Juaneda Hospitales launched the first Traveler Consultation, which is attended at the Juaneda Miramar Hospital by Dr. Eliana Cortés, specialist in Internal Medicine, and whose objective is to provide all the health information, vaccines and prophylactic measures for those who travel to areas with some health risk.
«For many trips, preventive vaccines are necessary —explains Dr. Cortés—which could only be administered in the public health service or in international vaccination centers or in specialized vaccination centers for travelers. Furthermore, it is not just about vaccinating: in all cases, the risks must be assessed.
The advice and precautions that each traveler should take into account “depend on their state of health, their co-morbidities, the place where they are traveling, the type of trip (backpacking or luxury) and depending on all this, some prevention or other measures will be necessary , ” adds the internist, and emphasizes that “it is very important to individualize what the patient needs for his trip”.
The areas with the most health care are “all areas of the tropics, for example India, countries in Southeast Asia such as Thailand, Laos, Cambodia, Vietnam, all in sub-Saharan Africa, as would be the case for many people who go on safari in the Kenya, Tanzania, Namibia… and Latin America, from southern Mexico to northern Argentina.”
Special prevention must also be taken when traveling “to parts of the world in specific contexts, such as natural disasters or wars, where outbreaks of previously undetected infections or highly focused epidemics such as cholera may occur”. Among the infections that the traveler must prevent are malaria, typhoid fever, hepatitis B, hepatitis A, meningococcal meningitis, tetanus, rabies and yellow fever.
Malaria stands out for its mortality potential. “Vaccines are being investigated, the only one that exists is indicated only for children in high transmission regions, we hope that in a short time we will have one for traveling adults”, explains Dr. Cortés and warns that “although it is not frequent, there is a risk of death for the patient if it is not treated in time.
Therefore, when traveling to areas where there is malaria, “it will be necessary to carry out a risk assessment of each patient and prophylaxis with medication for those who travel to the geographical areas with the highest incidence”. Malaria can be serious, especially if it is caused by Plasmodium falciparum, a parasitic microorganism transmitted by Anopheles mosquitoes.
In these cases, prophylaxis consists of medication that the traveler must take a few days before traveling to risk areas and a few days after returning, depending on the regimen that will be adapted to each person after knowing their medical history. In addition, the use of repellents and the use of mosquito nets is recommended.
Those who should be more careful when traveling to areas at risk of tropical diseases are people with chronic diseases, immunocompromised people, pregnant women, children and, of course, those over 65 years of age. All these patients will receive specific instructions when they arrive at the Juaneda Hospitales Viajante Clinic.
The Doctor. Cortés will take a medical history of anyone who comes to Clínica do Viajante to discover possible comorbidities and weaknesses that may increase the risk of complications in case of being affected by malaria or another disease, even if the user himself does not claim to know, in principle , which has risk factors.
“It has to be seen,” explains Dr. Sections— the vaccination history of each traveler, the serologies, perhaps updating the vaccination schedule according to their age and checking whether they are immunized against infections that they must take care of, not only if they are going on a trip, but in their usual environment and that the patient probably doesn’t know it’s out of date. This may be the case with pneumococcal, tetanus-diphtheria and flu vaccines.
Among the preventable diseases, after malaria, we must also pay attention to traveler’s diarrhea (caused by different bacteria or parasites), as well as other pathologies, such as typhoid fever, hepatitis A and E, which are called “Water Transmission Diseases”. and Food”.
“There are several profiles of travellers”, points out the internist: “those at high risk, such as rescuers, missionaries, adventure tourists in wild rural areas and hunting tourists, who will require specific vaccines”. On the other hand, there are “lower risk travelers, such as business travelers or those staying in good hotels with little contact with the area”.
“Meningococcal meningitis is another preventable disease,” explains Dr. Cortés, “so it may be advisable for some travelers to schedule vaccination and for those who intend to travel to Saudi Arabia during the pilgrimage period to Mecca, it should be mandatory” . For yellow fever, it is not possible to offer vaccination in a private centre.
The yellow fever vaccine is the only one regulated by international health standards and is therefore only accessible through the international vaccination centers of the Ministry of Health. Some countries may require mandatory vaccination for entry. These requirements may change at any time.
“It is important for travelers to verify their need by consulting the relevant consulate or embassy or by consulting the updated data on the WHO website on international travel and health,” adds Dr. Eliana Cortés, specialist in Internal Medicine and head of the new Juaneda Hospitales Traveler Consultation.
It is recommended that this consultation be booked one to two months before the trip. Vaccines do not have an immediate effect, it takes approximately two weeks for the onset of protection, from the first dose and in some cases requires 2 to 3 doses. In any case, “the Traveler Consultation is not just for vaccines”:
This new service “is also an advisory consultation, where we will give advice and recommendations on aspects such as managing food and water to avoid infections transmitted through this route. In addition, for managing traveller’s diarrhea, help prepare the travel kit (with prescriptions for necessary medications), precautions to avoid problems with environmental hazards such as heat stroke or altitude sickness, to avoid mosquito bites, or discuss risks such as STDs or HIV,” concludes Dr. Polite.