Who should you ask for travel health info?
Specialists in travel health can advise on immunisations and diseases in tropical or developing countries and will also consider wider aspects such as your health, ability to travel, preparation needed and the risks posed by your travel plans. However, your GP or practice nurse should also be in a position to advise you on general travel health issues and immunisations for common destinations.
Travel health specialty
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 - which currently results in around a billion travellers crossing international borders each year (World Tourism Organization figures).
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
- prevention of alcohol-related, drug-related or sexually transmitted diseases, where appropriate
- air travel, eg, fitness to fly, prevention of deep vein thromboses (DVT) and jetlag
- the safety of land travel in developing countries
- advice on protection against insect, mosquito and animal bites
- 'safe' food and water, and diarrhoea prevention and management
- the prevention of injuries while travelling, and where to seek advice if injury or illness occurs
- the essentials of a basic medical kit for the traveller, and correct use
- what conditions to self-treat, guidance on appropriate treatment, and when to seek medical attention.
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 eight 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:
- tropical and infectious diseases in the intended regions of travel
- pregnancy, women's health issues and travel
- children and travel
- people requiring particular assessment, eg, the elderly, those with heart problems, disabled travellers, those with HIV, etc
- sports groups, school groups
- expedition and adventure travel, seafaring, remote locations
- psychological aspects of travelling (eg, loneliness)
- altitude medicine (New Zealand GPs and nurses are generally knowledgeable about altitude sickness [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.
Risk assessment before travel
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 of health problems among travellers relate to heart, lung or gut issues, or are due to accidents. 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 doctor in your area
Original content courtesy of Dr Marc Shaw, Medical Director, WORLDWISE Travellers Health Centres of New Zealand, adapted from the Travel Medicine Guide, 6th edition, 2011. Edited by everybody, December 2011.
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