Guidelines for the prevention of travel-associated illness in older adults

Abstract

International travel to the developing world is becoming more common in elderly patients (defined here as individuals greater than 65 years old). When providing pre-travel counseling, providers must appreciate the changing physiology, comorbidities, immunity and pharmacokinetics associated with the aging process to prepare elderly patients for the stressors of international travel. These guidelines present an evidence-based approach to pre-travel counseling, immunization, and pharmacology concerns unique to elderly patients seeking care in a travel clinic setting.

The older traveller

“…The hazard is higher in patients with pre-existing risk factors, e.g. older age, malignancy, obesity, recent surgeries, inherited or acquired thrombophilia, polycythaemia or oestrogen therapy [10,18]. As pointed out by Lee et al [10] patients at the highest risk of venous thromboembolism may benefit from well fitted medical compression stockings and subcutaneous enoxaparin administered before and 1 day after air travel if the journey lasts more than 3 hours.…”

“…Therefore, preventive measures against respiratory infections are particularly important for older adults [11,13]. Another problem is hypobaric hypoxemia induced by high altitude and a poorer ventilatory response to hypoxia compared with younger patients, which may lead to exacerbation of underlying pulmonary diseases [10,19]. Lee et al [10] suggest that for this reason geriatric patients with certain chronic (e.g.…”

“…Another problem is hypobaric hypoxemia induced by high altitude and a poorer ventilatory response to hypoxia compared with younger patients, which may lead to exacerbation of underlying pulmonary diseases [10,19]. Lee et al [10] suggest that for this reason geriatric patients with certain chronic (e.g. chronic obstructive pulmonary disease) or acute (e.g.…”

“…Therefore, elderly people are at an increased risk of negative effects associated with their underlying medical conditions and medications they receive [9]. Concomitantly, physiological changes put older travellers at a much higher risk of travel-associated infections and complications compared with younger patients [10]. For this reason, the effects of aging and physiological changes associated with this process are particularly important while discussing travel-related diseases.…”

“…As international travels have become increasingly available to larger groups of travellers, elderly individuals now represent an increasing proportion of patients with travel-associated diseases [11]. Furthermore, as the number of elderly travellers is constantly growing, there may be an increase in the number of elderly patients who seek pre-travel counselling [10].…”