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.

We found the median duration of travel for business travelers was 10 days, which was similar to US Department of Commerce Office of Trade and Tourism's finding of 8 days. 2 Other occupational travelers with shorter durations of stay included those providing medical care (10 days) and missionaries (11 days) . Both leisure travelers and VFRs had significantly longer stays of 14 and 30 days, respectively. All travelers, but especially short-term travelers, may not fully recognize the illness and injury risks associated with international travel. 4, 16 Business travelers often do not consider unexpected risks, such as those associated with unanticipated medical treatment or casual sexual activity. 19 In addition, business travelers often travel multiple times a year. 2 We did not collect information on the number of trips taken each year by the travelers; however, each trip can contribute to the risk of a travel-related illness. Clinicians seeing travelers should consider this cumulative risk assessment when advising business travelers and consider interventions, such as vaccinations, an investment for future trips. 7 The pre-travel health consultations described here increased the vaccination coverage for all of the vaccines and provided malaria prescriptions for most travelers, although several gaps still remain. Of particular interest, many business (49%), leisure (44%), and VFR (61%) travelers declined influenza vaccine. Despite high morbidity and mortality rates associated with influenza, a significant proportion of the US population chooses not to get vaccinated against the disease. 20 According to CDC estimates, only 42.8% of all people older than 2 years, and 48.4% of people with high-risk indications between the ages of 18 and 64 years were vaccinated against influenza in the 2010 to 2011 season. 21 A GeoSentinel analysis of returned ill travelers found that business travel was associated with influenza. 22 Further, a study of Swiss business travelers found that only 27% had their annual influenza vaccination. 23 In addition to reducing the risk of decreased productivity due to illness, increasing influenza vaccination coverage in travelers can prevent the translocation of disease back to coworkers in the United States. It is beneficial for employers to emphasize the importance of vaccination, especially influenza vaccine.