Horvath Lynn L, Murray Clinton K, Dooley David P
Department of Clinical Investigation, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
J Travel Med. 2005 Nov-Dec;12(6):332-7. doi: 10.2310/7060.2005.12606.
Even among travelers who undergo evaluation in travel medicine clinics, illnesses develop despite the emphasis placed on prevention. It is possible that travel-associated disease rates may be modified by maximizing access to care and augmenting educational methods of disease prevention. Use of alternative preventive measures such as alcohol hand gel sanitizers may also alter illnesses among travelers.
We assessed medical outcomes in a travel population cared for in the setting of free vaccinations, medications, and travel medicine consultation, in which personal preventive measures were presented in numerous formats by a physician specializing in infectious diseases. An initial demographic questionnaire was administered at the time of travel consultation. A post-travel telephone interview conducted 2 weeks after return from travel evaluated illness while abroad, illness upon return, and adherence to travel recommendations. An assessment was also performed regarding the utility of an alcohol hand gel sanitizer.
One hundred fifty-five travelers were evaluated (primarily older, well-educated US-born travelers, on vacation with family or coworkers). Travelers filled their prescriptions 98% of the time; 77% reported adherence to antimalarial chemoprophylaxis. Sixty-four percent of travelers developed illness abroad, and 20% developed illness upon return. The most frequent complaints were diarrhea and upper respiratory illness. Ten percent of travelers altered their itinerary owing to illness. The use of alcohol hand gel sanitizers did not appear to impact the development of diarrhea or respiratory illnesses.
In this small group of travelers, access to free consultation, vaccinations, and medications along with presentation of personal protective measures in various formats did not seem to influence the development of illnesses among travelers. Although not rigorously analyzed, alcohol hand gel sanitizers did not seem to alter diarrhea or respiratory tract illness rates. These data highlight the need for new or more effective methods to prevent illness among travelers.
即使在前往旅行医学诊所接受评估的旅行者中，尽管十分重视预防，但仍会生病。通过最大限度地提供医疗服务和加强疾病预防教育方法，旅行相关疾病的发病率有可能得到改善。使用酒精洗手液等替代预防措施也可能改变旅行者的患病情况。
我们评估了在提供免费疫苗接种、药物和旅行医学咨询的环境中接受护理的旅行人群的医疗结果，其中由一位传染病专科医生以多种形式介绍了个人预防措施。在旅行咨询时发放了初始人口统计学调查问卷。旅行归来2周后进行的旅行后电话访谈评估了在国外的患病情况、回国后的患病情况以及对旅行建议的遵守情况。还对酒精洗手液的效用进行了评估。
共评估了155名旅行者（主要是年龄较大、受过良好教育的美国出生旅行者，与家人或同事一起度假）。旅行者98%的时间会按处方取药；77%的人报告遵守了抗疟化学预防措施。64%的旅行者在国外患病，20%的人回国后患病。最常见的症状是腹泻和上呼吸道疾病。10%的旅行者因患病改变了行程。使用酒精洗手液似乎并未影响腹泻或呼吸道疾病的发生。
在这一小群旅行者中，获得免费咨询、疫苗接种和药物以及以各种形式介绍个人防护措施似乎并未影响旅行者患病情况。尽管未进行严格分析，但酒精洗手液似乎并未改变腹泻或呼吸道疾病的发病率。这些数据凸显了需要新的或更有效的方法来预防旅行者患病。
