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School of Public Health, Tropical Medicine & Rehabilitation Science

Travel Medicine

Travel Medicine

The DPHTM Travel Medicine Home Page is designed to assist travel medicine practitioners in using the internet to offer a sophisticated travel medicine service. Doctors and physicians interested in travel medicine can use the links in this file to keep ahead of their clients and their less internet literate colleagues.

School of Public Health and Tropical Medicine Staff

Travel Medicine Topics

Sites with Comprehensive Travel Health Data

  1. Australian Travel Health Advisory Group. THAG is a joint initiative between the travel industry and travel medicine professionals that aims to promote healthy travel amongst travellers. THAG membership is drawn predominantly from representatives of the travel industry and travel medicine. These representatives are drawn from both the private and public sectors.
  2. Travel Health Online (TRAVEX) The Travex database has been the industry standard in North America for travel health professionals. Shoreland, the owners of Travex, has now made this database accessible on-line to the Internet user. This is a very comprehensive database of use to both the traveller and the travel health professional.
  3. Centers for Disease Control and Prevention (CDC) CDC has very high quality travel health data. Data is accurate, reliable, and reflects US government policy.
  4. International Society of Travel Medicine (ISTM) site This is a useful site for accessing data for the travel medicine professional. Data is accurate, reliable and up to date. It has links to reliable non-ISTM sources and to travel medicine clinic home pages. The Travex database can be accessed via this site. Although the ISTM is an international organisation, the site reflects ISTM's North American origins. It has a comprehensive listing of travel medicine physicians based in USA.
  5. Australasian College of Tropical Medicine (ACTM) gopher. This contains good quality data of relevance to travel health for the health professional, not just the public. It also has links to good quality sources on travel medicine. The National Health and Medical Research Council recommendations on malaria prophylaxis for Australians can be found here.
  6. Medical Advice Service for Travellers Abroad (MASTA). The MASTA home page is probably of more use for the traveller than the travel medicine practitioner since the data provided free is fairly basic. More comprehensive data has to be purchased from MASTA.
  7. Lonely Planet. This site has some useful travel health related data designed more for the traveller than for their physician.
  8. Outbreak WWW Site This privately operated site, as well as having information on outbreaks, has good quality data on many diseases of concern to travellers.
  9. Medical On Line, travel page This page is of little value at the time of writing since it contains only a short list of links.
  10. International Travel and Health The WHO Yellowbook is now on-line in English, Spanish and Japanese. This very useful publication gives data on hazards and vaccine requirements for international travel and for individual countries.
  11. Yahoo Travel Health. Although a metadirectory and not a primary source of travel related data, the Yahoo Travel Health page does contain useful links.
  12. Travel Health Information Service. This private site has a comprehensive body of original information on various aspects of travel health, some of which are rarely available; e.g., sun exposure and use of scunscreens, high altitute problems, and travel insurance.
  13. High Altitude Health. This site at Princeton has comprehensive information on the health problems of high altitude travel.
  14. Healthy Flying with Diana Fairechild. A site devoted to the problems of flying and how to overcome them. The data provided is possibly not comprehensive enough to be of use to medical practitioners, but it would be useful for the inexperienced air traveller.

Sites with Regional Data

  1. CDC, country data. Good quality comprehensive data with the authority of the world's leading organisation for control of infectious diseases.
  2. Open CDC's global disease map
  3. Travel Health Online, Country Profiles. The US Department of State Consular Advice is included with each country profile.
  4. Pan American Health Organization (PAHO). The PAHO Web site deals with the Americas only, and is designed for the health professional. It has very detailed country and regional data, including excellent overviews of significant diseases.
  5. Staying healthy in Asia, Africa and Latin America. Quite a comprehensive document, but aimed more at the informed traveller than the health professional.
  6. US State Department Travel Advisories. All countries in the world have one or more databases. A very useful site for reports on civil unrest and personal risks to travelling US citizens. The updates issued periodically to the Travel Advisories mailing list are stored here. In addition this site contains useful information on legal topics particularly relevant to US citizens.
  7. Australian Consular Advise. The Australian Government has a site with the official consular advice for Australians. All countries in the world have a file giving details on legal requirements, civil unrest, and risks to Australian citizens. In addition it has a general travel advice section. The advisories seem less comprehensive than those from the US Consul.
  8. CIA World Fact Book. The CIA World Fact Book (yes, it is what it says it is!) contains a wealth of statistics for each country, and summarised information for global regions. There is no specific travel health data per se, but one gets a very comprehensive idea of the nature of the country, its economy, infrastructure, population statistics including crude health indices, and its politics.
  9. US Dept of State Country Background Data. Country data made available by the US State Department.
  10. USAID Country Data. Here one can access data on USAID projects, including health projects. Background briefings particularly for the health projects often provide useful information about country specific problems. Information can also be obtained by query. Information is available only for countries with projects run by USAID. Similar data, but with some differences, is available at the USAID WWW site at http://www.info.usaid.gov/regions. The USAID gopher and WWW pages are closely interlinked.
  11. International Federation of the Red Cross. Both contain press reports and Situation Reports on civil and natural disasters of interest to IFRC. The Situation Reports are more comprehensive than the press reports. Situation reports are now in Acrobat format on the WWW server, but ASCII on the IFRC Gopher.
  12. Internet Disaster Information Center. This site has reports on natural and civil disasters as well as links to other disaster sites. It does not appear to have an inbuilt search engine, but countries are arranged alphabetically.
  13. Country vaccination requirements and Country hazards. These are two useful sections from the WHO Yellowbook, International Travel and Health. Recommendations are the official WHO recommendations.
  14. Human Rights Reports by country. Each country has a comprehensive report which describes the status of human rights in principle and practice in that country. Very comprehensive and interesting data and quite useful for the traveller, particularly those travelling independently.
  15. Data on countries with AusAID projects. AusAID is the Australian Assistance and International Development organisation funded by the Australian Government. This site contains good information on the Pacific and other regions from an Australian perspective.

Sites with Data on Outbreaks

  1. ProMED Mailing List (see Email lists).
  2. ProMED Archives. This site contains all the posting from ProMED in a searchable archive.
  3. Outbreak Page. The Outbreak site is run by David Orstein and volunteers. It has information on major outbreaks from all regions. The target audience appears to be the educated lay person.
  4. WHO Outbreak Page. The WHO has global statistics on diseases, particularly in developing countries, on outbreaks, and WHO official recommendations. It also has the Weekly Epidemiological Record, a publication that reports on global disease trends and events including epidemics.
  5. UK Communicable Disease Surveillance Centre. Weekly report on diseases from the UK Government. Department of Health also has Health of the Nation, a white paper, available on-line at http://www.open.gov.uk/doh/hon.htm#hontop.
  6. Communicable Diseases Intelligence (CDI). This journal focusses on communicable disease in Australia and New Zealand, but does have summaries of disease outbreaks outside Australia.
  7. EuroSurveillance. This is a site that contains the European Communicable Disease Bulletin on behalf of the European Union. The site has a comprehensive overview of vaccination schedules in European countries.
  8. US Consul Travel Advisories. Brief references to major epidemics are occasionally circulated by Travel Advisories.

Travel Medicine Clinics on the Web

There are a number of sites on the WWW that list home pages of travel medicine clinics. Here I have listed only those travel medicine clinics sites that provide original data of interest to travel medicine practitioners.

  1. International Travelers Clinic at Medical College of Wisconsin. The ITC clinic has reliable information on infectious diseases, as well as some unique pages, Travelling While Pregnant, Altitude Sickness, Auto Accidents,and Motion Sickness.
  2. Travel Doctor: Travellers' Medical and Vaccination Centres. A very comprehensive site with accurate and up to date information, and a focus on the needs of Australian travellers. TMVC also send out periodic alerts on risky events in their Travel Health News.
  3. Travel Medicine Alliance. This is the newest of the travel medicine groups in Australia and has a comprehensive site of useful information, including weblinks, for the traveller.
  4. Travel Clinics Australia. This is a moderately large travel clinic group based in Australia (more than 30 clinics). There is some useful information for travellers available. For clinicians, there is a link to the site to purchase the handy reference for travellers: the Traveller's Pocket Medical Guide and International Certificate of Vaccination.
  5. Tropical Medicine Bureau. This Irish site has original data on a range of tropical diseases. It also has a series of email news groups where people can post questions or comments on a range of tropical medicine and travel medicine related topics (e.g., Tropical Travellers' Lounge, Insect Bite Forum, Malaria Forum, and Vaccination Forum). Medical questions posted on these groups are usually answered by a medical practitioner.

Other Data Useful to Travel Health

  1. CDC - Cruise Ship inspections This is a US Government service that provides reports on the conditions of cruise ships servicing US ports. The key document with scores on individual inspections is located at ftp://ftp.cdc.gov/pub/ship_inspections/shipscor.txt and is accessible via the CDC WWW Travel page or directly via ftp.
  2. Electronic Maps at the University of Texas Library. Maps for all countries in the world are available here. Some are based on the CIA Fact Book maps; others are not. In general the electronic maps are useful for the broad overview, but detailed maps are hard to locate, although there are a smattering of city maps here too.

Electronic Journals Relevant to Travel Medicine

  1. NewsShare. NewsShare is the newsletter of the ISTM, and the complete newsletter is available on the Internet. NewsShare can be read on-line in ASCII and downloaded as ASCII, or in Acrobat format.
  2. Journal of Travel Medicine. Starting from 1996 all issues of JTM are on line although only abstracts of selected articles are made available.
  3. Emerging Infectious Diseases. EID is an electronic journal focussing on emerging infectious diseases with 4 issues per year. The compete text is available from the CDC Web pages by ftp in Acrobat format, Postscript or ASCII. Each issue in ASCII can be viewed on-line at the ACTM gopher at gopher://gopher.jcu.edu.au in the path Tropical Medicine Publications / CDC Publications / Emerging Infectious Diseases.
  4. Morbidity Mortality Weekly Report. The MMWR is published weekly by CDC, and often has data of relevance to travel medicine. MMWR is available in Acrobat format from the CDC Web site or in ASCII from gopher://cwis.usc.edu in path Health Sciences / Medical and Health-Related Electronic Periodicals / Morbidity and Mortality Weekly Report. By subscribing to the mailing list lists@list.cdc.gov, or to ProMED, one can receive the table of contents of MMWR as each issue becomes available (see Email Lists below).

    5. This is efficient as it allows busy people to decide whether the current edition is of relevance. MMWR can be searched at the CDC site.

  5. Weekly Epidemiological Record. WER gives a global overview of disease, including outbreaks. It is available only in Acrobat format. By subscribing to the WER-TOC mailing list (see Email Lists below), or to ProMED one can receive the table of contents of each issue of WER as it becomes available.
  6. Communicable Diseases Intelligence. CDI contains data on communicable disease of relevance to Australia and New Zealand, including overseas events. CDI is issued biweekly, and is available as ASCII, or in Acrobat (*.pdf) format. The files are also available by ftp from ftp://ftp.health.gov.au/pub/CDI/. CDI cannot be searched, but a TOC for each issue is available at http://www.gov.au/hfs/pubs/cdi/cdicont.htm.
  7. Communicable Diseases Report CDR contains information on communicable diseases in the UK. CDR is produced weekly, with monthly reviews, and is available only by ftp. Copies of CDR cannot be searched on-line. Accessing the report is fairly tedious because of this limitation.
  8. European Communicable Diseases Bulletin. This is a publication of the European Union and contains information on communicable diseases relevant to the counties of the European Union. It also gives links to the on-line communicable disease bulletins of member countries.
  9. Travel Health News. This newsletter produced by TMVC deals with topics of current interest, with a focus on high risk events in the Pacific and southeast Asia. One can subscribe to Travel Health News at the site and receive notification of new alerts by email.

Email lists relevant to Travel Medicine

  1. TravelMed is a mailing list restricted to members of the ISTM. It is a moderated list which commenced in April 1996, and in June 1996 had about 100 subscribers. The travel medicine focus makes it uniquely valuable to travel medicine practitioners. Listserver: listserv@yorku.ca Listaddress: travelmed@yorku.ca Listowner: ISTM; moderator, Y. Fortin, travelmed-requests@yorku.ca To subscribe: Send email to listserver with text subscribe travelmed your name.
  2. ProMED is the leading mailing list for disseminating and collating information on emerging diseases. particularly outbreaks. This is a moderated mailing list of good quality. It now has over 11,500 subscribers from 110 countries. For travel medicine practitioners ProMED is an excellent way of staying ahead of the clients! Listserver: majordomo@usa.healthnet.org Listaddress: promed@usa.healthnet.org List owner: Program for Monitoring Emerging Diseases; Moderator, Jack Woodall, promed-owner@usa.healthnet.org. To subscribe: Send email message to listserver with text subscribe promed.
  3. Travel-Advisories. This list distributes updates on the USA Consular recommendations for USA citizens. It is particularly useful in monitoring risks from civil unrest and natural disasters. It does provide some basic data on medical problems per se, but this is usually too basic to be of assistance to the travel health practitioner. One cannot send messages to Travel-Advisories. It is a distribution only list, not a discussion list.

    Subscribers to Travel-Advisories receive updates as they occur. The general USA consular information on each country is changed only every couple of years, but emergency updates are issued as needed. These updates deal mainly with civil disturbances particularly as they affect US citizens, but information on natural disasters and epidemics are also issued.

  4. Listserver: travel -advisories-request@stolaf.ed u To subscribe: Send email to listserver with text of subscribe.
  5. Morbidity Mortality Weekly Report, Table of Contents MMWR, TOC is emailed to subscribers once a week. Listserver: lists@list.cdc.gov List owner: CDC, mmwr-questions@list.cdc.gov To subscribe: Email to listserver with text of subscribe mmwr-toc
  6. Weekly Epidemiological Record, Table of Contents WER, TOC is emailed to subscribers when each issue is available on the Web. Listserver: majordomo@who.ch List owner: WHO To subscribe: Send an email to the listserver with the following in the body of message subscribe wer-reh
  7. Outbreak-Announce A distribution list about outbreaks run by volunteers, led by David Orstein. Listserver: listserv@outbreak.org List owner: David Orstein, davido@apocalypse.org To subscribe: Email to listserver with message in body of text subscribe outbreak-announce.

Travel Medicine Organizations

  1. International Society for Travel Medicine
  2. Australasian College of Tropical Medicine - Travel Medicine SIG

How to Use the Internet in a Travel Medicine Practice

  1. Make up a bookmark list that contains the key sites for travel medicine
  2. For each client print out a standard set of documents from the internet for each country on their itinerary:
  3. According to the needs of the client, print out information on immunisations or diseases relevant to their trip. Best sites to obtain these are from Travel Health on Line or from the Centers for Disease Control site.
  4. Use the internet to keep up to date on outbreaks using ProMED and other sources.
  5. Use the DPHTM Travel Medicine Home Page to keep up to date with new sites relevant to travel medicine practice as they come on line.

    Courses in Travel Medicine

    1. Travel Medicine This subject is offered by the Department of Public Health and Tropical Medicine for those wishing to gain theoretical skills in travel medicine. It is taught once a year as an external subject with a four day sandwich block. Students are health professionals, predominantly doctors, working or intending to work as travel health advisors. Travel Medicine is the major subject in the Certificate of Travel Medicine offered by James Cook University.
    2. Medical Student Elective in Tropical and Travel Medicine An elective in travel and tropical medicine is offered to 4th year medical students at the University of Tasmania.

    Please email enquiries about Travel medicine to Peter.Leggat@jcu.edu.au
    and enquiries about Internet resources for travel medicine to Richard.Speare@jcu.edu.au

    PRIMER OF TRAVEL MEDICINE

    The Primer of Travel Medicine aims to give concise, practical information for the general practitioner or health professional who advises or manages people who travel, particularly to more exotic destinations, as well as for those studying travel medicine. It presumes some knowledge of tropical medicine and public health.

    As the name suggests, it applies only the primer or framework upon which to build with further reading and experience. It is also necessary to point out at the outset, that various countries use different guidelines. Some may adopt the World Health Organisation's recommendations, but many choose to modify or expand upon this, or even independently develop their own guidelines.

    The book is divided into 20 chapters concentrating on major areas of travel medicine. In travel medicine, it is important to keep up to date, and it should be appreciated that even textbooks will be dated on publication. Various chapters have been written by different contributors, who have an interest in that area.

    There are standard chapters on vaccination for travel, malaria prophylaxis and prevention, travellers' diarrhoea, HIV/STDs, viral hepatitis and travellers, air travel for people with medical problems, jet lag and surviving air travel, post- travel check-up, environmental health and safety and personal protective measures against disease vectors. There are several innovative chapters including dietary advice for airline travel, working overseas, culture shock, extreme travellers, aeromedical evacuation, dental health and travel, travelling with children, the internet and travel medicine and an Epilogue: Advocacy and Research.

    Primer of Travel Medicine is the culmination of many years of developing course materials for the subject, travel medicine, in conjunction with colleagues at James Cook University of North Queensland and private travel medicine consultants.

    The subject is often taken by students completing the Postgraduate Diploma in Tropical Medicine and Hygiene (DTM&H) or the Masters degree in Public Health and Tropical Medicine (MPH&TM). Hence, students often have a background of training in tropical medicine.

    For those with a special interest in travel medicine, you may wish to obtain further information on joining the International Society of Travel Medicine. The Australasian College of Tropical Medicine also has a Standing Committee on Travel Medicine. Contact details of these organisations are given in Appendix I.

    Hopefully, you will find Primer of Travel Medicine a useful and easy to use general reference textbook in travel medicine.

    Dr Peter A. Leggat (EDITOR)

    The Primer of Travel Medicine is an ACTM Publication:
    ACTM Secretariat
    PO Box 123
    RED HILL QLD 4059
    Tel. (07) 3872 2246. Fax. (07) 3856 4727
    Email. actm@tropmed.org
    Internet. www.tropmed.org