- International travel for tourism or family visits by immigrants to
their native country is rampant these days
- Travel to certain regions such as Africa and Asia is associated
with a higher risk of infection and morbidity, especially in children who
form a vulnerable group.
- Pharmacists can play a crucial role in giving travel related advice
that is specific to the region and based on the risk profile of children.
are qualified professionals whose
knowledge and services are under-utilized
currently. Their knowledge about
common drugs and vaccines can be utilized to obtain
travel related advice, drugs for common illnesses and precautions to take
before travel. This can help to potentially
reduce the risk of infections and illnesses in children
particularly susceptible to the risks associated with travel. A recent research
highlighting this important but often overlooked aspect has appeared in the
April edition of the Pharmacist
‘Pharmacists’ knowledge of drugs and vaccines make them ideal and accessible health professionals to seek travel specific advice, and to ensure a smooth and illness free holiday.’
Travel Boom In The Modern Age
- Global travel has become very common
these days be it for tourism purposes, business reasons or immigrants wanting to travel
to their native country.
- The world has shrunk because of excellent connectivity
between various international destinations and a booming hospitality industry.
- The average spending capacity of
persons has also increased and more families plan holidays abroad.
- Many immigrant families and their
kids travel to their home country to visit friends and relatives (VFR).
- To give an idea about the huge
overseas travel in the present day, more than 70 million Americans
traveled abroad in 2015 and nearly 2 million were children.
Why do Children Form A Vulnerable
Though international travel can affect
adults and children alike, kids form an especially vulnerable group during such
long trips for various reasons.
- Children are
naturally liable to contract infections easily due to their weak immune system.
- Infants and young children often put their hands and objects into their
mouth increasing the risk of transmission.
- Unlike grown-ups, children
are not able to communicate
what is troubling them and more likely to fall sick.
traveling to their native country often
do not take precautions by virtue of having grown there, consequently
exposing their kids to risk.
Role of the Pharmacist In Travel Health
Most people embarking on a holiday or
trip abroad do not consult a physician for travel related advice. However it
is important to consult a qualified and
knowledgeable health professional when traveling to certain regions
world known to have high prevalence of certain diseases and of course to take
precautions against diarrheal illnesses which can strike without warning.
This is where pharmacists, with their knowledge about drugs and vaccines, can play an important role in advising
about travel health
A visit to the nearest pharmacy will help
gain information about region specific
disease, whether vaccines are available, medications to carry, and
over the counter drugs
available for common ailments
. Depending on the
local regulations, pharmacists can prescribe certain drugs and antibiotics.
them to consult
the physician for vaccines or may be able to provide the vaccines in some cases.
As in the case of any consultation, a fee may be applicable.
Common Illnesses Encountered During
There are several diseases that could occur during long trips. This discussion will be about diarrhea and fevers, the two most frequently encountered
conditions during travel, and ways to prevent and treat them.
Precautions to take
Traveler's diarrhea is caused by agents such as norovirus, rotavirus, Giardia, enterotoxigenic E coli
Asia, Africa, Mexico, the Middle East, and Central and South America
• Adult supervision of what children eat
• Avoid street food
• Eat well cooked food; avoid raw food
• Avoid iced drinks
• Avoid drinking tap water; drink boiled water
• Use clean boiled water to reconstitute baby food and formula
• Using an alcohol based sanitizer to clean hands regularly will reduce transmission risk
• Oral rehydration therapy (ORT) available at all medical shops prevents dehydration and saves lives
• Anti-diarrheal and drugs for vomiting usually not recommended in children
• Antibiotics if approved by a physician
Mosquito borne illness caused by a protozoan parasite Plasmodium spp
Africa; parts of Asia and South America
Chemoprophylaxis of malaria based on region, age of child, ease of dosing and side-effect profile
Protection against mosquito bites, for eg. mosquito nets, clothes to cover arms and legs, and use of repellents with DEET (diethyltoluamide)
May vary depend on age of patient, health condition and region of travel
Mosquito borne illness caused by a Flavivirus
Tropical and subtropical regions
A vaccine, Dengvaxia (CYD-TDV), has been approved for use in patients aged 9 to 45 years in areas with high prevalence
Protection against mosquito bites
No specific treatment. Early diagnosis and symptomatic treatment
Typhoid and paratyphoid infections are bacterial infections caused by
Salmonella enterica subsp. enterica, serotype Typhi, and serotype Paratyphi
Safety precautions while consuming food and water as mentioned
Strict hand hygiene
Typhoid vaccine is available; no vaccine for paratyphoid
Azithromycin, ciprofloxacin, and ceftriaxone advised based on region and resistance.
Fluoroquinolones contraindicated in children in some countries; however WHO guidelines recommends its use if benefits outweigh the risks where suitable alternatives may not be available
In conclusion, pharmacists can potentially bridge the gap between doctors and the public in providing guidance for optimal travel health and referring the public to a specialist where
- Malini Ghoshal, Sanjat Kanjilal, Travel-Related
Infection in Children: Pretravel Counseling to Reduce Morbidity. (2017) US