International Travel With a Chronic Medical Illness – Health Risks, Practical Challenges and Evidence-Based Recommendations

Abstract

Introduction: Primary care practitioners and travel medicine physicians are primarily responsible for identifying individuals who may be unfit for overseas travel and consulting with them pre-travel. Pre-existing medical conditions such as cardiovascular disease, chronic respiratory conditions and diabetes mellitus (DM) have the potential to complicate travel journeys. A considerable percentage of travel-associated illness may be due to the decompensation of a pre-existing medical condition. This review seeks to address the challenges faced by travellers with each of these conditions, including recently updated and evidence-based practical approaches for travel with comorbidities. Methods: Sources for this review were identified through searches of PubMed/Google Scholar for materials published between 1st January 2000 and 31st December 2019, using combinations of search terms. Results: The volume of literature on travelling with a pre-existing condition exploded with more than 865 associated articles indexed on the PubMed alone as of March 2020. After screening titles, abstracts and, in some cases, the full text version of indexed articles, 121 articles were deemed relevant to the subject matter of this review. Conclusion: Rational approaches to pre-planning for travel with a medical condition will contribute to the prevention of problems while in transit as well as when at the travel destination. It is imperative for health care providers to be aware of the preventative measures and current recommendations that should be taken before and during travel to protect individuals with a chronic illness. Further research and studies should be directed to protect this vulnerable group of travellers.

Retrospective cohort study of the characteristics of traveller patients presenting to the accident and emergency department of a regional hospital in Hong Kong

“…Travellers with chronic medical problems may have acute exacerbations precipitated by long‐haul flights and jetlag, 4 or may suffer from acquired conditions, including traveller’s diarrhoea, vector‐borne diseases or rarer conditions, such as altitude sickness. Various challenges are encountered when managing international traveller patients, including language barriers, cultural differences, unclear medical records and differences in expectations for health service needs.…”