When not travelling, I thoroughly enjoy living vicariously through others' travel plans.
Every incoming script for a travel vaccine to a community pharmacy presents an opportunity to assess a patient’s preventable travel-related health risks. A pre-travel consult would be the optimal level of care, but this may require the pharmacist having additional training, booking an appointment, and is normally associated with a fee. For a patient who has already seen their doctor and received a prescription, they may not see the value of this service. Nevertheless, there are online resources that can allow any pharmacist to determine the suitability of travel vaccine prescriptions in workflow. Obtaining information about a patient’s itinerary, vaccine history, and medical history will provide sufficient data to allow appropriate assessment of the most common travel risks.
Internet access to view the Canadian guidelines for destinations is available from the Committee to Advise on Tropical Medicine and Travel (CATMAT), and US guidelines are available from the Center for Disease Control and Prevention (CDC). Pharmacists may find the information on the CDC clinician view more concise and easier to interpret in the dispensary setting.
Although patients may not want a pre-travel consult, it is still possible to ensure that the patient is aware of the most widespread illnesses present at their destination(s). Diseases transmitted by contaminated food and water include hepatitis A, typhoid fever, cholera, and travellers’ diarrhea, for which there are vaccines and medications available to prevent or treat. There is a lack of studies validating food and beverage precautions can prevent travellers’ diarrhea, despite the fact that they are widely recommended.
Frequent insect-borne sicknesses include malaria, dengue fever, zika, and chikungunya, and they may have a higher prevalence than diseases transmitted by contaminated food or water. Antimalarial tablets can be offered if the patient will enter a malaria risk area. There are no vaccines or medications for dengue, zika, and chikungunya, highlighting the importance of mosquito bite prevention.
Utilizing the resources available provided by CDC and/or CATMAT, a pharmacist can advise a patient on their travel risks for the prevailing diseases transmitted by contaminated food and water, as well as those transmitted by mosquitos. Pharmacists can offer additional vaccinations and medications providing comprehensive and accessible for patients travelling abroad, forging a stronger patient-pharmacist partnership.
Adrian Azim is pharmacist-owner at Prepared Traveller/Travel Clinic. Prepared Traveller is a travel clinic operating as part of the service offering at the Shoppers Drug Mart North Hill Shopping Centre location owned by Azim. Prepared Traveller offers pre-travel consults to individuals travelling internationally.