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The number of international travelers surpassed the 1 billion mark
in 2014, an increase of 51 million over 2013.1 Many US residents
who travel internationally do not seek pre-travel health advice,
even when planning trips to developing countries.2 Yet as many
as 64% of people who have traveled to developing countries report
travel-related health problems.
Today, pharmacists in both community and clinic settings are
providing a full or partial range of high quality travel health
services that are well accepted by patients.4-7 In some states, such
as California, pharmacists can provide travel-related prescription
medications and vaccines, and order relevant laboratory tests.8
This issue provides an overview of the healthcare provider’s role
in travel health services and serves as a primer for common travel related
diseases. Table 1 lists practical facts about travel-related
vaccines. The Patient Connection addresses common questions
about travel immunizations and safety measures that help prevent
food-, water-, and insect-borne infections.
Within the specialty of travel medicine, travel health primarily
focuses on pre-travel services. The goal of a pre-travel consultation
is to identify all potential health risks and to educate and
equip travelers to respond to those risks. In addition to addressing
vaccine and non-vaccine preventable diseases, the travel clinic
provider can anticipate the need for treatment of environmental
conditions such as motion sickness, altitude sickness, and jet lag.
(These travel concerns will be explored in a future issue.) Ideally,
the consultation takes place at least 4 to 6 weeks before travel.
The travel health provider must carefully assess the health background
of the traveler including age, immunization history, pregnancy
status, medical conditions, and current
The traveler’s geographic destinations,
planned activities, duration of travel, and
types of accommodations must also be considered.
3,9-11 Based on the information gathered,
advice should be personalized, highlighting the
likely exposures. Appropriate vaccinations and
medications, both prescription (eg, malaria chemoprophylaxis)
and nonprescription, should be
Vaccinations should be discussed in the context of routine, required, and recommended. Routine vaccinations that are part of normal health maintenance (eg, tetanus), should be brought up-to-date. Recommended vaccinations are those that should be obtained based on the potential for vaccine-preventable diseases that might be encountered during travel. Required vaccinations are those necessary for entry into certain countries, such as the yellow fever vaccination for travel to some West African countries (eg, Angola, Rwanda, Republic of Congo).3
The traveler should be informed of destination-specific precautions concerning food, water, insects (eg, mosquitoes), arachnids (eg, ticks, spiders), and the potential for sexually transmitted infections. Providers may need expertise in water disinfection/purification methods and mosquito netting so that travelers can be appropriately educated. A thorough pre-travel consultation also includes information about travel insurance and access to medical care abroad. Patients should be instructed to seek medical attention if they develop any unexplained symptoms after they return; travel-related illness can occur days to months after travel has been completed.9 The interaction between the traveler and healthcare provider should be collaborative, and written information should be provided to supplement the oral advice.3,9-11
Publication Date: 08/23/2015
Expiration Date: 08/23/2018
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based
This program was developed by The Rx Consultant and published by Continuing Education Network, Inc.
The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and
is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased,
balanced information to health care practitioners.
Programs developed by The Rx Consultant are written by health care providers with expertise in the topic
area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure
that every program presents information that is current, accurate, relevant to "real world" health care
providers, and written in an easy reading, "plain English" style.
Jeff Goad, Pharm.D., MPH, FAPhA is Professor and Chair,
Chapman University School of Pharmacy and specializes
in Travel Medicine and Immunizations. Pamela Mausner,
MD, is a Medical Writer/Editor and Healthcare Advocate.
Tracy Farnen, Pharm.D. is an Associate Editor for The Rx Consultant.
Dr. Goad is a speaker for Merck & Co., Inc. and a consultant for Shoreland’s Travax 1®
. Dr. Mausner and Dr. Farnen
report no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or
service that appears in this issue.
This accredited program is targeted to pharmacists and nurses.
Goals & Objectives
At the conclusion of this program, participants will be able to:
- Describe the key components of a travel health consultation and list 4 resources for information and/or training.
- Discuss travel-related diseases and their major routes of transmission. State whether or not they are vaccine preventable.
- Discuss the indications, contraindications, doses, schedules, and side effects of common vaccines and oral medications for prevention of travel-related illnesses.
- List precautions for the prevention of water-, food-, and mosquito-borne infections. Discuss the self-treatment of traveler's diarrhea.
The Rx Consultant is a publication of Continuing Education Network, Inc.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a
provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.
ACPE Universal Activity Number: 0428-0000-15-008-H01-P
Exam & Credit Statement Procedures
Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and
Editorial and Review Board
Chief Editor and CE Administrator
Terry M. Baker, PharmD
Tracy Farnen, PharmD
James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA
Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA
Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA
Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System
Adjunct Clinical Professor
College of Pharmacy
Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Visiting Associate Professor and Lecturer
Samuel Merritt University
Pamela Mausner, MD
Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Senior Editorial Advisor
Gerard Hatheway, PharmD, PhD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD
Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners
Meuleman, RN, C, MS
About the Rx Consultant
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educate patients about drugs and manage drug therapy. The reader is responsible for confirming
the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.
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