Abstract

Background

As the recognition of the discipline of Travel Medicine grows with increased international travel, an examination of both the value of pretravel advice as well as the general practitioner's role in preparation for, care during, and diagnosis and treatment after travel is necessary. This study was conducted to determine the incidence of travel‐related illness in a typical urban population in Scotland and to examine the efficacy of our pretravel clinic related to reduction of illness, preparedness of our patients for travel, and the effects of our travel clinic on the workload generated by the returning ill in our practice.

Methods

In this retrospective study, 1568 patients, presenting within a 1‐year period from 1992–1993 at a medical practice and 100 patients at a travel clinic were studied. Their morbidity rates and, therefore, the effect of the travel clinic on prophylaxis and pretravel advice were determined.

Results

In the practice sample, 42% of travelers became ill while abroad, with 48% of ill travelers returning to consult their family doctor at home. Travelers to Africa and Asia were shown to have the highest rates of illness. Travel clinic attendees were more likely to be traveling to high‐risk destinations, but were better prepared, experiencing a significantly lower rate of illness during travel (22%). Clinic attendees were less likely to consult their doctor on return home, preferring instead to resolve their illness by self‐medication.

Conclusions

The results suggest that travel clinics significantly reduce the morbidity of illness for travelers and that the burden on general practices could be reduced with the pretravel advice and prophylaxis that travel clinics provide.

References

1
Handszuch
H.
Tourist trends and patterns: travel medicine 2. Proceedings of the Second Conference on International Travel Medicine.
May 912, 1991
. Atlanta, Georgia.
2
Cossar
JH.
Traveller's health
.
Practitioner
 
1992
;
236
:
354
361
.
3
Cossar
JH
Reid
D.
Health hazards of international travel
.
World Health Stat Q
 
1989
;
42
:
61
69
.
4
Cossar
JH
Reid
D
Fallon
RJ
, et al.
A cumulative review of studies on travellers, their experience of illness and the implications of these findings
.
J Infect
 
1990
;
21
:
27
42
.
5
McEwan
A
Jackson
MH.
Illness among Scottish holidaymakers who have travelled abroad
.
Communicable Diseases (Scotland) Unit. Weekly Report
 
1987
;
16
:
7
9
.
6
McIntosh
IB
Power
K
Penman
D.
Travel induced illness
.
Scott Med J
 ,
1991
;
4
:
14
15
.
7
Porter
JD.
Travelling hopefully, returning ill
.
Br Med J
 
1992
;
304
:
1323
1324
.
8
Carosi
G.
, The Lombard Study Group on International Travellers. Knowledge, attitudes and practices in international travelers from Lombardy (Italy). Third Conference on International Travel Medicine,
April 2529, 1993
, Paris , France . (Abstract No. 42:47).
9
Gorman
D
Smyth
B.
Travel agents and the health advice given to holidaymakers. Travel Med Int
1992
;
111
115
.
10
Reid
D
Cossar
JH
Ako
TI
Dewar
RD.
Do travel brochures give adequate advice on avoiding illness?
BMJ
 
1986
;
293
:
1472
.
11
Campbell
H.
Imported malaria in the UK: advice given by doctors to British residents
.
J R Coll Gen Pract
 
1987
;
37
:
70
72
.
12
Mott
A
Kinnersley
P.
Over‐prescription of cholera vaccine to travellers by general practitioners
.
BMJ
 
1990
;
300
:
25
26
.
13
Berger
SA
Dan
M.
Combatting health hazards abroad: the work of a travel advisory clinic
.
Travel Med Int
 
1993
;
11.1
:
14
16
.
14
Peppiatt
R.
International travel medicine, (editorial)
.
J R Coll Gen Pract
 
1989
;
39
(
319
):
42
43
.
15
Sloan
DG.
Travel medicine and general practice: a suitable case for audit
BMJ
 
1993
;
307
:
615
617
.
16
Steffan
R.
The epidemiological basis for the practice of travel medicine. Proceedings of the Second Conference on International Travel Medicine, May 912,
1991
:
10
14
Atlanta, Georgia.
17
McIntosh
IB
MacPherson
F.
The impact of travel‐acquired illness on primary care services at home and abroad
.
Scott Med J
 
1992
;
13
:
2
15
.