Travel preparation

Question 1

An 18 year old man is leaving for a year’s holiday trekking through South East Asia. What advise would you give him with relation to staying healthy?

Answer 1

Intro
Young man intending travel, concerned about potential safety risks with endemic diseases.

Aims
- hx and investigation, assess risk for developing diseases, conduct serology for current vaccinations, offer additional vaccines and any relevant prophylaxis depending on region of intended travel.

Question 2

Travel preparation - History

Answer 2

History

• PC: ask about where intended on travelling (search for current endemic diseases), local rules/laws for travellers (refer to Ausgov smart traveller website). Any intended animal contact (Rabies risk)
• PMHx: immunocompromised, regular mediations, allergies.

Question 3

Travel preparation - Investigations

Answer 3

Investigations

• serology for effective vaccination coverage (HiB, Hepatitis viruses, etc): check if any boosters are required
• consider Tb screening (CXR, Mantoux vs quantiferon gold)

Question 4

Travel preparation - Counselling and management

Answer 4

Management
Safe practices
- avoid uncooked meat, unwashed veggies
- safe sex practices
- avoiding mosquito bites (clothing, nets, etc)

Vaccines available

• JEV (SE Asia)
• Hep A/B and Typhoid
• BCG for TB
• Yellow Fever (Africa/South America)
• Cholera - only recommended if known outbreak.

Malaria

• Initiate before travelling to regions of high risk (including SE Asia).
• Prophylaxis: malarone, doxycyline, need to take for period of time following return. Prophylaxis doesn’t prevent infection but does suppress and reduce the clinical course of the illness. Advice about A/E including increased risk of sunburn and thus the need for vigilance.

Consider broad spectrum ABx courses and patient education for when to take (superficial infections, etc). [if high health literacy, competent etc].

Counselling

• Provide info printouts to patient
• health insurance
• check SmartTraveller
• DVT prevention for long-haul flights
• sexual health: utilise barrier protection