New CDC campaign can save lives by helping prevent or diagnose travel-related diseases By Dr. Gary Brunette, Chief of the Centers for Disease Control and Prevention’s Travelers’ Health Branch
CDC Launches “Think Travel”
In a call for conversations and action between health care providers and their patients about travel health, the Centers for Disease Control and Prevention (CDC) has launched a new travel awareness campaign. The goals of this campaign are to help health care providers protect the health of and diagnose infectious diseases in international travelers.
US residents are traveling to destinations around the world where they can get sick from infections such as yellow fever, Zika, Lassa fever, dengue and travelers’ diarrhea. Resources tied to the “Think Travel” campaign will give primary or urgent care physicians, physician assistants, nurse practitioners, and pharmacists tools to help them keep their patients healthy during and after international travel. Here is how Think Travel can help you in your practice:
Thinking Travel Can Prevent Disease
While conducting a routine physical exam, your patient mentions an upcoming Amazon cruise through the Brazilian rainforest. You ask if she has scheduled a pre-travel consultation. During the pre-travel consultation, international travelers receive preventive guidance, vaccines (e.g., yellow fever), and medications for prophylaxis (e.g., malaria) or self-treatment (e.g., travelers’ diarrhea) recommended for their destination. She tells you she has not, but will as soon as she leaves. Thinking travel may have helped prevent any number of infections in this traveler.
Thinking Travel Can Save Lives
A patient presents to your emergency department with fever, chills, and myalgia. The resident on duty prescribes oseltamivir for suspected influenza. From the hall, you overhear the patient sharing with a Ghanaian nurse that his parents live in Ghana. You step in and ask about the last time he visited his family, and it turns out he returned from Ghana only recently. After additional tests, a blood smear reveals Plasmodium falciparum malaria. Thinking travel may have saved this patient’s life.
Thinking Travel Can Protect Communities
A mother brings her 6-year-old child to your clinic with fever, rash, and upper respiratory symptoms. You ask about travel history and learn that the family just got back from vacation in France, where there is currently a measles outbreak. Upon further questioning, the mother tells you that her child has not received an MMR (measles-mumps-rubella) vaccine. Thinking travel helped identify the exposure risk in your clinic and potentially prevented the spread of measles to other unvaccinated people.
Get Your Patients Travel-Ready
US-based travelers made nearly 90 million international trips in 2017, with only an estimated 14% seeking any sort of pre-travel advice. A pre-travel consultation is your opportunity to provide patients with the protection they need against travel-associated diseases: recommended vaccines, medications, and guidance about preventive behaviors (such as insect bite prevention and food safety). If you have patients planning international travel, make sure to provide pre-travel care with Think Travel support resources. If your clinic does not offer these services, help patients find a travel health clinic here: https://wwwnc.cdc.gov/travel/page/find-clinic.
CDC offers several resources to help you conduct pre-travel consultations, including
- A Pre-Travel Guide (https://www.cdc.gov/thinktravel): highlights major topics of discussion to support pre-travel consultations with patients traveling abroad.
- A Destination Finder Tool (https://wwwnc.cdc.gov/travel/destinations/list): provides destination-specific information on disease risk, CDC recommendations for vaccines and medications, and topics for patient counseling.
- A Pre-Travel Tool (https://wwwnc.cdc.gov/travel/page/gten): offers step-by-step tool for clinicians conducting pre-travel assessments and generates customized recommendations for vaccines, medications, and counseling.
Always Ask About Recent Travel
People who live in the US are traveling internationally more now than ever before. Increasingly, they are traveling to areas where tropical infections, such as Zika, dengue, and Lassa fever, are a risk. Taking a travel history from an ill patient can help you expand your differential diagnosis to include etiologies that would be much less likely for patients who had not left the United States.
CDC posts travel health notices (https://wwwnc.cdc.gov/travel/notices) that identify international disease outbreaks or notify clinicians and travelers about diseases appearing in new or unexpected locations or outbreaks that exceed baseline disease-endemic case rates. Being aware of these notices can assist you, if you think to ask about recent international travel or include questions about recent travel as part of the patient intake.
In addition, CDC offers resources for clinicians evaluating recently returned travelers (https://wwwnc.cdc.gov/travel/yellowbook/2018/post-travel-evaluation/general-approach-to-the-returned-traveler), including specific guidance for ill travelers with
- Fever (https://wwwnc.cdc.gov/travel/yellowbook/2018/post-travel-evaluation/fever-in-returned-travelers)
- Diarrhea (https://wwwnc.cdc.gov/travel/yellowbook/2018/post-travel-evaluation/persistent-travelers-diarrhea)
- Skin and soft tissue infections (https://wwwnc.cdc.gov/travel/yellowbook/2018/post-travel-evaluation/skin-soft-tissue-infections-in-returned-travelers)
One Conversation Is All It Takes
When providers have conversations with their patients about travel, they can help them have a safer, healthier time abroad. Thinking travel can also help clinicians arrive at solutions to diagnostic challenges. Thinking travel can help prevent disease, save lives, and protect communities. Go to www.cdc.gov/ThinkTravel to find CDC resources to help with pre-travel consultations and post-travel evaluations.