Dr Marc Shaw. Medical Director Worldwise Travellers Health Centres Auckland
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1 Dr Marc Shaw Medical Director Worldwise Travellers Health Centres Auckland
2 Developing a Checklist Marc Shaw DrPH, FRNZCGP, FACTM, FFTM (ACTM), MFTM RCPS (Glas) Associate Professor, James Cook University, Townsville, Australia Medical Director, WORLDWISE Travellers Health Centres, NZ WORLDWISE OnLINE ( New Zealand Travel Health Information for Professionals
3 Objectives In this session Look at the information that is needed for travellers health and safety Develop a checklist of required information from the traveller Develop a checklist of information travel health professionals require to GIVE the traveller
4 Scope of Travel Medicine Travel medicine seeks to prevent illnesses and injuries occurring to travellers going abroad manages problems arising in travellers returning from abroad is concerned about the impact of tourism on health advocates for improved health and safety services for tourists
5 Why do we need to give correct advice to travellers?
6 NZ Travellers to May 2011 Short-term departures of NZ residents in May 2011 yr = million, up 127,500 (7%) from May 2010 year 50% trips were to Australia (990,000) Next United States, Fiji (each 99,000), the United Kingdom (93,900), China (67,000), the Cook Islands (62,800), and Samoa (44,100) Holiday = main purpose for 833, ,800 = VFRs 291,700 departed for business
7 Estimated monthly incidence of health problems per 100, 000 travellers to developing countries for 1 mth
8 What do we need to do to give the correct advice to travellers?
9 Travel Health Advice needs: Information Training Experience Documentation Travellers
10 Getting the correct advice from travellers needs: Information about the traveller
11 What Information is required? From the audience
12 The Pre-Travel Assessment (i) Itinerary detailed itinerary of overseas trip, including air-travel direction, places, duration of travel type of accommodation, rural or urban Season, climate, temperature and altitude of the trip General Practitioner letter RE dis-eases and medications
13 The Pre-Travel Assessment (ii) Personal Health Immunizations, allergies Pregnancy, women s health O/C, hygiene Children and infants immunisations, medications Chronic disease diabetes, chest disease, HIV Lifestyle qualities of living Dental Check-up Personal problems of travel psychology of travel Holiday comfort Travel Health Insurance note any evacuation clause
14 The Pre-Travel Assessment (iii) Type of Holiday Adventure holiday Expedition-type holiday Scuba Diving (? decompression ) Swimming in fresh water Risk of Schistosomiasis Risks Possible encountered health hazards Problems of eating and drinking JetLag Personal security Risk assessment
15 Risk assessment the art of travel medicine is in selecting the necessary prevention strategy without unnecessary adverse events, cost or inconvenience (Steffen, 1994) Need to determine: * What are the likely risks of a person travelling to particular destinations? * What are the likely benefits of intervention?
16 Risk assessment for Traveller Risks of the destination/activity Risks of the mode of travel Risks of the traveller s medical & dental history, including previous documented travel history Risks of the intervention Risks of the (preventative) Rx
17 Giving the correct advice to travellers needs: Information for the traveller Sources of information to devise a discussion template
18 What Information is to be given? From the Audience
19 Tools and Sources of Information Atlas Guidelines Policies Textbooks, including an World Atlas Journals Professional organisations Staff/colleagues Electronic Databases WWW
20 Information - www-sites US Centers for Disease Control US Guidelines Similar government sites for UK and Canada World Health Organization New Zealand MFAT US CIA Australian Travel Health Advisory Group
21
22 Information - multicountry travel medical advisory service Worldwise Online, specific NZ service - (subscriber-based) Travel-essentials, specific NZ service - (public/lay-based) Others: CDC Travel Health, see TRAVAX, see
23 Declared Interest
24 Pre-Travel Health Advice needs Training Helps give structure and consistency: Provides a framework for practice Discusses evidence for practice Courses: WORLDWISE annual courses: Level 1 and Level 2 James Cook University courses in Public Health Otago University course Policy and Procedures Manual Development: Consistent approach to travel health Yellow Fever Certification
25 Travel health advice needs to be documented Standardised forms/questionnaires Informed consent International Health Certificate/Vaccination record Doctor s letter/copy of prescription/medialert bracelet Written advice/videos/books/health advisory documents
26 Take home points More people are travelling to more destinations, becoming exposed to the health and safety of that destination and also having the potential to impact on the health and safety of that destination It is essential that the travel health practitioner develop a checklist of questions for the intending travellers to determine risk of travel It is essential that the travel health practitioner develop a checklist of discussion points for the intending traveller about their travel Travel health advice needs information, training, experience, documentation and travellers
27 Till the World Ends Tour I ve never really wanted to go to Japan. Simply because I don t like eating fish; and I know that s popular out there in Africa. - Britney Spears One can see WHY the WORLD Tour ended it never really started!
28 THANK YOU Worldwise Travellers Health Auckland I met a traveller from an antique land PB Shelley
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