TM

Travel Health Issuesfor Globetrotting Students

Amanda Whatley, MPH, CHES

Division of Global Migration and QuarantineCenters for Disease Control and Prevention

Background Information

People on the Move

Number of U.S. Residents Traveling Abroad (2000-2007)*

05

1015

2025

3035

4045

2000

2001

2002

2003

2004

2005

2006

2007

Num

ber o

f Tra

vele

rs (m

illio

ns)

Europe All Other Destinations

*ITA, includes air travel to Canada and Mexico (not land border *ITA, includes air travel to Canada and Mexico (not land border crossings)crossings)

Percentage of U.S. Students Abroad by Region

0% 20% 40% 60% 80% 100%

2006/07

2005/06

2004/05

2003/04

2002/03

2001/02

2000/01

1999/00

1998/99

1997/98

1996/97

Percentage of Students Abroad

Europe

Latin America

Asia

Oceania

Africa

Middle East

North America

MultipleDestinations

Source: Open Doors

84,403

241,791

Source: Open Doors (Institute of International Education)

IndiaCosta RicaNew ZealandIrelandAustriaGermanyEcuadorMexicoChileAustraliaCzech RepublicChinaSouth AfricaFranceGreeceSpainArgentinaItalyJapanUnited Kingdom

Leading Destinations of U.S. Study-Abroad Students, 2006/07

Travel Health Basics

Travel Health RisksTypes of risk

Infectious diseasesInjuries and safetyManaging current health issues away from home

Risk varies according to different—DestinationsLength of travelPlanned activitiesAge of travelersMedical historyVaccination history

Important Infectious Disease RisksDiarrhea InfluenzaHepatitis AHepatitis B Meningococcal MeningitisMeaslesMumpsRubellaTetanusVaricellaTyphoidPolio

TuberculosisTick-borne EncephalitisMalariaYellow FeverDengue FeverChikungunya FeverJapanese EncephalitisLeishmaniasisSchistosomiasisLeptospirosisRabiesAND MORE . . .

Travel

Distribution of Hepatitis A

Distribution of Hepatitis B

Travelers’ Diarrhea

Motor Vehicle

Drowning

Air Crash

Homicide/Suicide

Poisoning

Other

Injury Deaths and International Travel

N = 601

Hargarten S et al, Ann Emerg Med, 1991. 20:622-626

Healthy and SafeStudent Travel in Europe

Pre-Travel Preparation PerspectiveUnited States

Study Abroad Program Location

Within-country travel

European regional travel

More exotic destinations closer to Europe than the U.S.

Importance of Seeing aHealth-care Provider

CDC recommends most travelers see a provider 4-6 weeks before their trip

General health careChronic health issues (e.g., asthma, diabetes)Dental check-up

Pre-travel careOnly a provider will be able to give

VaccinesMedicinesCounseling and advice

Travel Medical InsuranceCoverage of medical services abroad

Consider supplemental medical insurance

Institutional packages for travel insurance

Coordinate the requirementsCollege/University policiesSpecial policies for the studyabroad programCountry policies

Vaccinations for Student Travelers

1. Routine vaccines

2. Recommended vaccines for travel

3. Required vaccines for travel

Routine & Recommended VaccinesRoutine

Measles – Mumps – Rubella (MMR)Diphtheria – Tetanus – PertussisVaricellaPneumococcusMeningococcalHumanpapillomavirus (HPV)

Others often recommendedInfluenzaHepatitis AHepatitis B

Required Vaccines for TravelRequirements by country governments

Yellow FeverMeningococcal

No vaccine requirements by countriesin EuropeOther types of requirements?

College/University requirementsStudy abroad program requirements

Travel Health KitCopy of medical records and prescriptions for medications and/or corrective lensesPrescription medicationsOver-the-counter medicines and supplies

Band-Aids, gauze bandages, Ace wraps Fever and pain reducersDecongestant, antihistamine, cold/cough medicinesAntibiotic, antifungal, hydrocortisone creams Upset stomach/diarrhea medicineInsect repellant, sunscreenTweezers, scissors, thermometer

Basic Healthy BehaviorsHandwashing!Food and drinks

Avoid unpasteurized dairy productsUse safe food preparation techniques

Protection against ticks and other insect bites

Use insect repellent and treat clothesInspect for ticks

Sun protectionBe careful around animals and birds

If bitten or scratched, seek medical care

Other Basic Health Concerns

General SafetySeatbelts and helmetsTake extra precautions on the roadsLocal laws and customsLocal crime risksPolitical movements and protests

Alcohol and drug abuse

Activity-Related Health ConcernsWater recreation

Drowning, boating, & diving accidents

Extreme heat and colddehydration, heat strokehypothermia, frostbite

Altitude

STD and Bloodborne DiseasesDiseases of Concern

STDs Hepatitis BHepatitis CHIV

Think before you act!Unprotected sexual activityCommercial sex workersTattooing and body piercing

Health care and blood product standards for some locations

Auto accidents or other major injuriesDental and surgical procedures

Medical Care AbroadMedical care

Everyday illnessesUrgent careCounseling servicesPre-travel care for excursions

Investigate sources of medical careAssistance from U.S. Department of State consular officesInstitutional arrangements (possibly joined with the travel medical insurance)

Communicate options with students

CDC Resources

You’re not stranded!

CDC Health Information for International Travel 2010

Travelers’ Health Websitewww.cdc.gov/travel

Travel Notices & Announcements

Situation informationAdvice for travelersLevels:

In the NewsOutbreak NoticeTravel PrecautionTravel Warning

Study Abroad Information

Your Survival Guide to Safe and Healthy Travel

Incorporating New TechnologyCommunicating News

RSS FeedsGovDelivery

Social MediaPodcastsE-cards

New Ventures to ComeCDC TV and CDC’s YouTube channelWidgets, Twitter, Blogging

Other Travel Health ResourcesUS Department of State

travel.state.govWorld Health Organization

www.who.int/intInternational Travel and Health (Green Book)

International Society of Travel Medicinewww.istm.org

National Travel Health Network and Centre (NaTHNaC) – U.K.Subscription services

Collaboration with CDC

How can we help you?Communication with youCommunication with students

What are the emerging health issues that you observe?

Areas of possible researchSpecific topics or needs

Thank You!

TM