Travel & Vaccinology is more than ‘jabs’. Medical Practitioners. Many GP’s find it useful to refer patients to us who are travelling to ‘at risk destinations’, complex itineraries; travellers with special needs e.g. the elderly, pregnant, children & immune -compromised. We are also expeditious in diagnosing post travel issues.
On referral from you, your patients will receive the most up to date information, recommendations, along with extensive travel health education. Please note that we normally spend 45 minutes with each traveller on the health education.
Common Pitfalls
If you or your nurses are attempting to prepare travellers please note the following:
- there is more to travel medicine & vaccinology than just ‘shots’
- yellow fever is a live attenuated vaccine, so best to get this done first and well in advance
- when requesting serology for antibody titres, do interpret in the context of what your traveller may or may not have had in the past
- hepatitis A vaccine is highly immunogenic ie. avoid unnecessary antibody testing
- please oversee that your nurse administers the correct vaccine combinations, schedules and timing of vaccines (incl. live vaccines)
- avoid overuse of rapid vaccine schedules unless absolutely necessary
- recommend a booster dose of pertussis to adults with either dTaP or dTaP-Polio, as immunity from both vaccine and natural pertussis infection is relatively short-lived, lasting only 5-10 years. Avoid funded dT as you lose the opportunity to protect your patient from pertussis.
- if your patient had chicken pox, they are carrying the virus that causes shingles so offer them the shingles vaccine
- do ensure they are up to date with their routine non-travel vaccines e.g. pertussis, MMR, hep B, influenza and pneumonia.
- document and document all the routine non-travel vaccines in the ‘yellow book’ first before the travel vaccines
- Hepatitis B can survive outside the body for 7 days on surfaces like eating utensils. Travellers who may need local healthcare are at risk of hepatitis B (also, it is estimated there are ~ 110 000 people in NZ with chronic hepatitis B). It can enter the body through mucous membranes or minor skin cracks.
- hepatitis B can also be spread through close non-sexual contact – infected blood or other body fluids can get into cuts or scratches
- do discuss rabies as any animal scratch or bite will ruin the trip and human rabies immune globulin is not readily available in developing countries ( we advise and manage 2 travellers per month with accidental animal bites)
- provide the correct documentation to your traveller i.e. medication card and NZ MOH ‘yellow book’ – not pharmaceutically branded ‘vaccine passports’
- avoid over prescribing anti-malarials for travel within a country especially doxycycline because it’s ‘”easier to give a script if you are not sure ” !
- a ‘malaria consult’ at a travel clinic costs $35 vs lots of unnecessary and inappropriate pills
- if you are unsure of your patients travel health needs refer your patients to a travel clinic rather than doing your patients a disservice
- Finally: if you are unable to diagnose your patients post trip illnesses: please refer to us ASAP
The Travel Medicine Consultation: Every client who visits our clinic receives a personalized travel risk assessment with our team.
Included in the consultation process is:
- individual risk assessment to determine the traveller’s health risks based on travel itinerary
- previous travel experience and travel medical problems
- evaluation of any underlying health problems (e.g. pregnancy, chronic illness, immunodeficiency)
- location of travel (rural or urban)
- style of travel (e.g. first class, adventure)
- anticipated travel activities (e.g. animal contact, fresh water exposure, sexual contact)
- duration of travel (short or long-term)
- current immunization status
- status of infectious diseases and other health risks at destinations during the proposed time of travel
- risk-reduction strategies, including recommended vaccines and behaviour modification to maintain health
- strategies for the management of illness while travelling, as well as destination care
- provision of routine, recommended and required vaccines
- malaria prophylaxis advice as well as advice on other vector borne diseases
- advice on traveller’s diarrhoea, medical kits, personal water filters, DVT risk assessment, altitude sickness, travel insurance etc.
Costs
We believe we deliver a high quality travel medicine service to your travellers at a reasonable cost. We receive no funding from the government for our staff or consulting travellers.
Travel Products NZ
Our range of travel health products are available to your travellers online . Of particular importance are permethrin for clothing and sleeping bag liners, personal water filters and compression stockings.
Medical Assistance whilst Travelling
We also provide travellers that consult us free access to our ‘online doctor’ service’ 365 days a year. In the event your patients need medical advice whilst travelling , they are able to access us telephonically or online and we will assist them with their medical concerns or refer them to accredited medical providers worldwide.
Post- Travel Clinical Support
We will assist you in the diagnosis and treatment of illnesses contracted during travel. We can liaise with professionals in the field of travel and infectious diseases.
How to refer your travelling patients to us :
- fax us a referral letter on 477 3748
- give your patients our telephone number – 477 3747
- refer them to our website www.travelclinic.co.nz , and they can request an appointment online
- send our doctor an email: doctor@travelclinic.co.nz