Whether for vacation, pleasure of discovery, for work or to reach a loved one but far away, the Italian people do not deny their historical spirit of the traveler. In order to travel safely on all these occasions, one should always be informed about the mandatory vaccinations and recommended vaccinations that one must have in order to reach a given destination, in maximum health safety. As we have learned our ill degree, in this time of global pandemic, health safety while traveling is fundamental.
The 2018 data showed a continuing upward trend:
- Total trips made with overnight stays: 78.940 million. This is up steadily from 2017 (+19.5%);
- International trips accounted for more than 20% of the total, a growth of 31.4% again compared to the previous year;
- Business travel increased 57.7% compared to 2017. [1]
Increasing globalization and migration, makes the composition of the classic traveler increasingly diverse and complex in relation to the clinical-health aspect.
Before embarking on a trip, whether for business or leisure, it is crucial for the traveler to gain awareness of the place he or she is going to visit, the related risks, and the best strategies to prevent and cope with them. Different foods and climate, insects and multiple stressors can affect our travels and our health. Therefore, it is important to know what changes are likely to occur, what diseases are present, what mosquito or general insect repellent to use, and what other precautions to follow.
Unfortunately, studies show that only a small fraction of travelers seek the advice of professionals in a travel medicine center, such as those found within a tropical medicine center or vaccination center. Only a few are properly informed about any international vaccinations that should be considered before making a trip. Specialists in these travel clinics, can advise and educate would-be travelers, regarding mandatory vaccinations, recommended vaccinations, and what travel medicines to obtain, before embarking on their trip.
Travel Medicine is the branch of medicine dedicated to the health of travelers. It is an interdisciplinary specialty that addresses, not only the prevention of infectious diseases and tropical diseases while traveling, but also the personal safety of travelers and the prevention of environmental hazards. [2]
The knowledge of the experienced professional includes:
- the study of the global epidemiology, transmission, and prevention of infectious and noninfectious diseases associated with travel;
- a comprehensive understanding of vaccine indications and procedures;
- the prevention and management of travel-associated health risks;
- health regulations, immunization requirements of various countries, and changing patterns of drug-resistant infections;
- recognition of major syndromes in returning travelers.
A consultation with a specialist, is essential in order to accurately assess the specific risks of the traveler, itinerary, and chosen destination.
The goal of Travel Medicine's preliminary consultation is to reduce the traveler's risk of illness, during and after travel, through information and education for the proper prevention, prophylaxis, and treatment of diseases endemic in a given place, advice on best practices, appropriate immunizations, and medications.
Traveler-specific risks
Preliminary assessment of the traveler's medical history and health status is essential. In fact, some travelers might be considered "at risk," such as immunocompromised or chronically ill patients, pregnant or lactating women, young children, the elderly, and VFRs (travelers who have migrated from a developing country to an industrialized region and are returning to their country of birth).
Destination-specific risks
The assessment and determination of destination-specific risks is critical and requires a thorough understanding of global epidemiology. Indeed, professionals will assess the latest information on current outbreaks and any recommended or required immunizations.
Route-specific risks
The assessment of the itinerary concerns the regions to be visited, relating urban versus rural areas, travel period and duration, types of accommodations, and modes of transportation. It is also important to assess possible high-risk activities during the trip (e.g., hiking, rafting, caving, scuba diving...) or contact with wild animals, which may increase the risk of contact and/or transmission with specific pathogens.
Immunization
Based on the previous assessments, the professional will be able to determine which vaccination and pharmacological prophylaxis protocols are most appropriate for the individual traveler. In fact, the vaccination program is tailored to the traveler's immunization history, the countries to be visited, the type and duration of travel, and even the amount of time available before departure.
Conclusion
Travel Medicine is an evolving specialty and requires special medical knowledge and skills, passion and experience to be practiced. Prevention is essential, not only for the health of the individual, but also for the whole community.
The Travel Medicine Outpatient Clinic is the first public service to protect travelers who want to leave protected, but most importantly return home only with positive memories and experiences.
References
[1] ISTAT, 2019(www.istat.it)
[2] The Practice of Travel Medicine: Guidelines by the Infectious Diseases Society of America, David R. Hill et all
Travel medicine What's involved? When to refer? Brian Aw et al, PMC, Can Fam Physician. 2014 Dec; 60(12): 1091-1103.
(www.ncbi.gov)
