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Travel Medicine
Questions and Answers About
TRAVEL MEDICINE
1.
What is travel medicine?
2.
How do I find out what I need for travel to a particular country?
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)?
4.
How far in advance of my trip do I need to worry about travel
medicine?
5.
What are the advantages of going to UAMS's Travel Medicine program for
my injections/tests?
6.
Where can I find out about the side effects of any of the injections
that I might need to take?
7.
Do I need an appointment?
8.
What about my children? Can UAMS be involved in their travel medicine
needs as well?
9.
What causes travelers' diarrhea?
10.
Are my risks of contacting AIDS and other blood-borne pathogens higher
in developing countries?
11.
What is malaria?
12.
What does someone do if they become seriously ill overseas?
13.
What doctors treat Travel-related conditions
at UAMS Medical Center?
Making an Appointment at UAMS Medical
Center
To make an appointment, call 1-501-686-8000.
1.
What is travel medicine?
Travel medicine is a preventive health intervention that attempts to
recognize, anticipate and prevent potential health adversities that
may be encountered while traveling. It may include a simple health
history review, educations, administering proper immunizations, and
prescriptions for necessary or potentially necessary medications.
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.
The following information
is provided by the CDC. For more information, go to the CDC Medical
Emergency page at http://www.cdc.gov/travel/med_emergency.htm.
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.
Making an Appointment at UAMS
Medical Center
To make an appointment, call 1-501-686-8000.
13.
What doctors treat Travel-related conditions
at UAMS Medical Center?
Andrew
Prychodko, M.D., M.P.H., J.D.
Assistant Professor; Director, Preventive, Occupational, and
Environmental Medicine
Making an Appointment at
UAMS Medical Center
To make an appointment, call 1-501-686-8000.
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