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Government of Canada

Statement from the PHAC (Public Health Agency of Canada)

"When travelling outside of Canada, you may be at risk for a number of vaccine preventable illnesses.  You should consult a Health Care Provider or visit a Travel Health Specialist preferably 6 weeks before you travel.  You may need additional vaccines depending on your age, planned travel activities and local conditions.  Preventing disease through vaccination is a lifelong process."

TRAVEL HEALTH SPECIALIST (THS)

Travel Health Specialists have in-depth knowledge of immunizations, risks associated with specific destinations, and the implications of travelling with underlying conditions. Therefore, a comprehensive consultation with a Travel Health Specialist is indicated for ALL travellers and is particularly important for those with complicated health history, special risks (such as travelling at HIGH ALTITUDES, or working in REFUGE CAMPS), or Exotic and Complicated Itineraries.

Table 2-03. Major topics for discussion during pretravel consultations

Immunizations
  • Review routine immunizations and those travel immunizations indicated for the specific itinerary and based on the traveler's medical history.
  • Discuss utility of titers when records are unavailable or unreliable, particularly for measles, mumps, rubella, hepatitis A, and varicella.
  • Screen for chronic hepatitis B for people born in countries with HBsAg prevalence ≥2%.
  • Discuss indications for, effectiveness of, and adverse reactions to immunizations.
Malaria chemoprophylaxis
  • Determine if there is a risk of malaria.
  • Discuss personal protective measures.
  • Discuss risks and benefits of chemoprophylaxis and recommended choices of chemoprophylaxis for the itinerary.
Other vectorborne diseases
  • Define risk of disease in specific itinerary and insect precautions needed.
Respiratory illnesses
  • Discuss areas of particular concern (such as avian influenza in Asia or MERS in the Arabian Peninsula).
  • Consider influenza treatment for high-risk travelers.
Travelers’ diarrhea
  • Recommend strategies to decrease risk of diarrhea.
  • Discuss antibiotics for self-treatment, adjunct medications such as loperamide, and staying hydrated.
Altitude illness
  • Determine if the itinerary puts the traveler at risk of altitude illness.
  • Discuss preventive measures such as gradual ascent, adequate hydration, and medications to prevent and treat.
Other environmental hazards
  • Caution travelers to avoid contact with animals to reduce the potential for bites and scratches that can transmit rabies.
  • Advise travelers to avoid walking barefoot to avoid certain parasitic infections.
  • Advise travelers to avoid wading or swimming in freshwater where there is risk for schistosomiasis or leptospirosis.
  • Remind travelers to apply sunscreen to skin exposed to the sun.
Personal safety
  • Discuss precautions travelers can take to minimize risks, such as traffic accidents, alcohol excess, personal assault, robbery, or drowning.
  • Provide information on travel health and medical evacuation insurance.
  • Advise travelers to look for security bulletins related to their destination and consider areas to avoid.
Bloodborne pathogens
  • Inform travelers who will provide health care overseas what to do in case of needlestick or bloodborne pathogen exposure.
  • Discuss use of postexposure prophylaxis for HIV.
  • Sexual health recommendations for travelers.
Disease-specific counseling
  • Remind travelers to keep medications and supplies in carry-on luggage.
  • Advise travelers to prepare for exacerbations or complications from underlying disease.

Abbreviation: HBsAg, hepatitis B surface antigen; MERS, Middle East respiratory syndrome.