For those patients who consult with a health care professional regarding their travel plans, a referral to a dedicated travel clinic is an option, particularly for persons traveling to developing countries or where the risk of exposure to serious diseases that are uncommon in North America is significant.

Unfortunately, many patients don’t consult with a health care professional when planning travel. For this reason, ensuring that all patients are up-to-date on routine adult and childhood vaccinations will help protect your patients against common vaccine-preventable disease whenever they travel. Adults should routinely be assessed for the need for measles, mumps, tetanus, diphtheria, hepatitis A, hepatitis B, and influenza vaccines, and children and adolescents should be up-to-date on all recommended vaccines. Children traveling to areas where certain vaccine-preventable diseases are endemic (e.g., measles), may need to receive vaccines at different ages and intervals than those in the routine childhood vaccination schedule. For specific questions about whether and how to vary the routine childhood vaccine schedule for children who are traveling, please contact the Public Health-Seattle & King County immunization section at 206-296-4774.

For those patients who would benefit from the comprehensive services offered by a good travel clinic or consultant, a complete physical exam should be performed prior to referral to detect or monitor any long-term or acute health problems. The travel clinic will then assess the risks specific to the patient’s individual travel plans. A travel assessment visit should be scheduled at least one month prior to travel begins in order to allow adequate time to receive vaccinations that require more than one dose.

What happens during a pre-travel consultation?

• A review of the travel itinerary - Some countries require that people arriving from locations where a particular disease is occurring, provide proof of vaccination. For example, some countries require that people arriving from areas where yellow fever is endemic provide proof of yellow fever vaccination. The itinerary will also be assessed for risks of arthropod–borne diseases, such as malaria, Japanese encephalitis, and Lyme disease, and risks of food or water-borne illnesses.
  
  
• An assessment of risk factors for specific illnesses and injuries - The travel clinic provider will review the type of accommodations that are planned (e.g., 4-star hotel vs. camping or living with local residents), and risks related to meals and drinking water (e.g., hotel dining room vs. street vendor). Travel activities are also considered. For example, do they involve high altitudes, swimming in areas with water-borne bacteria or parasites, or possible exposure to rabid domestic or wild animals?
• A review of medical history and plans for medical and emergency care - Travelers requiring medication for existing conditions or possible emergency care while traveling can learn from travel clinic staff how to access medical care in various locations.
  
  
• Vaccine Requirements and Recommendations - Travel consultants help travelers determine whether they need to update routine immunizations (e.g., Td, MMR), and which travel-specific vaccines or medications (e.g. malaria chemo-prophylaxis) they may need for their trip.

There are several travel clinics located throughout King County as well as expert travel consultants in private practice. Ask your usual source of healthcare for more information. Public Health Travel Clinics can be found at: www.metrokc.gov/health/immunization/travelclinics.htm, or by calling the communicable disease hotline at 206-296-4949. Extensive international travel related information can be found at: www.cdc.gov/travel.