Who should you ask for travel health info?
As a potential international traveller you may wonder where is the best place to get good medical advice before you leave New Zealand as well as the vaccinations and medications you'll need to make sure you stay well and enjoy your trip. Should you see your own general practitioner (GP) or a travel health specialist?
The concept of 'travel health' as a separate specialty is a recent advance that has arisen due to the explosion in numbers of the worldwide travelling population - World Tourism Organization data released in 2002 estimates there were 693 million international tourist arrivals in 2001, and this number is expected to rise.
Specialists in travellers' health will consider several wide-ranging aspects, such as your pre-travel health, ability to travel, pre-travel preparation and the health risks posed by your travel plans.
Information about disease outbreaks in countries and recommended preventive or treatment measures can change frequently - this means a doctor who deals with travellers regularly is more likely to have the best information, particularly for those with extended travel plans or those going to remote regions. However, many GPs and practice nurses are usually able to prepare you for trips that are more commonly made.
Getting the 'essentials' from your GP
For New Zealand travellers, if you are going to a developing country, your GP or practice nurse should be able to give you advice (the 'essentials') on:
- pre-travel issues such as malarial prevention, appropriate travel vaccinations and when they need to be given
- health advice on protection against insects and mosquitoes
- eating 'safe' food and drinking 'safe' water
- the prevention of injuries while travelling, and where to go for advice if injury or illness occurs
- the essentials of a basic medical kit for the traveller
- what conditions to self-treat, guidance on appropriate treatment, and which conditions you should seek medical attention for.
In a busy general practice, the GP or nurse cannot be expected to know everything there is to know about tropical diseases and travellers' infections. However, there are six diseases, for which there are immunisations or partial immunisation, that GPs and nurses should be able to help you with regarding prevention and treatment:
In general practice, most health advice for travellers is given by the practice nurse, and an average consultation time for this process is about 20 minutes. Anything less could be inadequate. If more time is needed you should book a further consultation, or consider seeing a travel health specialist.
Specific advice may sometimes be provided by your GP
In addition to the 'essentials' listed above, your GP or nurse may know about other conditions if they have had the time to specialise. These relate to the specifics of a travel health situation, for example:
- pregnancy and travel
- issues specifically relevant to women and children who travel, and also to the elderly, those with heart problems, disabled travellers, etc.
- air travel (eg, fitness to fly, prevention of deep vein thromboses and jetlag)
- expedition and adventure travel
- psychological aspects of travelling (eg, loneliness)
- altitude sickness (New Zealand GPs and nurses are generally knowledgeable about acute mountain sickness in its early and recognisable stages). Prevention of the more serious forms of the syndrome needs specialist management.
More and more, travel is becoming specialised, so advice needs to be focused on particular situations. In such cases, a travel health specialist may be the best source for advice.
While the list of diseases seems to get longer and longer by the year, infectious diseases actually account for a very small proportion of disease and death among travellers. The vast majority is cardiac or accident-related. Therefore, pre-travel prevention and risk-assessment counselling is important for those at risk.
Related topics
See also Travel health checklist before you go
Find a travel medicine doctorin your area
Original content courtesy of Dr Marc Shaw, Medical Director, WORLDWISE Travellers Health Centres of NZ, adapted from the Travel Medicine Guide, 3rd Edition, 2003. Edited by everybody
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