UAMS Department of Family and Preventive Medicine

Travel Medicine
Center for Preventive,
Occupational & Environmental Medicine
521 South Elm
Little Rock, AR 72205
Office 501/686-6565
Fax 501/296-1230

For an appointment at UAMS Travel Medicine Clinic call 501/686-6565.
Our office hours are Monday -Friday, 8:00-4:30.

In 2000, it was estimated [by Ryan and Kain] that over 1 billion passengers travel by air, and over 50 million people from industrialized countries visit the developing world. Travelers can be exposed to a variety of infectious agents against which their immune system is not prepared. Different studies have shown that 20 - 70 % of travelers report some health problems while away from home, and up to 5% of international travelers seek medical attention, and a fraction of these require emergency medical evacuation, and a small fraction of those may die (the leading cause of death abroad is from heart attacks, and the second leading cause of death are motor vehicle accidents).

2. How do I find out what I need for travel to a particular country?
There are several reliable sources of information available to the general public, and others that are geared toward health care providers. Perhaps the most widely utilized resource is the U.S. Centers for Disease Control and Prevention (CDC). They have a toll-free information number 1-877-FYI-TRIP and a toll-free automated fax response attendant at 1-888-232-3299. A large amount of material is also available on their Travelers' Health website http://www.cdc.gov/travel. Other excellent websites include the World Health Organization's International Travel and Health page at http://www.who.int/ith and the Medical College of Wisconsin's Travel Health Links page at http://healthlink.mcw.edu/travel-links.html.

3. What happens if I need to travel to a country and do not want to take one of the listed injections (i.e., yellow fever)?
Countries vary on their absolute requirements for short term travelers, but border control officials in those places where Yellow Fever vaccination is required will turn unvaccinated travelers back at their ports of entry. The requirements for persons seeking longer term visas or residency permits are usually more extensive than the requirements for short term travelers, and may include testing for AIDS, Tuberculosis and other communicable diseases as well as more extensive immunizations requirements.

4. How far in advance of my trip do I need to worry about travel medicine?
There's really no such thing as too much advance planning in this regard. Most immunizations can be obtained months in advance, while prescriptions can be held and filled just prior to departure. Getting travel medicine services closer than 15 days prior to departure is testing the boundaries, and less than 10 days will not allow enough time prior to departure for the immunizations to start kicking-in immunity. Along these lines, Yellow Fever immunization received less than 10 days before arrival to a country where it is mandatory, is not valid for entry.

5. What are the advantages of going to UAMS's Travel Medicine program for my injections/tests?
While our Travel Medicine service line is a recent addition, it is being provided by a clinical staff that is highly experienced in prevention and immunization issues. For many years prior to this we have been providing analogous services for 7,500 UAMS employees and 2,100 students, as well as for new immigrants to the United Sates. We strive to maintain current knowledge of the global Epidemiology of infectious diseases, thereby allowing us to offer up-to-date recommendations.

6. Where can I find out about the side effects of any of the injections that I might need to take?
Your personal physician or pharmacist can be valuable resources in this regard. If you come through UAMS Travel Medicine, we will make every effort to fully discuss and explain any such issues that may be of concern.

7. Do I need an appointment?
We request that you make an appointment by calling 501-686-6565. Usually someone can be seen quickly (say, within 2 business days), but an appointment allows us to align our staffing and resources so as to serve you more effectively.

8. What about my children? Can UAMS be involved in their travel medicine needs as well?
Yes, we are able to provide Travel Medicine services to children. We may require an extra day or so lead time, however, as we do not keep pediatric doses for some immunizations in our office and would obtain them from our supplier.

9. What causes travelers' diarrhea?
Diarrhea is the most common illness of travelers. Where 10-60% of travelers to developing nations have diarrhea, at least 20% of these become bedridden for part of their trip, and 40% change their itinerary because of the diarrhea. Bacterial causes are by far the most common, with viral and parasitic causes less so. Part of the Travel Medicine consultation involves anticipating the possibility of diarrhea and providing anticipatory prescriptions for antibiotics and medications for intestinal motility.

10. Are my risks of contacting AIDS and other blood-borne pathogens higher in developing countries?
Not necessarily. There are some developing countries in Sub-Saharan Africa and the nations formerly part of the Soviet Union that have a much higher prevalence of AIDS, Hepatitis B and Hepatitis C than in the United States. This may change the odds of becoming infected for a traveler engaged in risky behavior. However, the same considerations apply there as here: avoidance of unprotected sexual contact, sharing of needles, or other contact with body fluids.

11. What is malaria?
Malaria is a blood parasite that is spread by mosquito vectors in areas where it is endemic. As many as 30,000 travelers from industrialized countries acquire malaria annually. Malaria infection can be prevented by taking steps to reduce exposure to mosquitos, and by taking anti-malarial medications. These medications are not without side effects, so the travel itinerary needs to be analyzed. For example, travel to major cities that are free of malaria, may not call for taking such medications whereas travel to more rural destinations in the same country would require this treatment. These details can be explored further through the various travelers' health websites, or during a Travel Medicine consultation at UAMS.

12. What does someone do if they become seriously ill overseas?
This can present significant challenges in certain
developing countries and remote areas. If a traveler has a pre-existing condition that may place them at higher risk of health adversity abroad, such as advanced heart disease, it would be best to identify in advance suitable hospitals and health care facilities in the region of travel. The U.S. State Department website http://travel.state.gov/medical.html has excellent information and links addressing various aspects of dealing with
medical emergencies abroad.

If Medical Care Is Needed Abroad
If an American citizen becomes seriously ill or is injured abroad, a U.S. consular officer can assist in locating appropriate medical services and informing family or friends. If necessary, a consular officer can also assist in the transfer of funds from the United States. However, payment of hospital and other expenses is the responsibility of the traveler.

Protection against potentially hazardous drugs is nonexistent in some countries, increasing the risk of adverse reactions. Do not buy medications "over the counter" unless you are familiar with the product.

Before going abroad, learn what medical services your health insurance will cover overseas. If your health insurance policy provides coverage outside the United States, remember to carry both your insurance policy identity card, as proof of such insurance, and a claim form. Although some health insurance companies will pay "customary and reasonable" hospital costs abroad, very few will pay for medical evacuation to the United States. Medical evacuation can easily cost $10,000 or more, depending on the location and medical condition.

For an appointment at UAMS Travel Medicine Clinic call 501/686-6565.
Our office hours are Monday -Friday, 8:00-4:30.

Making an Appointment at UAMS Medical Center
To make an appointment, call 1-501-686-8000.

For more information contact:
University of Arkansas for Medical Sciences
Department of Family and Preventive Medicine
4301 West Markham, Slot 530
Little Rock, Arkansas 72205
(501) 686-6560