Better Late Than Never - An Analysis of Last-Minute Travelers Attending a Specialist Travel Medicine Clinic in Ireland

Document Type : Original Article

Authors

1 School of Medicine, National University of Ireland Galway, Galway, Ireland

2 School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia

3 Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia

4 Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia

Abstract

Introduction: Last-minute travelers (LMTs) are a vulnerable group, because it may not be possible to adequately vaccinate them against exposure to infectious diseases. The purpose of this retrospective cross-sectional study was to describe the characteristics of LMTs attending a travel health clinic.
Methods: The following data was extracted from records of travelers attending the Tropical Medical Bureau (Galway, Ireland) over a 6-year period with less than 2 weeks remaining before their departure: gender, age, occupation, destination(s), purpose of travel, departure date, travel duration, travel group size, accommodation, past medical history, medications, and vaccination history.
Results: Of 7555 traveler records, 1296 (17.2%) were of LMTs, of whom 45 (3.5%) were recurrent LMTs. LMTs were equally likely to be male or female. The mean age of this cohort was 32.2 years. The most common travel destination was Asia, and holiday was the most frequent purpose of travel. The mean interval before departure was 7.54 ± 3.65 days, and the mean travel duration was 7.36 ± 2.3 weeks. The majority (n=454, 35.1%) of LMTs traveled in pairs. Approximately 2 in 5 (n=497, 38.4%) travelers reported a past medical history; over half (n=674, 52.0%) had previously received travel vaccinations. The majority (n=1202, 92.8%) of LMTs were unable to complete a scheduled course of pre-travel vaccines.
Conclusion: This study provides insight into the characteristics and travel patterns of LMTs. A large proportion of LMTs have pre-existing medical conditions. Further research should focus on the travel health risk-taking behavior of these individuals.

Keywords


  1. Flaherty G, Md Nor MN. Travel itinerary uncertainty and the pre-travel consultation--a pilot study. J Travel Med. 2016;23(1). doi:10.1093/jtm/tav010.
  2. Zuckerman JN, Van Damme P, Van Herck K, Löscher T. Vaccination options for last-minute travellers in need of travel-related prophylaxis against hepatitis A and B and typhoid fever: a practical guide. Travel Med Infect Dis. 2003;1(4):219-226. doi:10.1016/j. tmaid.2003.10.001.
  3. Yates JA, Rao SR, Walker AT, et al. Characteristics and preparation of the last-minute traveler: analysis of vaccine usage in the Global TravEpiNet Consortium. J Travel Med. 2019;26(6). doi:10.1093/ jtm/taz031.
  4. Rosselot GA. Last-minute travelers. In: Brunette GW, Nemhauser JB, eds. CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford University Press; 2019:19-21.
  5. Flaherty GT. One size does not fit all: towards personalized risk assessment in travel medicine. J Travel Med. 2018;25(1). doi:10.1093/jtm/tay076.
  6. Flaherty G, Lim D, Fry G. Travel agency awareness of the health risks of international travel; a pilot study. Int J Travel Med Glob Health. 2015;3(2):45-48. doi:10.20286/ijtmgh-030268.
  7. Hartjes LB, Baumann LC, Henriques JB. Travel health risk perceptions and prevention behaviors of US study abroad students. J Travel Med. 2009;16(5):338-343. doi:10.1111/j.1708- 8305.2009.00322.x.
  8. Heywood AE, Zhang M, MacIntyre CR, Seale H. Travel risk behaviours and uptake of pre-travel health preventions by university students in Australia. BMC Infect Dis. 2012;12:43. doi:10.1186/1471-2334-12-43.
  9. Johnston N, Sandys N, Geoghegan R, O’Donovan D, Flaherty G. Protecting the health of medical students on international electives in low-resource settings. J Travel Med. 2018;25(1). doi:10.1093/ jtm/tax092.
  10. Torresi J, Steffen R. Redefining priorities towards graded travel-related infectious disease research. J Travel Med. 2017;24(6). doi:10.1093/jtm/tax064.
  11. Soentjens P, Andries P, Aerssens A, et al. Preexposure intradermal rabies vaccination: a noninferiority trial in healthy adults on shortening the vaccination schedule from 28 to 7 days. Clin Infect Dis. 2019;68(4):607-614. doi:10.1093/cid/ciy513.
  12. World Health Organization (WHO). WHO expert consultation on rabies: third report. WHO Technical Report Series, No. 1012. Geneva: WHO; 2018.
  13. U.S. Food and Drug Administration. Package Insert and Patient Information—Ixiaro. https://www.fda.gov/media/75777/download. Accessed 23 November 2019.
  14. Kennedy KM, Flaherty GT. Medico-legal risk, clinical negligence and the practice of travel medicine. J Travel Med. 2016;23(5). doi:10.1093/jtm/taw048.
  15. Brower V. Counterfeit and substandard malaria drugs in Africa. Lancet Infect Dis. 2017;17(10):1026-1027. doi:10.1016/s1473- 3099(17)30528-5.
  16. Flaherty GT, Rossanese A, Steffen R, Torresi J. A golden age of travel: advancing the interests of older travellers. J Travel Med. 2018;25(1). doi:10.1093/jtm/tay088.
  17. Han CT, Flaherty G. Profile of travelers with preexisting medical conditions attending a specialist travel medicine clinic in Ireland. J Travel Med. 2015;22(5):312-317. doi:10.1111/jtm.12221.
  18. Flaherty GT, Geoghegan R, Brown IG, Finucane FM. Severe obesity as a barrier to international travel: a qualitative analysis. J Travel Med. 2019;26(3). doi:10.1093/jtm/taz018.
  19. Chang L, Lim BCW, Flaherty GT, Torresi J. Travel vaccination recommendations and infection risk in HIV-positive travellers. J Travel Med. 2019;26(6). doi:10.1093/jtm/taz034.
  20. Flaherty GT, Kennedy KM. Preparing patients for travel to high altitude: advice on travel health and chemoprophylaxis. Br J Gen Pract. 2016;66(642):e62-64. doi:10.3399/bjgp16X683377.
  21. Flaherty G, Gouda J, Fry G. Awareness of rabies risk in a sample of travelers attending an Irish travel medicine clinic. Int J Travel Med Glob Health. 2015;3(2):53-57. doi:10.20286/ijtmgh-030262.
  22. Flaherty GT, Lim Yap K. Bibliometric analysis and curriculum mapping of travel medicine research. J Travel Med. 2017;24(5). doi:10.1093/jtm/tax024.