Say the word “travel” to many nurses. They’ll likely think of travel nursing, which gained a high level of attention during the height of the COVID-19 pandemic when nurses were needed in large numbers at hundreds of facilities nationwide. However, if you mention “travel medicine,” some nurses might stare at you blankly.
Travel medicine is a specialty focused on travelers’ health, often those bound for international destinations. From tourists and businesspeople to students and missionaries, being appropriately protected against travel health risks is no small feat, and many people don’t know where to begin when planning for their health on the road.
Since it’s so common for people to turn to nurses they know for advice, it’s a good idea for nurses to be familiar with some of the basics of travel medicine so that they can provide the guidance that their loved ones, friends, colleagues, and neighbors are seeking, and also to protect themselves when abroad.
Travel Medicine Offers Protection in a Hyper-Connected World
In a hyper-connected world where diseases can be spread through the movements of people around the globe, considering the risks of particular destinations is a smart strategy. And with the recent coronavirus pandemic sweeping the world still fresh in many of our memories, we might also be concerned about other potential travel-related diseases.
Despite the relatively high cost of many vaccines not commonly covered by health plans, not being protected and getting sick while away from home can result in significantly more costs, including unexpected but necessary emergency medical evacuation. In light of this, fee-for-service travel medicine clinics often fill the gaps and provide travelers with the advice and protection they need for their upcoming time away from home.
Not only do illnesses spread through travel, but several diseases (e.g., malaria, yellow fever, Japanese encephalitis, etc.) are endemic in certain countries, and some of these can pose significant short- and long-term risks to your health.
All travelers should be up-to-date on tetanus (the CDC recommends every 5 years for international travel), as well as pneumococcus (as age-appropriate); influenza; COVID-19; hepatitis A and B; varicella; measles, mumps, and rubella; and polio (some countries with wild-type or endemic polio may require proof of vaccination for entry).
Malaria: A mosquito-borne illness, malaria infects almost 300 million people per year and causes over 400,000 deaths. Sub-Saharan Africa, South and Southeast Asia, the Pacific Islands, Central America, and northern South America are all target areas for malaria prophylaxis. Protective clothing, insecticides, and medications to prevent infection are the go-to strategies for this deadly disease.
Zika, Dengue, and Chikungunya: This trio of tropical and sub-tropical mosquito-borne illnesses can be severe. Since travelers can take no medications to prevent infection, protection against bites is crucial.
Japanese encephalitis (JE): Mosquito-borne with a 25% fatality rate, travelers to Asia must rely on bite prevention and the additional option of the Japanese encephalitis vaccine.
Yellow Fever: Yet another disease spread by mosquitos, the yellow fever virus is a tropical and subtropical disease found in Africa and South America. There is no known treatment or cure, so the yellow fever vaccine and bite prevention are paramount. Some countries require proof of yellow fever vaccination for entry.
Rabies: Although the multi-dose rabies vaccine is costly, rabies is 100% fatal if not treated within 24 hours of exposure (bite, scratch, or lick on open skin). Most developing countries lack access to the blood product that must be injected directly into the wound or have poor asepsis practices that can expose international travelers to diseases like hepatitis C and HIV during medical intervention.
Traveler’s diarrhea can become quite dire. Thus, carrying medical-grade bovine colostrum and antibiotics for severe cases is essential. (Most physicians are unaware that certain countries have E. coli strains resistant to ciprofloxacin, and azithromycin is needed in those areas).
Public Health Ambassadors
Due to how the general public leans on nurses for health advice, all nurses are, in essence, public health ambassadors. Understanding the risks posed by international travel — especially travel to the developing world — is an important knowledge base for nurses who want to be well informed.
Although not comprehensive, this article provides a grounding in the due diligence recommended for international travelers in a world filled with fantastic destinations and consequential health risks. The importance of good travel insurance — including emergency medical evacuation — cannot be overstated.
Find your comfort level with knowledge about travel medicine and share freely with friends, family, colleagues, and community members who are avid travelers needing sound advice, safety, and good health abroad.
