The ability to listen, the secret of Pre-Travel Counselling
Category: News - Author: Edoardo Zanini
At a time when everyone can say “I looked it up on the Internet”, it is important to reiterate that it is imperative to seek expert advice before travelling outside Italy, especially for tropical destinations.
Everyone has probably heard of malaria and yellow fever, a few of dengue, but I challenge anyone who is not in the industry or has not travelled extensively to know something about chikungunya, schistosomiasis or Chagas disease.
People often underestimate the problem. We suffer slightly from the 'Superman' syndrome.
While true that in 2021 a tropical disease is unlikely to be fatal if you receive the right treatment, why would you take the risk when you have all the means to avoid it?
Or why would you spoil a trip that has been planned for years because of a disease?
Data from the ECDC Annual Epidemiological Report (AER) for the year 2019, published in April 2021, show that 8,641 malaria cases (99.8% imported cases) were recorded in 29 European Union (EU) countries. About 800 cases of malaria are reported in Italy every year. More generally, between 2011 and 2017, there were 4,132 cases of neglected tropical diseases in Italy, for which, nearly always, very little information is available.
Consequently, it is advisable, before departure, to consult qualified personnel about potential dangers during your stay. As well as booking hotels and flights, it is advisable to carry out a pre-trip consultation in good time, at least 1 month before departure.
Pre-trip counselling is not “you must do this!”.
Counselling is first and foremost about listening: the health professional listens to the user, gets to know about the type of journey, but also the type of person, the planned stop-offs, the length of stay and the period. The offer should be structured according to the situation presented. It is not limited to a “standardised plan” according to the country to be visited.
Let's take an example: two different people have to travel to Tanzania. Let's remember that Tanzania is 945,090 km² (3 times the size of Italy):
- the first will honeymoon with his partner in the most touristy part of Zanzibar in an all-inclusive 5-star resort for a fortnight in June;
- the second will travel to the north of the country for 3 weeks in December, sleeping in a tent with his partner and volunteering with wild animals. The nearest hospital is a 5-hour bus ride away.
The country is the same, but it is clear that the potential risks are different between the two types of stay. If you look for health advice anywhere on the Internet, it will be the same: a long list of vaccinations and prophylaxes that do not take into account the intrinsic variables of the trip itself.
Since vaccination is a fundamental tool, it is always good to assess the traveller's priorities.
It is clear that the second traveller has a much higher risk of contracting, for example, rabies, due to the type of activity he will be exposed to and at the same time would have more difficulty in reaching a medical centre if bitten. Consequently, although among the possible indications when travelling to Tanzania, the rabies vaccine is only to be recommended in certain situations.
As is an antimalarial prophylaxis: the risk is directly proportional to the time of exposure, the time of year and the area of the trip.
Listening is essential in order to properly protect and inform the patient.
If on the one hand the health professional must be attentive to the needs of the traveller, the user, on the other hand, they must take this opportunity, not as an obligation, but as an opportunity for discussion and learning. This toolkit will also be useful in the event of future travels, both in terms of knowledge and vaccinations received.
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