the CDC site. CDC re: Meningococcal Meningitis
Malaria prevention is done by preventing or deducing exposure to mosquitos (screened rooms, air-conditioning, nets) use of repellants (usually DEET). In addition chemoprophylaxis is started before the travel, during the time of potential exposure, and for 4 weeks (chloroquine, doxycycline, or mefloquine) or 7 days (atovaquone/proguanil or primaquine) after leaving the risk area. See detailed CDC site.CDC re:Malaria
Medication Kit
The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances it should include also malaria prophylaxis, condoms, and medication to combat traveler's diarrhea. In addition, a basic first aid kit can be of use.
See also
References
External links
- Travelers' Health - Centers for Disease Control and Prevention - includes information on outbreaks, specific diseases, recommended vaccinations
- Traveler's Health - MedlinePlus
- GIDEON also available at Global Infectious Diseases and Epidemiology Network
- Safe Water for International Travelers includes a Worldwide Rating of Drinking Water Safety and waterborne diseases prevention.
Organizations
"Travel medicine"