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Authors

  1. Saathoff, Angela D. DNP

Article Content

OVER 50% OF ALL travelers become ill while traveling abroad, with 8% requiring medical attention during or after a trip.1 Retail (or walk-in) clinics, located in pharmacies, grocery stores, and "big box" department stores, offer services for people anticipating travel out of the country, such as travel consultations and recommended vaccinations. Retail clinics are staffed by NPs or physician assistants and accept most major insurance plans. This article highlights common travel health services provided by many retail clinics.

 

Travelers' health needs

Retail clinics are an ideal option for travel-related healthcare. The availability of walk-in appointments is convenient for patients, and many clinics carry hard-to-find polio, typhoid, and hepatitis vaccines. Primary care providers often send their patients to a retail clinic for a travel health consultation or to receive necessary vaccinations.

 

The CDC advises travelers to visit a healthcare provider 4 to 6 weeks before an international trip to receive recommended vaccinations and to make any other preparations necessary to safeguard their health.2 Services are individualized to each traveler's needs, taking into account health history, current medications, and travel destination.

 

During a routine travel health visit at a retail clinic, providers will consult the CDC Health Information for International Travel (commonly called the Yellow Book), which serves as a reference for healthcare professionals when giving destination-specific health advice and pretravel vaccine recommendations.3 A typical travel health visit includes a thorough assessment of the traveler's health history, a physical assessment, and an inquiry into his or her destination, length of travel, and activities planned. If a traveler is visiting one of the 106 countries with areas where people are at risk for malaria transmission, for example, the provider evaluates antimalarial drug resistance in the region and chooses the best drug for the patient, considering cost, risk of pregnancy, and potential adverse reactions.3 If typhoid fever prophylaxis is necessary, many retail travel health clinics stock the Vi capsular polysaccharide vaccine and can prescribe and administer it onsite.

 

Risk reduction strategies

Providers at retail clinics also discuss tips for eating and drinking safely while traveling abroad. Food can be problematic anywhere, and it's advisable to avoid eating any raw or cooked food served at room temperature. Drinking water may contain pathogens that are foreign to a traveler's immune system, so the traveler should also be advised to drink only out of sealed bottles or cans, and to avoid ice.4 (For information on mobile apps that can help travelers stay healthy, see Resources for tech-savvy travelers.)

 

Travelers to tropical regions can reduce the risk of contracting malaria, Chikungunya, and Zika virus infections, and other vector-borne diseases by covering exposed skin with permethrin-treated clothing and sleeping in screened rooms or using bed netting. They need to understand that using the right insect repellent is essential. DEET is the gold standard; no other repellent is known to have broader coverage on arthropods.5 However, using DEET in high concentrations has been associated with rashes, dyspnea, headaches, and in rare cases, seizures.6 Other effective active ingredients in mosquito-protective products include picaridin, oil of lemon, eucalyptus, and IR3535.7

 

Although retail clinics don't sell travel insurance, staff should inform patients that their health insurance may not cover illnesses while traveling and advise them to call their insurance carrier for detailed information on their plan and what it covers before traveling. They may want to consider purchasing a supplemental commercial travel insurance policy that covers medical care and evacuation or transport home for the duration of the trip when traveling outside of the country. Traditional health insurance policies generally don't provide this type of coverage.

 

Convenient and reliable

Wherever one may roam, the answer to travel health needs may be as close as a local retail clinic. Available in most urban and suburban areas, these clinics can provide easy access to fast and reliable healthcare for those planning to travel abroad.

 

Resources for tech-savvy travelers8

The CDC has three travel apps to assist the globetrotter with health-related questions. Visit http://wwwnc.cdc.gov/travel/page/apps-about to download any of these apps for free.

 

* TravWell: Provides destination-specific vaccine recommendations, checklists, and a customizable healthy travel packing list. It also has an area to record immunizations and set a reminder for boosters.

 

* Can I Eat This?: Allows travelers to answer a few questions about a desired meal, snack, or drink and lets them know if it's safe for consumption.

 

* Yellow Book: Primarily designed for healthcare professionals and updated every 2 years, this app provides the same information available on the website and the printed Yellow Book, with pretravel vaccination and preventive care guidelines.

 

 

REFERENCES

 

1. Leder K, Torresi J, Brownstein JS, et al Travel-associated illness trends and clusters, 2000-2010. Emerg Infect Dis. 2013;19(7):1049-1073. [Context Link]

 

2. Centers for Disease Control and Prevention. See a doctor before you travel. 2011. wwwnc.cdc.gov/travel/page/see-doctor. [Context Link]

 

3. Centers for Disease Control and Prevention. Explore travel health with the CDC Yellow Book. wwwnc.cdc.gov/travel/page/yellowbook-home. [Context Link]

 

4. Centers for Disease Control and Prevention. Food and water safety. 2018. wwwnc.cdc.gov/travel/page/food-water-safety. [Context Link]

 

5. Breisch NL. Prevention of arthropod and insect bites: repellents and other measures. UpToDate.com. 2017. http://www.uptodate.com. [Context Link]

 

6. Yung A. Manual of Travel Medicine. Melbourne, Australia: IP Communications; 2014. [Context Link]

 

7. Centers for Disease Control and Prevention. Malaria. 2017. wwwnc.cdc.gov/travel/diseases/malaria. [Context Link]

 

8. Centers for Disease Control and Prevention. Mobile apps. 2017. wwwnc.cdc.gov/travel/page/apps-about. [Context Link]