Ask Your Pharmacist

February 15, 2017
Q:

My family is planning a trip to the Dominican Republic for March Break.  We’ve never travelled outside Canada before, and I’m not sure whether we need vaccines. Do you recommend them for this area?

A:

Because community pharmacists are easily accessible to the public, they get lots of questions regarding travel health, particularly this time of year. When it comes to travel vaccines, the needs of each patient vary depending on age, health status and the area and nature of the trip. As such, recommendations for travel health do not follow a cookie cutter approach and often require a pre-travel assessment. This article will provide some information on how to prepare for your next vacation from a health perspective.

It is recommended that an individual who is planning for international travel should consult a healthcare provider four to six weeks before departing. This allows for the identification of any potential health hazards and methods of prevention as well as the provision of any immunizations or other medications for vaccine preventable illnesses.  In fact, some countries require proof of vaccination against certain illnesses before entrance is permitted to the traveller.

The timing of vaccination is also important to ensure that you have appropriate immunity against an illness before entering an area in which you may be at risk. It is not uncommon for pharmacists to see patients presenting for vaccines within a couple of days of their anticipated departure. This is troublesome as it can take several weeks to develop appropriate immunity following vaccination, and as a result they will have a higher risk of illness, particularly during the early portion of their trip.

It is a good idea to get in the habit of considering your health needs as part of the initial planning of any international vacation. Upon choosing a destination, educating yourself on travel health for the area should be the next step after booking your flights and hotel. There are a few websites that provide excellent information on health and safety advisories for destinations all over the world. The websites for the World Health Organization and the Public Health Agency of Canada are excellent resources. My personal favorite is CDC.gov which is the site for the Centers of Disease Control and Prevention in the United States. 

Most community pharmacists have basic training in travel health and can help make recommendations for those visiting low-risk destinations with standard planned activities. However, travelers who have complex itineraries such as those visiting multiple countries or unusual, remote destinations or those with special health needs (pregnancy, immunocompromised, etc.) are recommended to consult with a travel medicine clinic that have healthcare professionals with specialized training in this field.  Unfortunately, surveillance data on travel-related illnesses suggests that less than half of those who travel internationally receive pre-travel medical care and 60 per cent of patients who require treatment for such illnesses did not consider their health needs before travelling.

The most common travel-related illness experienced by patients in our area when visiting developing regions is traveler’s diarrhea. It is estimated that anywhere from 30 to 70 per cent of travelers will experience this issue depending on the time of year and destination. The majority of cases are bacterial infections resulting from the consumption of contaminated food or water which is often attributed to poor hygiene practices by those preparing meals. Getting a vaccine such as Dukoral and consuming bismuth subsalicylate (eg. Pepto Bismol) daily can be appropriate means of preventing this issue. Ask you pharmacist what may work for you.

When preparing for your next international vacation, a conversation with your pharmacist is a great place to start for your pre-travel health assessment. The majority of pharmacists in the province can recommend products or even prescribe vaccines for low-risk travel. Some pharmacists are trained to provide the necessary consultations for higher-risk travel and run travel-health clinics. Even if you pharmacist hasn’t received this training, chances are that he or she can recommend someone who has.

Ryan Kennedy (BSc., Doctorate of Pharmacy, MBA) is a pharmacist/owner at Jean Coutu in Saint John. His opinions expressed in this newspaper are published for educational and informational purposes only and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.