The objective of Dr. Eliana Cortés is to provide all the health information, vaccines and prophylactic measures to those who are going to travel to areas with some health risk
Juaneda Hospitals has launched the first Traveler Consultation, which attends in the Hospital Juaneda Miramar la Dra. Eliana Cortésa medical specialist in Internal Medicine, whose objective is to provide all health information, vaccines and prophylactic measures to those who are going to travel to areas with some health risk.
«For many trips, preventive vaccines are required —explains Dr. Cortés— which could only be administered from the public health service or in international vaccination centers or in specialized vaccine centers for the traveler. In addition, it is not just about giving vaccines: in all cases you have to evaluate risks.
The tips and precautions that each traveler should take into account “They depend on your state of health, your comorbidities, where you are traveling, the type of trip (backpacking or luxury) and depending on all this, you will require some prevention or another,” adds the internist, and stresses that “it is very important individualize what the patient needs for their trip”.
The areas with the most health precautions are “all areas of the tropics, for example, India, Southeast Asian countries such as Thailand, Laos, Cambodia, Vietnam, all of sub-Saharan Africa, as would be the case with many people who go to do safaris to Kenya, Tanzania, Namibia… and Latin America, from southern Mexico to northern Argentina.” Special prevention must also be taken when traveling “to parts of the world in specific contexts, such as natural disasters or wars, where outbreaks of previously undetected infections or highly focused epidemics, such as cholera, can occur.” from among the infections that the traveler should prevent Malaria, typhoid fever, hepatitis B, hepatitis A, meningococcal meningitis, tetanus, rabies, and yellow fever are found.
Malaria stands out for its potential for mortality. “Vaccines are being investigated, the only one that exists is only suitable for children in regions with high transmission, we hope that in a short time we will have one for traveling adults”, explains Dr. Cortés and warns that “although it is not frequent, there is a risk of death of the patient if not treated in time. Therefore, when traveling to areas where there is malaria “a risk assessment of each patient will be required and prophylaxis with medication for those who travel to the geographical areas with the highest incidence.” Malaria can be serious, especially if it is due to Plasmodium falciparum, a parasitic microorganism, transmitted by Anopheles mosquitoes.
In these cases, prophylaxis consists of a medication that the traveler must take a few days before traveling to risk areas and a few days after returning, depending on the regimen that will be adapted to each person after knowing their medical history. In addition, the use of repellents and the use of mosquito nets is recommended. Who should be more careful when traveling to areas at risk of Tropical diseases They are patients with chronic diseases, immunocompromised, pregnant women, children, and naturally, those aged 65 and over. All these patients will receive specific instructions when they come to the Juaneda Hospitales Traveler’s Clinic.
To all people who come to the Traveler’s Consultation, Dr. Cortés will take a medical history to find out about possible comorbidities and frailties that could increase the risk of complications in the event of being affected by malaria or another disease, even if the user himself does not state that he knows, in principle, that he has risk factors. “You have to see -explains Dr. Cortes- the vaccination history of each traveler, the serologies, perhaps updating the vaccination calendar according to their age and verify that they are immunized against infections that must be taken care of, not only if they are you are not going on a trip, but in your usual environment and that the patient probably does not know that it is out of date. It could be the case of the pneumococcal, tetanus-diphtheria and flu vaccines.
Among the preventable diseases, after malaria, it is necessary to also pay attention to traveler’s diarrhea (caused by different bacteria or parasites), as well as other pathologies, such as typhoid fever, hepatitis A and E, which are called “diseases transmitted by water and food”. “There are several profiles of travelers,” highlights the internist: “Those at high risk such as aid workers, missionaries, adventure tourists in a wild rural environment and hunting tourists, who will require specific vaccinations.” On the other hand, there are “lower-risk travelers such as business travelers or those who go to good hotels with little contact with the area.”
“Meningococcal meningitis is another preventable disease,” explains Dr. Cortés, “so it may be advisable for certain travelers to schedule vaccination, and for those who intend to travel to Saudi Arabia during the time of pilgrimage to Mecca, it must be mandatory” . For yellow fever, it is not possible to offer a vaccination from a private center. The yellow fever vaccine is the the only one regulated under the international sanitary regulation and therefore it is only accessible through the international vaccination centers of the Ministry of Health. Some countries may request compulsory vaccination for entry. These requirements may change at any time.
“It is important that travelers verify their need by consulting the relevant consulate or embassy or consulting the updated data on the WHO website on international travel and health,” adds Dr. Eliana Cortés, specialist in Internal Medicine and head of the new Juaneda Hospitales Traveler Consultation. It is recommended that the appointment for this consultation be done one to two months before the trip. The vaccines do not have an immediate effect, they take approximately two weeks for the start of protection, from the first dose and in some cases it requires regimens of 2 to 3 doses. In any case, “the Traveler’s Consultation is not only for vaccines”
This new service “is also an advisory consultation, where we will give advice and recommendations on aspects such as food and water management to avoid infections transmitted by this route. Also, for the management of traveler’s diarrhea, help prepare the travel kit (with the prescriptions for medications that are required), precautions to avoid problems with environmental risks, such as heat stroke or altitude sickness, to avoid mosquito bites or discuss risks such as STDs or HIV”, concludes Dr. Cortés.
