With the age of aviation, traveling the world has become an easy and enriching experience. Although some of us may stay within the limits of our national borders, many of us will travel to exotic locales in countries with varying degrees of sanitation and standards of hygiene. The risk of food- or water-borne illnesses, as well as more harmful diseases, including malaria and yellow fever, can be a reality of travel. Despite these significant health risks, many will not seek medical advice before a trip. But whether your destination is Cancun or Calcutta, it may be well worth the time to visit a travel health clinic before your departure.
The following individuals should seek medical advice before traveling abroad:
- Infants and young children
- Those with chronic conditions, such as diabetes, cardiovascular disease, kidney disease, irritable bowel syndrome, epilepsy, or HIV infection
- Cancer patients undergoing chemotherapy
- Pregnant women
While these individuals must take extra precautions when traveling, anyone planning a trip overseas should consider seeking medical advice from a travel clinic.
Food- and Water-borne Illnesses
Food- and water-borne illnesses, such as traveler’s diarrhea, are the most common maladies faced during travel. Contaminated food and water can be sources of infection from bacteria, parasites, and hepatitis A—all of which can lead to severe dehydration. In general, the Centers for Disease Control and Prevention (CDC) recommends drinking only bottled water and avoiding undercooked or raw foods, dairy products, shellfish, or food that has been allowed to cool to room temperature. Based on the country you will be visiting, a travel health clinic can provide you with a complete list of CDC precautions and recommendations along with necessary antibiotics and water sanitation devices.
Depending on your destination, general health risks can range from the common cold to typhoid fever. The World Health Organization (WHO) cites malaria as one of the most serious risks to international travelers. This potentially fatal disease, transmitted through mosquito bites, occurs in popular destinations, such as Mexico, the Caribbean, India, Egypt, and South Africa. Also of concern are vaccine-preventable hepatitis A and B, both of which can cause liver damage.
Travel health clinics can provide you with information about the year-round health risks that exist in your destination and alert you about new outbreaks that may arise prior to your time of travel. They will also provide you with the recommended immunizations and antibiotics to safeguard against tropical and other illnesses. Of main concern are the following:
- Hepatitis A or B—Mexico, Central and South America, Africa, the Middle East, Asia, the Caribbean, eastern and southern Europe
- Malaria—Asia, Africa, the Middle East, the South Pacific, Mexico, eastern Europe, Central America, and the Caribbean
- Traveler’s diarrhea—Central and South America, Africa, Asia, and the Middle East
- Yellow fever—Africa and South America
- Cholera—Southeast Asia, Africa, Central and South America, and eastern Europe
- Typhoid—Asia, Africa, Russia, Central and South America
- Japanese encephalitis—Southeast Asia
While some countries only recommend that visitors get vaccinated before arriving, others require vaccination as a condition of entry, and will inspect health records to verify that the necessary vaccinations have been taken. In these countries, anyone who has not been vaccinated may be quarantined until they have been, or denied entry altogether. A travel health clinic can determine the vaccination requirements for your destination, give inoculations, and provide you with necessary documentation, such as an International Certificate of Vaccination as well as other travel health records. These documents can be updated before each trip.
Travel Clinic Services
Your destination, length of stay, itinerary, and previous medical history are important factors to consider when seeking travel health advice. The staff at most travel health clinics consist of doctors and nurse practitioners with specialized degrees in infectious diseases or tropical medicine. They are qualified to develop a travel care plan customized to your individual health needs, administer necessary vaccines and booster shots, and write prescriptions for antibiotics and other medications. It is important to make an appointment 4-6 weeks in advance of your trip. This will give you enough time to begin a malaria vaccine regimen if you need to, and for vaccinations to boost your immune system before your trip.
In general, services provided by most travel health clinics include:
- CDC and WHO information about health risks and recommendations in your area of travel
- United States State Department travel advisories and consulate information
- Pre-travel counseling based on destination, length of stay, and medical history, including how to care for chronic conditions while traveling
- An individualized plan of prevention and treatment, including recommendations for food and water safety, and recommendations for avoiding insect-borne diseases
- Vaccination certificates required by some countries before entry
- Antibiotics or over-the-counter medications for diarrhea or prescriptions for malaria prevention
- Permanent medical records listing any present illness as well as medical needs
- A list of recommended doctors or clinics abroad
- Information about traveler’s medical insurance, which provides affordable coverage for medical emergencies—also check with your current insurance provider
- Tests to determine whether any illnesses were acquired abroad
- Treatment of any illnesses acquired abroad
Another essential aspect of travel clinic services is post-travel care. This is particularly important for those with chronic conditions and anyone experiencing persistent health problems when they return, including the following:
- Fever—seek medical attention right away if you have traveled to an area where malaria is prevalent
- Trouble with urination from urinary tract or genital infections
- Rashes from skin disorders or infection
Many hospitals and medical centers provide travel health services. Consult the CDC website to find a travel clinic near you.
Centers for Disease Control and Prevention
US State Department
Public Health Agency of Canada
Travel and Tourism—Government of Canada
Cholera. EBSCO DynaMed website. Available at:https://www.dynamed.com/topics/dmp~AN~T115474/Cholera. Updated December 28, 2016. Accessed May 2, 2017.
Traveler's checklist. Available at: http://travel.state.gov/content/passports/english/go/checklist.html#checklist_parentitem_1. Accessed May 29, 2015.
Travelers' health: vaccines, medicines, advice. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/page/see-doctor. Accessed May 2, 2017.
Travel medicine services and immunizations. Passport Health website. Available at: http://www.passporthealthusa.com/travel-medicine. Accessed May 2, 2017.
Last reviewed May 2017 by Michael Woods, MD, FAAP Last Updated: 5/29/2015