Polio in Russia. Measles in France. E. coli in Germany. Diseases that are particularly harmful to children. Diseases that you thought you would no longer hear much about are popping up in countries where you least expect to find them.
Health-wise, is foreign travel become more hazardous?
1. On the contrary. Foreign travel is less likely to cause illness today than at any time in history. Ironically, dire sounding news reports about disease outbreaks reflect how safe travel has become.
2. Many disease outbreaks make headlines specifically because the diseases have become so uncommon. Twenty years ago cases of polio in most of the world were not newsworthy. There were tens of millions of cases yearly, mostly in children, with tens of thousands of children left with serious lifelong health issues and some dying. Last year, there were only about a thousand cases, all in countries in Africa, the Indian subcontinent, and in some countries of the former Soviet Union.
3. Sophisticated surveillance systems monitor disease activity in all
areas of the world. Outbreaks of diseases are tracked immediately. The World Health Organization (WHO) in Switzerland and the Centers for Disease Control (CDC) in the US compile data from national health departments all over the world and from other sources. The WHO oversees that all symptoms suggestive of polio (usually paralysis) are immediately tested for polio. If polio is diagnosed, WHO promptly sends teams of experts to study the outbreak and to vaccinate all children who are at risk.
Also, designated research centers keep track of which drugs are currently effective against malaria, as drug resistance keep changing. Cruise ships calling at American ports must (by law) report to the CDC unusual disease activities occurring aboard ship.
4. Travel medicine has become a recognized and respected profession.
In the lead is the International Society of Travel Medicine (ISTM) with about 2500 members in 75 countries, with many members certified by examination. In addition, many countries have their own travel medicine societies. And, increasingly, “travel” is a topic in journals and at meetings of specialists in cardiology, obstetrics, pediatrics, and other specialties. ISTM has a “chat room” where every day dozens of travel health practitioners from all over the world pose and answer pertinent questions.
5. Travelers are monitored for unusual diseases. Travelers are often the culprits who spread disease from country to country, endangering themselves and people they come in contact with. Two organizations, GeoSentinel and EuroTravNet, are networks of mostly travel clinics that have agreed to report the presence of new diseases among travelers or unexplained increases in known diseases. The information is processed and relayed to travel medicine practitioners, often before the news appears in the media. Travel medicine practitioners were among the first to learn about the recent outbreak of E. coli in Germany.
6. Private subscription services offer an array of information for travel medicine practitioners. These services compile up-to-the-minute travel health data from all available sources and provide tailor-made, traveler-specific computer printouts for travel itineraries. Occasionally, countries require immunizations based on countries previously visited on that specific trip, for example.
7. Vaccines routinely administered to children greatly reduce their risks of becoming ill overseas. No other country gives as many vaccines as the U.S., and in multiple doses, guaranteeing optimum immunity. Parents who refuse vaccines for their children, or who delay doses, make their children vulnerable to numerous illnesses. Parents should also insure that their own immunity is current.
| Routine immunizations in the U.S. | |
| Diphtheria | Varicella (chicken pox) |
| Tetanus | Polio |
| Pertussis (whooping cough) | Hemophilus meningitis |
| Measles | Meningococcal meningitis |
| Mumps | Hepatitis A |
| Rubella | Hepatitis B |
Also, children, even in the poorest countries, are being vaccinated in ever-greater numbers, reducing the risk of visitors becoming infected. However, in many countries much work remains to vaccinate all children.
8. There is far more to travel medicine than immunizations and preventative medications. Travel health practitioners usually know when it is safe for travelers to return to areas affected by a nuclear accident, tsunami, earthquake, or an El Nino climate change. Such events can affect visitors’ health for prolonged periods. It may take years to restore sewage treatment facilities, making food and drinking water safe, for example. Climate changes affect mosquito patterns. In recent years, smoke from huge forest fires in Indonesia badly polluted the air in Southeast Asia, sometimes a thousand miles from the fires.
9. Informative websites are available to travelers. In the U.S., the CDC (http://wwwnc.cdc.gov/travel/destinations/list has specific, detailed travel health-related information on every country in the world with just about everything you want to know. Similar services are available in most other countries. Examples: )
Canada: www.phac-aspc.gc.ca/tmp-pmv/index-eng.php
United Kingdom: www.travelhealth.co.uk
Australia: www.smartraveller.gov.au/tips/travelwell.html
New Zealand: www.safetravel.govt.nz/beforeugo/health
10. Avoiding accidents and crime. Traffic accidents are the most common cause of deaths among travelers overseas. (Waterfront-related accidents are second.) The U.S. Department of State has current information on driving and personal safety in every country (travel.state.gov/travel.) In other countries, check the websites listed above.
(Our next Newsletter will deal with the hazards of families driving overseas.)
