Preventive Interventions for International Travel: An Increasing Need in Family Medicine

Abstract

began offering preventive services for international travel in 1996.Local demand for such services has steadily increased, especially among families who need services for multi-generation members on the same itinerary. This paper discusses our clinic operation; the clients we serve and their destinations; and the specific services and counseling we provide. We feel many such needs could be met by more family medicine practitioners, as the volume of international travel continues to increase. Introduction: Each year more United States citizens travel abroad; this trend is expected to continue as the population increases, and larger proportions are expatriates. In 2015, U.S. citizens made more than 32,789,000 trips outside of North America, most during May through August. 1 As of November 30, 2016, U.S. citizens completed more than 72,550,000 trips outside the country, an 8.0% increase over 2015, year-to-date; trips outside of North America accounted for approximately 44.0%. 2 More "new" infectious diseases are being recognized; recent examples: influenza A (avian) H5N1, first recognized in humans in Viet Nam in 2004,became a widespread zoonotic disease by 2008; influenza A (pandemic) H1N1 was first identified and became a global concern in 2009; Lassa, Ebola, and Marburg viruses "reappeared" as human disease risks in Africa in 2012 through 2015. 3,4,5,6 Middle East respiratory syndrome corona virus (MERS-CoV) first appeared in 2013 and continues as a regional risk to human health; the ongoing risk of influenza A (avian) H7N9 in the Orient was first recognized in 2013, and, by the end of 2014, the H5N6 strain had appeared in China. 5,6 Since then, Chikungunya and Zika viruses have become human disease risks in the Western Hemisphere. 7,8 These agents have only added to, not replaced, already-existing infectious disease risks for international travelers.