Travel medicine can be a valuable occ-med add-on

Low-cost services can make a difference

It sounds exotic, but it’s a fairly low-cost service, and it’s relatively easy to implement. "It" is a travel medicine component that can easily be added to your ongoing occupational health services. Just ask Mary Ruth Hunt, MD, director of Moses Cone Occupational Health Services in Greensboro, NC. "I had been working with travel medicine for four years when I came to Moses Cone, " she relates. "At my previous job in Wilmington, DE, there was already an existing travel medicine clinic. As I worked there, I got experience with it and did a lot of research and learning. It’s something I love doing, and nobody was providing the service in this area."

Travel on the rise

Travel medicine services have become more important in recent years, Hunt asserts. "In the last few years there has been a huge increase in the number of U.S. citizens traveling to places where they are at risk for a number of diseases," she notes. "For example, hepatitis A is the No. 1 vaccine-preventable travel-related disease. It’s endemic in the entire world except for the U.S. and Western Europe; so as we grow up in the U.S., we are not exposed as children and do not develop immunity. When we travel, we can pick it up through contaminated food or water."

Hepatitis A can be a very devastating disease, she notes. "If you get it, you can miss four to six weeks of work," she observes. "Yet we have a great vaccine available that absolutely prevents it."

Another very prominent disease is malaria, which is carried by mosquitoes. "It can kill you," says Hunt. "You can go on vacation in Africa, contract malaria, and die."

Keeping travelers healthy

At Moses Cone, Hunt’s travel medicine services are provided inside the occupational health clinic. Employees simply call the office and set up an appointment. "People come to us, tell us where they are going, and we discuss pre-travel immunizations and other ways to stay healthy," she explains. "Wherever you go, there is always traveler’s diarrhea, and we prescribe medications to treat it, as well as ways to prevent it, such as not drinking the water, and washing your hands," she continues. The roster of potential diseases is a long one, including hepatitis A and B, yellow fever, typhoid, polio, malaria, rabies, and Japanese encephalitis. Hunt provides her patients with handouts that describe various diseases, symptoms, prevention and treatment.

Hunt is looking to expand the reach of her services and is contacting local health-related organizations to help boost referrals. "We also publicize the service in the hospital newspaper and on our web site," she adds. She’s also listing her clinic with the International Society of Travel Medicine (www.istm.org), which provides information about travel medicine clinic locations.

You don’t have to have a particularly large occupational health practice to be able to incorporate travel medicine, says Hunt. All it really takes is the desire to learn and to provide the service. "It’s very provider-oriented," she notes. "There are not a lot of start-up costs. What you basically need are the vaccines."

If you’re interested in learning more about travel medicine, there are a number of classes you could take. "I’d contact Shoreland Inc. [www.shoreland.com]," Hunt offers. Shoreland provides a computer software program called Travax, which offers a wealth of information about travelers’ diseases. "The CDC [Centers for Disease Control and Prevention] also has really good web sites, but some are not specific enough, especially in terms of specific regions within countries," she notes.

The bottom line, says Hunt, is that it’s important for occupational health professionals to consider offering travel medicine services — especially if their employee population has a number of business travelers. "So many employees are going to Asia now, to places like Hong Kong and India, and they really need to be vaccinated against diseases to keep them healthy," she concludes.

For more information, contact:

Mary Ruth Hunt, MD, Director, Moses Cone Occupational Health Services, 1309 N. Elm St., Greensboro, NC 27401. Telephone: (336) 273-9500.

Shoreland Inc., 2401 N. Mayfair Road, Suite 309, Milwaukee, WI 53226. Telephone: (800) 433-5256. Fax: (414) 290-1907.