Travellers’ Medicine Appointment: what is it and what is it for?

Original photo by Igor Ovsyannykov

Be it for professional, leisure, health or even no apparent reason, the amount of people travelling is ever increasing, the volume of individual travels performed by each person is growing and the spectrum of chosen destinations is expanding as well. All these factors are increasing the awareness regarding the health associated risks correlated with travellers, and the travels performed by them.

By knowing ahead of time that you will have to leave your country, with special consideration to destinations located outside the European Union, as a way to prevent risky and/or embarrassing situations as a traveller you should adopt a series of preventive measures :

  • study the map of the region you are going to or places you are going to be passing by;
  • investigate about the languages most used at the destination;
  • investigate about the local currency and, if required, the exchange rate in place;
  • search pre-travel medical counselling — Travellers’ Medicine Appointment.

Travellers’ Medicine Appointment

The Travellers’ Medicine Appointment is destined to all travellers seeking to depart from their country of residency. Ideally administered by a doctor specialized in infectious diseases and tropical medicine, the appointments can be performed by any physician in the exercise of their competences. They can be carried out at public health centres and hospitals, that are part of the National Health Service (Serviço Nacional de Saúde — SNS), as well as a group of accredited private medical services and clinics, from which CMIL — Clínica Médica Internacional de Lisboa is a part of.

The traveller should always, as a preventive measure, book a pre-travel medical appointment (ideally with one month in advance), as a way to gather informations about the possible medical hazards that can result from the future dislocation. Considering that these risks vary substantially depending on the destined geographic regions, the travellers’ heath condition has to be taken into consideration, namely regarding to: recommended behaviours, the existence of mandatory vaccinations and/or the need to start the intake of specific pre-travel medication. For travellers inserted in high risk groups — pregnant women, children, elderly and people with debilitated health conditions — special attention should be paid to required extra cares.

The appointment consists in the analysis and recommendation of preventive measures to adopt at the pre, during and post-travel. Among these measures are included the administration of mandatory/optional vaccination, the administration of prophylactic medication, as well as the explanation of special concerns regarding food and liquid intakes, or other pertinent aspects considered by the physician. The physician also advises about the medications required/recommended for your travel.

what is it for?

Every Travellers’ Medical Appointment is completely customized and serve as a way to ensure the best possible medical conditions for the traveller. They are essential in a way that they enable:

  • the evaluation of the travellers’ current health condition, with special consideration to cases of travellers included in health associated risk groups (pregnant women, children, elderly, people with chronic diseases and under medication, among others);
  • the gathering of special recommendations regarding the possible preventive measures to adopt at the pre, during and post-travel. Included are the vaccinations, preventive and prophylactic medication, concerns regarding personal hygiene, concerns regarding the ingestion of food and liquids, etc.;
  • the administration of mandatory vaccination required for the future dislocation, as well as the registration of the procedure in the Vaccination Card and the International Certificate of Vaccination;
  • the prescription of mandatory/recommended medicines that may be required to transport during the travel — travellers’ medical kit;
  • the gathering of informations regarding the local sanitary conditions, available medical assistance and security, as well as local relevant existing diseases;
  • the resort to post-travel medical assistance, as well as the diagnose of medical situations eventually contracted during the dislocation. For frequent travellers, or travellers that spend extended seasons in countries or regions associated with higher risks for infectious diseases, these control appointments should be taken periodically.

travellers’ medical kit:

Depending on the destination and route selected, the traveller may be advised by the physician to transport specific medicines. The selection of these rely upon various factors, namely the destination and duration of stay, local sanitary conditions and available medical assistance, most prevalent micro-organisms found in the region, the type of activity that will take place, in addition to the traveller’s present health condition, among others.

The medical kit should include:

  • Customarily taken medication for pre-existing conditions, in safe amounts for the duration of travel;
  • Paracetamol, for fever and minor pain relief;
  • Antimalarial medication, for malaria prophylaxis when justified;
  • Antibiotics, to treat infectious diseases, such as traveller’s diarrhoea;
  • Antiemetic medication, to treat sickness and vomits;
  • Antidiarrhoeal medication, to fight of watery diarrhoea without existing fever (through medical advice);
  • Antihistamine medication and/or topical corticosteroid, with special care for travellers with allergy records;
  • Oral rehydration solutions, as a way to prevent dehydration caused by vomits or diarrhoea;
  • Insect repellent, containing DEET or IR3535 (as proposed by the WHO), to protect against bites from disease carrying mosquitoes (malaria, yellow fever, dengue, encephalitis, etc.);
  • Sun screen, best suited for the traveller’s skin type and the degree of expected solar exposure;
  • Moisturising cream containing zinc, for the reparation of small cutaneous lesions and irritations, such as sun burns;
  • Small items to assist you in treating lesions, among which should be included an antiseptic, thermometer, band aids, sterile packs, bandages, scissors, tweezers and a nail cutter.

For the transportation of medication, the traveller must have some special concerns for personal safety and to maintain the integrity of the medication. Included among these: the traveller must always be accompanied by a list containing all the medication that he is currently taking, as well as a medical prescription containing every medication described with the generic nomenclature and the respective dosage. It may even be necessary to present to the authorities a medical declaration crediting the need of medicines or syringes being transported. The traveller should also adopt personal preventive measures when transporting medicines, such as keeping the drugs in their original cases (thus facilitating problems with the authorities and to enable rapid identification in case of emergency), to carry them preferably in the hand luggage when flying (thus eliminating the loss of cargo luggage), resort to thermal boxes when carrying perishable medication (such as insulin) and, when travelling by car, never place medicines at the glove compartment.

When travelling by plane, in order to transport liquid medication (syrups included) in the hand luggage, the traveller must pay attention to the fact that it is mandatory by law that liquids may only be transported in jars or tubes with a maximum capacity of up to 100ml, with a total of one litre per passenger. These must be conditioned in transparent plastic bags to enable verification by the authorities. If there is a need to transport volumes superior to 100ml, the traveller must be accompanied by both a medical prescription and a medical declaration (preferably written in English or French) exposing the need to do so. These restrictions do not include pills or other solid medication.

By adopting these safety preventive measures, such as the Travellers’ Medical Appointment, and carefully plan the dislocation, the traveller will have the best possible protection against any unpredicted advent that may appear.

Sources:

  • SANTOS, C. (2014), Medicação em Viagem. in CUF
  • www.sns.gov.pt
  • www.hgo.pt
  • www.tempodeviajar.com
  • www.clinicafeminis.com

Author: CMIL