Holiday Traveller

By Dr Eddy Bajrovic*

You’re about to travel overseas on business: Five days in a quality hotel, attending meetings, perhaps a little R and R squeezed in.

Nothing to worry about health-wise, right?

Maybe not… this time. But, as Clint Eastwood famously sneered: “You’ve got to ask yourself: Do you feel lucky?”

A corporate traveller may not get sick on any particular short overseas trip. In fact, they are far less likely to be exposed to the diseases typically encountered off the proverbial ‘beaten track’, such as malaria and typhoid.

But, for corporate frequent flyers, the chances of infection with common respiratory diseases like a cold, influenza and chest infections or getting Hepatitis A or traveller’s diarrhoea from contaminated food or water are much the same as those of a leisure traveller staying for a week or longer.

Why risk people and profits?

It’s hard to imagine why a company would risk the well-being of these key human assets when the job of developing or securing new business often rests squarely on their shoulders.

Yet, Business Pulse, a new corporate travel-focussed website developed by the US Centers for Disease Control and Prevention (CDC), claims only 10% of international business travellers receive pre-travel health care.

Every corporate traveller – especially those whose work takes them to the world’s developing regions – should begin their preparation with pre-travel advice from a doctor experienced in travel medicine.

While this should ideally take place a month or more before departure, even a last-minute consultation is often worthwhile to check on the status of their immunisations and for a briefing on the health risks of their destination – especially if it’s one they haven’t visited before.

OUR CHECKLIST FOR HEALTHY BUSINESS TRAVEL

Our checklist for corporate travellers includes:

Check your vaccinations

All corporate travellers should have up-to-date protection against the so-called childhood diseases, some of which have made a global comeback in recent years. These include measles, mumps, diphtheria, tetanus, whooping cough (pertussis), and polio.

Vaccination against Hepatitis A and B, and typhoid are also likely to be recommended for an executive who travels regularly. Here’s why:

Hepatitis A is one of the most common vaccine-preventable diseases acquired abroad and business travellers are by no means free of risk – even in five-star digs. The virus is highly prevalent throughout Asia, Africa, the Middle East, and Central and South America, and is a moderate risk in Russia and Eastern Europe. 

The risk of hepatitis B lies not only in unprotected sex but also through accidental exposure to unsterile medical equipment following an injury or accident, or transfusion with unscreened blood products.  (Studies have shown that more than half of international travellers have unanticipated casual sex, particularly with local residents, and as many as two thirds of them do not use condoms.)

Vaccination against typhoid is normally recommended for ‘adventurous eaters’ in developing countries where sanitation and hygiene is uncertain. But, once again, it’s the frequency of travel that makes vaccination a sensible idea for business travellers. The incidence of typhoid in Australia is steadily rising: We used to see 50-80 cases notified each year, now the figure is around 110-120 – all acquired overseas.

An annual influenza injection provides 6-12 months’ protection, covering a corporate traveller during and after our Southern Hemisphere flu season – especially in Asia and other tropical regions, where flu viruses circulate year-round.

Beware of mosquitoes

Mosquito-borne diseases shouldn’t be dismissed – even if business trip is confined to a city.

Malaria - The risk of malaria for business travellers staying in urban areas for short periods is usually low: Only rarely is malaria prevention medication recommended, although any potential exposure should be expertly assessed.

Dengue and Chikungunya - It’s these two viruses that pose the greatest potential risk for business travellers. Both are transmitted by urban-breeding mosquitoes which can be found in outdoor areas of even the best hotels, resorts and restaurants and large-scale outbreaks have become commonplace in recent years in tropical and sub-tropical countries. Yellow fever is an issue for travel to many African and South American countries. Even if the disease is not a risk, proof of vaccination may be required under International Health Regulations or by the country being visited, for transited through a country, or to return to Australia.

TD or not TD?

Travellers’ diarrhoea (TD) is the bane of travellers: 70% of travellers visiting a developing region of the world will suffer TD during a two-week stay. For business travellers it is the most likely health issue to disrupt a busy schedule – even during short stays. Early treatment is essential to shorten the duration of diarrhoea, reduce discomfort and incapacitation, and prevent severe complications - particularly dehydration and electrolyte imbalance. Treatment involves taking oral rehydration fluids and these should be part of every corporate first-aid kit.

BE TRAVEL-READY

Performing at your best means watching out for your health at all times. Always:

Prepare early – Always organise visas and any mandatory vaccination which requires you to show proof (such as Yellow fever for many Africa or South America countries) well in advance of departure: there’s nothing more stressful than having hassles on arrival there or on your arrival back home.

Be security-aware – Check the DFAT’s smartraveller web site for travel advisories on any current safety or security issues that you should be aware of.

Choose food carefully – On business trips it is very easy to be wined and dined each evening. Overeating with limited exercise isn’t healthy in the short or long term. Too much alcohol can also leave you below par for meetings, at risk of accidents and prone to inappropriate behaviour. Choose food carefully: Stick to hot, freshly cooked foods and never indulge in any undercooked, steamed shellfish dishes like mussels, oysters or clams. Leafy salads are easily contaminated and best avoided.

Beverages, too – The water supply in many large cities is safe. But, if you can’t smell chlorine in the tap water, stick to the bottled variety. Similarly, ice cubes may also be made from untreated water and are best avoided, along with the breakfast buffet’s ‘freshly squeezed’ fruit juices, which may have been reconstituted with tap water.

Pack first-aid essentials – A traveller’s first-aid kit should be one of the first items in your bag. Personal items and simple medications may not be available outside business hours at your destination. A thermometer, some paracetamol, a few plasters and your favourite cough and cold remedy are essential items for your kit. Remember to also carry a supply of medication for both diarrhoea and nausea.

Practice health habits – Not all hotels have a gym. Walking is not only a great way to relax, but also to see the sights. Pack your joggers for a daily walk: you’ll feel more relaxed and perform better for it. Large cities in developing countries often have chaotic and crowded road networks making injury even as a pedestrian a real risk. Get advice on where it’s safe to walk before you head out and also check air quality – especially if you have a respiratory condition, such as asthma.

*Dr  Eddy Bajrovic is the Medical Director of Travelvax Australia.