Today we are discussing international travel health and safety tips with Paula Monte, Physician Assistant at Vanderbilt International Travel Clinic.
Shaina Farfel: Welcome to this edition of the Vanderbilt Health and Wellness Wellcast. I am Shaina Farfel with Occupational Health. Today, we are speaking with Ms. Paula Monte, physician's assistant, at the Vanderbilt International Travel Clinic. Paula, thanks so much for being with us today.
Paula Monte, P.A.: Thank you, Shaina.
Shaina Farfel: As our world begins to open up again for the first time in almost two years, I wanted to discuss the importance of promoting health and safety during international travel. Paula, can you tell us what is travel medicine and under what circumstances is it appropriate for someone to think about scheduling an appointment with a travel clinic.
Paula Monte, P.A.: Travel medicine specializes in diseases and conditions that can be acquired traveling abroad, mostly to developing countries. Travel to different countries, it involves foodborne, inset borne diseases, amongst other potential risks. Diseases, injury, even security issues.
Shaina Farfel: For any type of travel or any destination, would someone maybe think about making an appointment for a travel clinic or are there only maybe certain areas that, that might be necessary to consider?
Paula Monte, P.A.: Good question. Mostly to developing countries. The industrialized world is fairly safe to travel to. It is just like living her in the United States, but when you travel abroad to countries where there are risks of diseases, some countries have requirements for vaccines in order to enter such as the Yellow Fever vaccine. If a traveler is at all concerned, making an appointment, coming in, sitting down for a consultation is always a good idea.
Shaina Farfel: So, sounds like it cannot hurt, maybe even if you are not quite sure.
Paula Monte, P.A.: Absolutely right. Cannot hurt.
Shaina Farfel: What vaccines or medications might be recommended for international travel? This also kind of gets into, for getting vaccines, when would be an appropriate to get those? How far in advance would I need to start thinking about that?
Paula Monte, P.A.: So, the most commonly recommended vaccines for travel is hepatitis A and typhoid and, of course, a current tetanus. Everyone should have a current tetanus vaccine. There are some vaccines that are in series. For instance, two to three given over the course of three to four weeks. So, a month prior to departure is always a good idea. At least 10 days. Most vaccines take about 10 days for them to become effective, but if you want to come in months before you travel that is always a good idea as well. Prescriptions, malaria is always an issue in of course malaria-risk area and then I always recommend and prescribe an antibiotic to treat traveler's diarrhea which can always be an issue when traveling abroad.
Shaina Farfel: So, it is good to have those things just on hand in case. Sure. Other than vaccinations, what do you think are some of the most important tips to protect an individual's health and safety when going on international trips?
Paula Monte, P.A.: I mostly talk about foodborne and bug borne diseases. Foodborne diseases, I usually talk to the traveler about their specific itinerary and a lot of my advice does depend on their specific itinerary. Where they are going exactly. What activities they plan to do while they are there. If they are traveling with a guided tour. If they are sleeping in a hotel or if they are sleeping under the stars. All of these factors are taken into consideration when I do sit down with the traveler. Foodborne and bug borne diseases are the biggest topics of conversation. I also talk about travel safety. Of course, in this world of the pandemic, COVID-19 entry requirements are a big part of the consultation. I always recommend that people who are leaving the United States, especially in this world, that they register with the Smart Traveler Enrollment Program and that is something that anyone can go online and Google and register. It is a communication tool. You can give them your itinerary, your contact information, and they basically track you while you are abroad. If there is anything going on in the areas, they have the opportunity and the ability to contact you and the U.S. Embassy if needed. I always recommend that they register about a month before they leave so that the COVID-19 entry requirements will start to pop up on their smart phones.
Shaina Farfel: That sounds like a great tool, and I am glad that you mentioned COVID because I know lots of folks are obviously having questions about that as they travel. We get this a lot from folks at Occupational Health, but what should a person do if they were to get sick or injured during an international trip? Any recommendations there or ways to prepare?
Paula Monte, P.A.: Good question. For patients who are at high risk to travel, for instance those that have underlying medical conditions, pregnant travelers, I always recommend that they research evacuation health insurance. This is an insurance that will evacuate them to an industrialized country in the event of an illness or an injury. For other travelers, the STEP program is a good resource, if there is something going on in the area, they will be made aware and then they can alter their plans if necessary. The embassies where they are traveling to, I always recommend you find out where the U.S. Embassy is in case you need it, especially for those adventurous travelers that plan to go without guides and go off of usual tourist itinerary. There are several organizations that do provide evacuation health insurance, fairly inexpensive. You can purchase them for short term. For instance, the length of your trip. They are very good at arranging evacuation and providing fairly good healthcare as well. Of course, the most important part of staying healthy is just to be careful. Know what the risks are where you are going. Know what the risks are with the activities. Plan ahead.
Shaina Farfel: Great advice. What resources are available locally here at Vanderbilt and how might somebody schedule an appointment with the Travel Clinic if they were interested. Does that require a referral? Do they just call to get in?
Paula Monte, P.A.: We are self-referral. So, the International Travel Clinic does require an appointment. So, any Vanderbilt University employee who is traveling for Vanderbilt business can go to the Occupational Health Clinic and receive the consult, vaccines, and prescriptions at no cost to them. If they do need the Yellow Fever vaccine, they are then referred to me. I will administer the vaccine again at no cost to them. The Occupational Health Clinic does require an appointment for that. All university students traveling, the Student Health does have a travel component. And again, it is an appointment. If they do need the Yellow Fever vaccine, they are referred to me. The students though are required to pay, but only for the vaccine.
Shaina Farfel: Wonderful. Well Paula, thank you so much for your expertise on this subject and I am sure many of our employees with future travel plans will find all of this very useful and we will also post a link with some information about the Travel Clinic and Occupational Health's international travel resources with this podcast for folks who are interested. Thank you again.
Paula Monte, P.A.: Great. Thank you, Shaina.
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