Pre-Travel Medical Preparation of Business and Occupational Travelers: An Analysis of the Global TravEpiNet Consortium, 2009 to 2012

Khan, Nomana M.; Jentes, Emily S.; Brown, Clive; Han, Pauline; Rao, Sowmya R.; Kozarsky, Phyllis; Hagmann, Stefan H.F.; LaRocque, Regina C.; Ryan, Edward T.

In our analysis, more than half of the business travelers were referred to the clinics by their employers. Although we were unable to elucidate whether travelers in our data set have employersponsored insurance or the employer was paying directly for the appointment and/or medications and vaccines, employers played a role in directing the travelers to the clinics. It is the traveler's responsibility to obtain pre-travel health advice, but employers also have a responsibility to ensure the well-being of their employees during and after business-related travel. This employer responsibility is not only to the travelers themselves, but also to employees who remain behind in the United States. Infections and injuries in business travelers not only negatively affect the travelers themselves but also have negative consequences for the business. Illness may disrupt business activities during or after travel, cause loss of time and productivity, and increase medical costs. 24 One study found higher rates of medical claims for almost all diseases categories after international travel by business travelers compared with their non-traveling colleagues; many claims were related to infectious diseases. 25 History has shown that diseases such as SARS, hepatitis A, measles, and tuberculosis have all been transmitted by individuals traveling for business and other occupational travelers [26] [27] [28] [29] [30] ; and infections such as these may be transmitted to non-traveling employees or the traveler's community. It should be noted that occupational travelers and especially business travelers are more likely to visit Asia than VFRs or leisure travelers so the groups have different destination patterns and infectious disease risks. Although employers may shoulder the costs of the pre-travel health consultations, the costs of ill employees may be higher. 31 To prevent illness in travelers and the translocation of disease to employees in the United States, employers can increase the proportion of travelers seeking timely pre-travel care by developing corporate health strategies, providing travel-related health education to improve risk perceptions, planning trips ahead of time when possible, and allowing time for health consultations for travelers with short time to departures.