In June I’m going on a mission trip to Nicaragua. About 40 of us from school will be visiting orphanages and building houses. We will be in a really rural area with malaria and all sorts of things,” says Jamantha Karlin, a sophomore at the Uptown Academy of the Sacred Heart.
Community service is a basic tenet at many high schools. At Sacred Heart, each junior must devote 50 hours to a service program benefiting those in need.
Whether a flight from the Louis Armstrong Airport will whisk you to a mission in Nicaragua or to safari in Africa, a good embarkation site is a clinic specializing in travel medicine. As travel becomes more exotic, health planning becomes more complex. Immunizations are just one part of good planning. A trip to a rural mission in Nicaragua calls for more advanced planning than a one-week fling in South Africa encased in a four-star Cape Town hotel.
Karlin’s mother is a nurse who understands the importance of advanced planning. She made an appointment for her daughter at a local travel clinic more than six months before her trip. A good travel clinic starts with a microscopic examination of the itinerary. It is essential to know where in a specific country a traveler will go and what they plan to do.
“We live in a global world. More and more folks are booking adventure vacations and companies are sending more employees overseas for all sorts of work from short meetings to longterm tours of duty,” says Michele Eichhorn, RN, who opened the first Passport Health franchise in Louisiana after Hurricane Katrina. Passport Health, the largest provider of international travel health services in the U.S., operates over 140 one-stop travel clinics across from Sixth Avenue in New York City to 3220 North Turnbull Drive in Metairie.
Travel education from a Passport Health office centers around your specific itinerary, medical history and season of travel. Typical topics of importance are food and water precautions, tips to reduce mosquito exposure, altitude concerns, road safety and even potential hotspots of political unrest. “Shots are important but other precautions are just as important. Gastrointestinal upsets are the most common illness of travelers, and most are acquired from eating uncooked salads. At Passport Health we don’t just vaccinate, we educate,” says Eichhorn.
Besides mission workers and vacationers, Eichhorn counsels employees for several companies that send their workers abroad. A typical example was a petroleum company worker going to Equatorial Guinea last January. Endemic health risks are drug-resistant malaria, yellow fever and meningococcal meningitis along with all the other diseases of mankind from hepatitis A to typhoid fever. He left Eichhorn’s office also armed with a 44-page individualized bound booklet addressing not only infectious diseases but other potential problems including jet lag and security.
Mosquitoes are responsible for over two million human deaths a year, making them by far the most dangerous creature in the world (next to man). Many species of these miniature flying syringes suck blood and disease causing organisms from other animals (including man) and then share their transported viruses and parasites when piercing the skin of their next meal.
It is possible to tour countrysides completely void of mosquitoes, especially if you have a hankering to visit Iceland or Antarctica. Otherwise, mosquito precautions and preventive measures depend on when and where you visit. For example, a Parisian camping in southwestern Louisiana in late summer is at risk for West Nile fever, a disease for which there is no vaccine.
Yellow fever, a classic mosquito-borne virus known for attacking the liver, has local roots. The last North American yellow fever epidemic fever occurred in New Orleans in 1905. It is still endemic in certain jungle areas of Africa and South America. If clandestine bioterrorists ever bring back yellow fever virus to New Orleans, we’ll be in for serious trouble – none of our area parish public health clinics even stock the vaccine.
“Yellow fever vaccine can be tricky to administer. It has to be kept under special conditions and when reconstituted is good only for an hour,” says Eichhorn, whose office is one of only a handful of places you can get yellow fever vaccine in the New Orleans area [see box].
“Sometimes you need yellow fever vaccine even if you’re not traveling to a part of a country where it’s needed. For example, the tourist beaches of Brazil aren’t yellow fever zones. Yet, if you travel from Brazil to Argentina, you must have proof of yellow fever immunization even though it wouldn’t be required if you entered Argentina direct from the U.S.”
Unlike yellow fever, there’s no effective vaccine against malaria. For travel to areas of the world where malaria is a concern, specific medications are needed to prevent infection. This is an area where travel medicine gets complicated. Some countries have malaria that’s resistant to some of the older, but safer, preventive drugs. Children, pregnant women and people with certain cardiac, renal and neuropsychiatric illnesses cannot take certain preventive medications.
For other mosquito-spread viruses, like dengue (“bone break fever”) and West Nile fever, there are no available vaccines. This is where good education becomes of paramount importance. Eichhorn dispenses a $30 “mosquito kit” containing a nice supply of controlled release 20 perfect DEET, an insect repellent to spray on clothing, and a long lasting sunblock.
Eichhorn also stocks all sorts of other special kits including a syringe/suture kit for $25. You may not want to sew up your own laceration but having your own sterile black nylon attached to a needle has advantages if you can tactfully ask your native doctor to use your stuff.
A good pair of compression stockings or hosiery is another item to consider, especially if you’re overweight or prone to blood clots. Regular support hose are often hot, damp and uncomfortable to wear. Passport Health stocks Therafirm socks, made with a special stretch fiber that’s comfortable and wicks moisture away from the body. Medication to prevent altitude sickness is another product provided on-site by Passport Health.
From the dangers of sunburn and avoidable food-borne infections to vaccine-preventable diseases, a good travel medicine clinic can keep you informed and protected on the international scene.
Local Travel Clinics
3220 North Turnbull Drive
Concentra Medical Centers
318 Baronne St.
New Orleans 561-1051
Tulane University Travel Clinic
127 Elk Place, Suite 261
New Orleans 988-6929
1514 Jefferson Highway
Occupational Medicine Center
of West Jefferson
4475 Westbank Expressway
East Jefferson Hospital
3601 Houma Blvd.
Travel Clinic Touro Infirmary
1401 Foucher St.
New Orleans 897-8147