Use and sources of medical information among departing international travelers to low and middle income countries at Logan International Airport-Boston, MA, 2009

Abstract

e13214th International Congress on Infectious Diseases (ICID) Abstracts was 14 days. Thirty-five percent of international travelers were traveling to low-income countries, 46% to low-middle income, 16% to upper-middle income, and 2% to upper-income countries. The main purposes of travel were vacation/leisure (63%), business (20%), extreme-adventure travel (14%), education/research (11%), visiting friends and relatives (10%), non-medical service work (6%), and providing medical care (4%). Two percent of travelers were attending large gatherings. Ten percent were children less than 18 years of age; 4% were less than 5 years of age; and 6% of travelers were over 65 years of age. Sixty-four percent of travelers listed a medical condition; 70% were on daily medication. Ten percent of travelers reported a pre-existing neurologic or psychiatric condition; 7% reported a pre-existing intestinal condition; 2.5% were immunocompromised; and 0.4% of female travelers were pregnant or breastfeeding. We analyzed vaccine usage for prevention of hepatitis A, yellow fever, and influenza. Eightyone percent of travelers received immunization against hepatitis A; 7% were considered preimmune. Of the 38% of travelers visiting countries that included areas endemic for yellow fever, 67% received yellow fever immunization; 18% were considered pre-immune. Yellow fever vaccine was administered to 407 travelers 60 years of age or older. Forty percent of international travelers received influenza vaccine; 30% were considered pre-immune. Of the 2082 travelers traveling to countries that included areas endemic for malaria, 65% received malaria chemoprophylaxis. Of these, 66% received prescriptions for atovaquone-proguanil, 3.5% received doxycycline, and 14% received mefloquine.Conclusion: These data suggest that international travelers range widely in age and frequently have co-morbid medical conditions that heighten the need for pre-travel advice.

Summary of the Statement on International Travellers Who Intend to Visit Friends and Relatives

“…VFRs and foreign-born travellers are less likely to seek pre-travel health consultation (9,10,11,12), are more likely to seek advice closer to departure (13) and are more likely to decline a recommended vaccine (13). These differences have been associated with VFRs' low perception of personal disease risk (8), but may also reflect language, cultural and/or financial barriers preventing uptake (14,15).…”