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Travel Medicine

Preparing for a healthy trip

The myHealth Clinic in Anchorage is among a handful of providers around the state offering services tailored to the traveler.

The myHealth Clinic in Anchorage is among a handful of providers around the state offering services tailored to the traveler.

Photo courtesy of myHealthClinic

For the business traveler, receiving an assignment to report out-of-country can be the start of an exotic adventure. But before the journey ever starts, often there are medical requirements as the initial threshold to overseas deployment.

Such was the case when an overseas contractor first rang me up years ago for a technical writing position in the polar regions of the southern hemisphere. Employment was dependent on first passing a strenuous battery of physical tests. The adventure travel would occur only if I were deemed physically qualified. First, I had to find a local provider in my small Southeast town who was willing to oversee the extensive physical examination requirements, perform the contract-required immunizations targeted to my job destination, and also to educate me about my medical needs specific to the countries and continents across which I would eventually meander on my way home to Alaska.

It was a process I would repeat another dozen times through the years as my job and penchant for travel took me away from the 49th State. In the decade since that first southern excursion, the medical industry has evolved a bit, polished its processes, and has recognized the need to provide travel-specific services as our business world becomes increasingly global. In fact, several providers in the state market themselves directly—on their websites and in advertising—as providing “travel medicine.” To the uninitiated, the term speaks of exotic ports and foreign cities. In fact, the service is a thorough suite of offerings ranging from a simple precautionary prescription to a more comprehensive screening for CDC-recommended immunizations specific to the destination country itself.

Regardless the traveler’s scope of need, Alaska offers several medical experts and clinics to make the process seamless and efficient.

 

Dr. Alex Baskous’s Anchorage practice includes a travel medicine specialty. Baskous is shown, right, conferring with Heather Garris, nationally certified medical assistant.

Photo courtesy of Dr. Alex Baskous

Growing Trend

At the myHealth Clinic at 2105 East 88th Avenue in Anchorage, Travel medicine is among highlighted services that clinic staff provides to their clientele. Jyll Green, an advanced nurse practitioner and former flight and ER nurse at area Anchorage hospitals, founded the clinic in February 2007. When asked what prompted her to include travel medicine among her clinic offerings, she indicates that she simply observed the need.
“myHealth Clinic is a family practice office that has always accepted walk-in clients in addition to regularly scheduled appointments,” Green says. “It was surprising how many people were coming in as a walk-in for travel vaccines, so—out of necessity and interest—I chose to get informed by attending travel medicine conferences and courses. We started offering travel medicine services in 2008. I think Alaskans really like to travel, so there is a high need for this service. It is amazing to hear about where people are traveling.”
As far as processes that someone should consider when preparing for international travel, Green suggests, “It is never too early to have a pre-travel medical consultation. We do a lot of last minute travel consultations which may not allow enough time for vaccines to take full effect. At least 30 days in advance is sufficient for most travelers; however, long-term travelers to countries where their risk is higher for rabies or Japanese encephalitis would want to consult earlier than that.”
Colette Lausier, a myHealth Clinic receptionist, reports that she regularly books travel-related appointments. “We probably see them at least multiple days a week—three or four days a week—new patients coming in for travel medicine,” says Lausier, who commented that she’s noticed the practice area grow through her years of employment there. “It’s mostly travel consults for people who are traveling out of country,” she says. Such pre-travel consultations—a visit with the practitioner about your intended destination, scope of potential exposure, duration of travel, and the like—may result in prescriptions, vaccinations or an emergency health plan. “Lately we’ve have been people going everywhere—a lot of Central America, the Far East, Africa—all over the place.”
Patients have an opportunity to explain their travel plans when they meet with the practitioner. “During the travel medicine consultation, we discuss all types of travel hazards and risks including the expected malaria prevention and vaccines for preventable diseases,” Green says. “I think it is wise to give the traveler the ability to self-treat common medical problems that arise while traveling, so I give basic medical treatment advice and a prescription for a broad spectrum antibiotic with instructions on how to use them properly.”
Just because the trip has ended, that doesn’t mean the traveler won’t experience its effects for some time to come. “After travel to a country with risk for malaria, people should be aware that any fever that develops up to one year after return should be considered malaria until proven otherwise. It is very important to continue malaria medication exactly as instructed, even if you don’t think you have been bitten by a mosquito,” Green says.
Green attributes the increase in travel-related medical interest to a variety of sources. “I am definitely seeing a lot more pre and post travel consultations since getting involved in the International Society of Travel medicine and moving to our new location with expanded hours,” she says. “I also think people are hearing about the resurgence of diseases, such as polio, in certain countries and are starting to take travel precautions more seriously. There are several cases of malaria in Alaska each year from overseas travel.”

 

The Traveler Perspective

Kent Colby of Ketchikan is one who frequently goes to “see the world,” traveling wide and far outside Alaska for business. On one winter day recently, he boarded the ferry to Gravina Island to catch an Alaska Airlines flight from Ketchikan to Seattle and on to San Francisco; and then to catch United Airlines to Sydney, Australia, toward an eventual stop in Christchurch, New Zealand, and destinations beyond. On contract for the National Renewable Energy Lab in Golden, Colo., Colby is a project manager whose work frequently takes him outside the country—not always without medical incident, he recalls. Whether it was the med-evac from our own Dutch Harbor (not foreign, but as far away from Ketchikan as one can get and still be in the state), the flu while in Toronto, or the toothache in New Zealand, Colby says his past experiences have made him cognizant that medical planning is a core part of any travel plan. For this latest trip—a short contract in Antarctica—he sought medical travel planning with his primary care provider at PeaceHealth’s Ketchikan Clinic. The clinic coordinated with the contractor’s medical branch regarding necessary physical qualifications and vaccinations, ensuring Colby a timely departure to meet his contract deliverables this winter.
“Perhaps the best aspect of traveling internationally for work is the adventure—and the anticipation of returning home. You want to make sure your papers are in order for any interesting recreational travel opportunities that arise,” he says. “Plus, riding on an airplane, there are potential problems of sitting that long in a less-than-ergonomically-designed seat, exposure to a diverse set of airborne bugs, and the natural upset to your system that comes from transiting one side of the globe to the other in a matter of hours.”
The concept of being medically prepared for medical needs once at your destination rang home to Colby several years ago when he survived the earthquake that destroyed much of Christchurch. While he managed to escape the bed and breakfast inn where he was staying in the city’s center, his luggage and all other belongings did not. Left with only the clothes he was wearing and his wallet in the days that followed, he realized first-hand how medicine—from access to regular prescription medications to basic emergency care—plays a role in any travel regime.
“You want to make sure that you are in reasonably good physical condition when you travel. One reason is that, when you get to a foreign location—even one as lovely and civilized as New Zealand—you don’t know where to go (if you need medical care),” he says. “Talking to your doctor beforehand about what care is available at your destination is worth considering.”

A Traveling Lot

Whether it’s the seasonal jaunt to Hawaii, or a contract in the other hemisphere, Alaskans appear to be a transient lot, enjoying the occasional travel to the Lower 48 and exotic locales beyond. For those seeking providers who offer the specialty of travel medicine, there are several to choose from. In addition to myHealth Clinic in Anchorage, the city also features the clinic of Dr. Alex Baskous at 2841 DeBarr Road. Baskous holds several travel-related certifications and writes eloquently on his clinic website about the benefits of adventurous travel—and the advantages of medical planning beforehand. He poses a series of travel-related questions for the patient to consider up front: any climate or altitude issues to consider, awareness of areas to potentially avoid during travel and destination-specific symptoms to monitor.
“Alaskans are adventurous and frequently go to exotic places and do exiting things around the world,” says Maria Baskous, the clinic’s manager. “Medical issues for them are very different in those places and a trained specialist in this field was needed here to prepare our travelers. This specialty has been a great pleasure. We get to meet wonderful, adventurous folks. The growth of our practice has increased through word of mouth among travelers.”
Baskous echoes the words of other clinic operators who recommend follow-up once back in the state. “In addition to preparing for travel, don’t forget that travel related health problems can show up well after returning home,” Baskous says. “Always mention recent travels to medical professionals after travelling to other parts of the world.”
Similarly, the Tanana Valley Clinic on Noble Street in Fairbanks advertises its medical travel offerings, providing a descriptive list of related services on its website—including topics of disease prevention while traveling and accident prevention.
Increasingly, the concept of foreign travel is commonplace—whether for business or pleasure. What is relatively new is the proactive attention being paid to ensuring a safe and healthy trip, from a medical perspective.
“Although I admit I have traveled unprepared, I wouldn’t recommend it,” says myHealth Clinic’s Green. “Sometimes, the most common, simple thing can ruin your entire holiday. We love doing group travel consultations. What could be more fun than getting vaccinated together?”

Nicole A. Bonham Colby writes from Ketchikan.

This originally appeared in the March 2013 print edition of Alaska Business Monthly magazine.

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