I have been a primary care pediatrician in Redmond, WA for 10 years. My pediatric practice recently gave me the luxury of a 3 month sabbatical. Ever since I was a teenager, I have loved to travel. Having a toddler was not going to stop me from fulfilling my dream of traveling the world with my family. My husband was fortunate to get time off from his job also so we took this once in a lifetime opportunity to visit 6 countries in 3 months. We traveled through China, Bali, Singapore, New Zealand, Australia, and the Philippines. I returned from this incredible trip with an even stronger passion for travel but also a new interest in pediatric travel health. I want to help other families be safe and healthy during their travels. I was inspired to start this blog after attending the CISTM14, a travel medicine conference in Quebec. I will be sharing some personal stories as well as helpful pre-travel health information to families with children.
As I currently sit in a room with about a thousand healthcare practitioners from all over the world dedicated to travel health, I keep thinking about all the families that I know who are traveling abroad. Over the last 2 weeks in clinic, I must have met at least 15 families that told me that they were taking trips overseas this summer to places like India, China, Philippines, and South America. I shared their excitement since I absolutely love travelling. Yet, only 1 of these families actually made a pre-travel health appointment to discuss their risks overseas. All of the other parents brought up their summer travels during their child’s well child checks or sick visits. Most of these families were traveling abroad to visit friends and relatives and staying abroad for a month or more. There is so much information that families need to know about how to keep themselves safe and healthy while traveling abroad.
Travel medicine is not just about giving vaccines or prescribing medications although those issues are very important. Parents need to be educated about issues like what to bring in a medication kit, road safety, avoiding bug bites, staying away from wild or stray animals, safe foods and drinks, and how to avoid diseases that they may never even heard about, like schistosomiasis, strongyloides, chikungunya, or zika virus (what is that?). People going back to their home country and staying longer are at a significantly higher risk of getting serious illnesses, like typhoid fever, malaria, or Japanese encephalitis. In fact, people visiting friends and relatives are 8x more likely to get malaria than other tourists. These diseases kill and are preventable! Did you know that 1/3 of travelers get traveler’s diarrhea while abroad? And children are particularly at high risk of getting dehydrated or even hospitalized. That would surely be a trip ruiner!
In addition,motor vehicle accidents and accidental injuries, including drowning, are the leading killers of travelers. Parents need to be extra vigilant with their young children. I remember trying to cross the road in Guilin, China, with my 3 year old. Drivers in cars and motorcycles did not care that I was in the crosswalk with my daughter. Many would honk or just continue to drive towards us while I was frantically running across the road.
So why are most parents bringing their children abroad to visit friends and relatives not seeking pre-travel health advice? Is it because they could not get access to that care? Is it because they refused care? Is it because they are not concerned about the health risks abroad? Do they think they are immune? Studies show that the vast majority are not concerned about the risks abroad. The primary purpose of this blog is to educate parents and healthcare providers that getting pre-travel health advice is good preventive medicine. Many of us buy travel insurance before a major international trip to prevent us from losing money in case unexpected issues or delays arise. However, only a third of people get pre-travel health advice to prevent major illness or even death when visiting developing countries.
For people who do seek pre-travel advice, studies show that most ask their primary care provider first. Now I am proud to say that I work with a fantastic group of pediatricians, who were educated in some of the best medical schools and residency training programs in the country. Travel medicine, however, was rarely taught in my education. Pediatricians need to be more up to date with pediatric travel medicine, especially since most of our patients will not end up going to a specialized travel clinic for various reasons. Not only do most pediatricians not have enough training in this field, but they also do not have enough time during the visit to discuss it. Before reading the CDC’s Yellow Book and attending the ISTM conference, I admit that the pre-travel advice I gave to patients who asked me was limited and very rushed. Many parents ask about travel as a “by the way” question during a visit for a different reason. And even though I encourage parents to make a separate appointment to discuss their trip, many parents tell me that their trip is next week or that they don’t have time to come back. This common scenario has compelled me to start an online pre-travel consultation service for my pediatric practice. When is the ideal time for a pre-travel consult? About 4-6 weeks before your trip. But if your trip was arranged last-minute or you just simply forgot, it’s never too late to get your pre-travel consultation before you leave.
Through this blog, I am excited to combine my love for travel and my passion for child health. I am looking forward to sharing my personal stories and educating my fellow travelers. I will be sharing important health information to families who want to explore other countries with their children and keep them safe and healthy.