Travellers with Special Needs
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Certain groups may be at increased risk or may face particular issues when travelling. Pregnant travellers and children present several questions around vaccination, travellers’ diarrhoea, malaria and noninfectious problems that are distinctly different to other travellers. These issues are dealt with in Sects. 7.1 and 7.2. Older travellers (Sect. 7.3) are also becoming increasingly recognised as having several specific requirements that deserve their own consideration. Other groups of travellers including humanitarian workers, expatriates, VFRs and those with underlying chronic medical conditions (Sects. 7.4–7.9) all have varied requirements that are different to the standard adult traveller. Immunocompromised hosts (Sects. 7.10–7.12) present a further challenge for the travel medicine practitioner and require a significant level of expertise in order to deal with the many difficult issues that will arise within a consultation. Finally, medical tourists (Sect. 7.13) pose an entirely different set of issues that practitioners must become familiar with. This chapter provides specific information and recommendations regarding these varied groups of travellers.
The Pregnant Traveller
- Women’s Health Committee, The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. College Statement: Influenza vaccination during pregnancy (and in women planning pregnancy). 2018. https://www.ranzcog.edu.au/Statements-Guidelines. Accessed 24 Aug 2018.
- Australian Immunisation Handbook, Australian Government Department of Health, Canberra. 2018. https://immunisationhandbook.health.gov.au.
- CDC Yellow Book. Chapter 7: International travel with infants & children. 2018. https://wwwnc.cdc.gov/travel/yellowbook/2018/international-travel-with-infants-children/traveling-safely-with-infants-children.
- Theeten H, Van Herck K, Van Der Meeren O, Crasta P, Van Damme P, Hens N. Long-term antibody persistence after vaccination with a 2-dose Havrix (inactivated hepatitis A vaccine): 20 years of observed data, and long-term model-based predictions. Vaccine. 2015;33(42):5723–7.PubMedCrossRefGoogle Scholar
- The Older Traveller: a guide for the health professional. 1st ed. In: Baker L, Brink GK, Lipschitz S, Marcolongo T, editors. South African Society of Travel Medicine (SASTM), South African Society of Geriatrics and the International Association for Medical Assistance to Travellers (IAMAT). Dunvegan: SASTM Publications; 2016.Google Scholar
Expatriates and Long-Term Travellers
- Gamble KL, Lovell-Hawker DM. Expatriates. In: JS Keystone, P Kozarsky, D O’Freedman, HD Northdurft, BA Connor, editors. Travel medicine. Mosby Elsevier; 2008.Google Scholar
Humanitarian and Health Workers
- Aid Worker Security Database. Aid worker security report 2018: figures at a glance. 2018. https://aidworkersecurity.org.
- Gushalak BD. Humanitarian aid workers. Updated 31 May 2017. In: Centers for Disease Control and Prevention, editor. CDC Yellow Book 2018. Health information for international travel. Atlanta: CDC; 2018. https://wwwnc.cdc.gov/travel/yellowbook/2018/advising-travelers-with-specific-needs/humanitarian-aid-workers.
- Wu HM, Dhara R, Czarkowski AG, Nilles EJ. Health care workers. Updated 31 May 2017. In: Centers for Disease Control and Prevention, editor. CDC Yellow Book 2018. Health information for international travel. Atlanta: CDC; 2018. https://wwwnc.cdc.gov/travel/yellowbook/2018/advising-travelers-with-specific-needs/health-care-workers.
- Chen LH, Hamer DH. Long-term travellers and expatriates. Updated 31 May 2017. In: Centers for Disease Control and Prevention, editor. CDC Yellow Book 2018. Health information for international travel. Atlanta: CDC; 2018. https://wwwnc.cdc.gov/travel/yellowbook/2018/advising-travelers-with-specific-needs/long-term-travelers-expatriates.
- NHMRC. Vaccination for people at occupational risk. Updated 5 June 2018. In: Australian Immunisation Handbook [Available Online]. https://immunisationhandbook.health.gov.au/vaccination-for-special-risk-groups.
Travellers Visiting Friends and Relatives
Travellers with Cardiovascular Problems
Travellers with Chronic Lung Disease
Travellers with Diabetes
- Kerr D, Martinez J. (Samsun Diabetes Research Institute). Diabetes travel. www.diabetestravel.org.
The HIV-Infected Traveller
- Immunization of People Living with HIV and People and people at risk of HIV infection. Clinical protocol for the WHO European region. 2017. http://www.euro.who.int/__data/assets/pdf_file/0004/78502/E90840_Chapter_12.pdf.
- Ruff T, O’Brien DP. Advice to the HIV-infected traveller. In: Crowe S, Hoy J, Mills J, editors. Management of the HIV-infected patient. London: Martin Dunitz Ltd; 2002. p. 601–8.Google Scholar
The Immunocompromised Traveller
- Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation Handbook, Australian Government Department of Health, Canberra; 2018. immunisationhandbook.health.gov.au. Accessed 1 Oct 2018. Section on “Vaccination of people who are immunocompromised.”
- Centers for Disease Control and Prevention. CDC Yellow Book 2018: Health Information for International Travel. Chapter 8: Advising travelers with specific needs—immunocompromised travelers. New York: Oxford University Press; 2017. https://wwwnc.cdc.gov/travel/page/yellowbook-home. Accessed 24 July 2018.
- Hall V, Johnson D, Torresi J. Travel and biologic therapy: travel-related infection risk, vaccine response and recommendations. J Travel Med. 2018;25(1).Google Scholar
The Splenectomised Traveller
- Crawford N, McMinn A, Nourse C, Philips L, Graham N, Jones P. Medical guidelines for individuals with asplenia or hyposplenism—paediatric guidelines (aged 0 to 18 years). Version 1, February 2016. https://spleen.org.au/VSR/information.html. Accessed 30 July 2018.
- Spleen Australia Recommendations for the prevention of infection in asplenic or hyposplenic patients over 18 years of age. Version 33, August 2017. https://spleen.org.au/VSR/information.html. Accessed 30 July 2018.
- Royal Australasian College of Surgeons. Position Paper on Medical Tourism, July 2017. https://www.surgeons.org/media/16070945/2017-06-29_pos_fes-pst-026_medical_tourism.pdf.