Preparing for at-risk travel

If your patients are going to at-risk destinations, here’s what you should know about travel vaccinations. 

The description ‘exotic paradise’ is often enough to get anyone dreaming about their next holiday destination, but Australian travellers often forget to focus on the not-so-fun reality of health risks they may face in some regions.

Travel health specialist Dr Sarah Chu reminds us that many Australians travel to overseas at-risk destinations (in regions with a known risk of contracting infectious diseases) without adequately preparing. In 2015, half of those Australians travelling to at-risk destinations did not get vaccinated before their latest trip, a study has indicated1.

The same research indicated that one in four Australians travelling to at-risk destinations fell ill on their latest trip, with 43 per cent of those surveyed needing to seek medical assistance while overseas.

Patients trust healthcare professionals to provide them with the best and most up-to-date advice on how to protect their health, so it’s important to educate your patients on recommended vaccines for their destination and help them make informed decisions about vaccinations.

What vaccines do your patients need?

The travel health consultation is the first step in providing protection for your patients while overseas, so it’s important to properly assess:

  • Travel destination.
  • Length of trip (half of Australian at-risk travellers are less likely to bother with vaccinations if they are going on a short trip1).
  • Planned activities during the trip.
  • Immunisations already received.

This will ensure you can tailor your recommendations appropriately. During the consultation, explain the benefits of vaccination and the potential costs of contracting the diseases they protect against, and address any questions and concerns they might have.

Required

There are two situations where your patients should understand that specific vaccines are mandated for travel:

  • Yellow fever vaccine is required if travelling to certain endemic areas and entry may be denied to those not vaccinated. In addition, many countries require that travellers arriving from countries with a risk of yellow fever virus transmission provide evidence of yellow fever vaccination prior to entry.
  • Meningococcal vaccine is required if travelling for the Hajj annual Islamic pilgrimage in Saudi Arabia.

Routine

Considering a patient’s health and travel plans, healthcare professionals should determine:

a) What routine immunisations the patient should be up to date for.

b) What additional immunisations the patient should be up to date for – looking at a patient’s medical history and individual factors (eg, whether pregnant women should receive the influenza and pertussis vaccinations, or whether asplenic patients should receive meningococcal, pneumococcal, haemophilus influenzae B, and influenza vaccinations).

Recommended 

Recommended travel vaccinations should be tailored to the individual traveller – following the mantra of ‘this traveller, this trip’. Potential health risks are accessed based on traveller and trip factors, likelihood of repeated travel, time until departure, vaccine interactions and the efficacy and safety of vaccines for this person.

In general, most travel vaccines are recommended rather than mandated. These recommendations are based on advice from organisations such as the Centre for Disease Control and World Health Organisation that monitor disease activity and constantly adjust recommendations based on risk.

Some of the more common diseases that travellers will face in countries such as Indonesia, Thailand and India include hepatitis A, typhoid, rabies, Japanese encephalitis, cholera, meningococcal disease and polio. 

Different itineraries, traveller characteristics, planned activities, trip duration and disease outbreaks all augment risks of potential travel health challenges, hence the importance of tailored advice for ‘this traveller, this trip’.

For more travel advice specific to at-risk destinations, you can advise your patients to visit http://vaccinehub.com.au.

1. Survey developed by Sanofi Pasteur and conducted by Lonergan Research, May 2015. Completed by 1,041 Australian travellers.
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