Announcer:
You’re listening to VacciNation on ReachMD, and this episode is sponsored by Valneva. The expert panelists have no honorarium for today’s discussion. Here’s your host, Dr. Charles Turck.
Dr. Turck:
Welcome to VacciNation on Reach MD. I’m Dr. Charles Turck, and joining me to discuss the ways that we can best ensure patients are prepared before traveling abroad are Drs. Norman Beatty and Marvin Bittner. Dr. Beatty is an Assistant Professor of Medicine at the University of Florida College of Medicine in the Division of Infectious Diseases and Global Medicine.
Dr. Beatty, it’s great to have you with us.
Dr. Beatty:
Awesome. Thanks for having me.
Dr. Turck:
And not only is Dr. Bittner the Interim Program Director of the Infectious Diseases Fellowship Program, but he’s also a Special Professor in the Department of Medicine at Creighton University in Omaha, Nebraska.
Dr. Bittner, thanks for being here today.
Dr. Bittner:
Glad to be here.
Dr. Turck:
So how about we start with you, Dr. Beatty. What strategies do you use to identify patients who might benefit from a pretravel consultation?
Dr. Beatty:
Yeah. This is a great question, and in our academic travel medicine clinic, we cater to many types of travelers. Those who may be undergraduate students going to a study abroad program, or faculty members going to do really exciting research somewhere in the world, or even some of our military folks who are going into different regions of the world, and community members who are just looking for the trip of a lifetime. What we really try to focus on is just advertising through our network, through our primary care providers, through other specialists that we have this amenity available. And that pretravel consultation is really essential for a lot of trips that are being had by many travelers just so that we can anticipate and mitigate any risks that may be that a traveler may encounter.
Dr. Turck:
And turning to you now, Dr. Bittner, how do you start a conversation with a patient about the health aspects of their travel plans?
Dr. Bittner:
It’s a highly individualized matter. In some cases, somebody makes an appointment well in advance. We know they’re coming in for a pretravel consultation, the staff can send them some information about travel health, and in a sense, the conversation has begun before they even walk into the exam room. Other cases are very different. In those situations, I’ll spend some time finding out about the trip. Not just where they’re going, but where in the country they’re going, and then I can relate that to some specific issues of interest to them. Maybe malaria is going to be an issue. Maybe we’ll have to talk about yellow fever vaccine. So it’s a highly individualized matter.
Dr. Turck:
And as a follow-up to that, Dr. Bittner, why is it important to have these conversations early in the travel planning stage?
Dr. Bittner:
Well, just about every pretravel consultation climaxes with a shot in the arm. And the patient is going to feel the pain of the needle right away, but it’s going to take a while before the vaccine that was injected actually provides protection. At least days, more likely weeks, and in some cases, the patient will have to come back for another round of injections, and that can be a week later, month later, sometimes even more. So the sooner a patient comes in and gets the process going the more chance we have of getting them adequately prepared before they step on the plane.
Dr. Beatty:
Yeah, Dr. Bittner, I think that’s a great point. Sorry to chime in here because you know sometimes our travelers are preparing, they’re planning their trip, and they make that appointment several months in advance, which is great. Allows us to get those vaccinations going and those booster shots available for them, but sometimes our travelers are coming in one week or two before this big trip, and it is really important that we just advocate that. If you are planning for one of these trips of a lifetime, going to a region where you may need a vaccination, it’s really important to make that appointment several weeks, if not months, in advance so that we can have these very important conversations.
Dr. Turck:
For those just tuning in, you’re listening to VacciNation on ReachMD. I’m Dr. Charles Turck, and I’m speaking with doctors Norman Beatty and Marvin Bittner about initiating travel health conversations with patients.
Now coming back to you, Dr. Beatty, should a patient be vaccine-hesitant or just not interested in discussing travel health considerations, how do you encourage them to prioritize their health through preventative measures?
Dr. Beatty:
Well, like Dr. Bittner was mentioning, when we start having some of these conversations about what the risks are in a region of the world or traveling where we’re going, we get to the details of where they will be in that part of the world or that part of the country. How will they be traveling? How will they be sleeping? What are they going to be placing themselves at risk for? Will they be exposed to insects, different arthropods? Will they be exposed to water? All these many things that are important for us to think about, vaccine-preventable diseases.
When a traveler comes in, I find often that they have already been thinking about a vaccination. Some are coming with the prenotion that they need a vaccine, and then sometimes they’re unaware that they have a risk for vaccine-preventable disease, and then we’re starting to do some education on that pathogen and what it takes to be vaccinated. Vaccines are probably one of the greatest advancements of medicine, and what we do is educate folks on a vaccine. What is this vaccine? What’s the technology behind this vaccine? What does it take to mount an immune response? And what kind of protection will you have?
Oftentimes, we’ll find that after sitting down with a patient, discussing the risk of their trip, and what a vaccine can do to prevent those risks, most folks are really understanding, and they want to be vaccinated, which is an important thing. We oftentimes, we'll just ensure that a patient knows the risks and benefits before they’re getting a vaccine. And we review the maps with them, and so overall, we do a lot of education, and that’s why some of these visits can be anywhere from 30 minutes to an hour because we really just need to focus on discussing some of these important points.
Dr. Turck:
And staying with you just a moment longer, Dr. Beatty, are there any other helpful tools or techniques you can use to help patients make informed choices about their health before and during international travels?
Dr. Beatty:
Yeah. I always come prepared to that visit. In our clinic, when a patient makes an appointment, we ask some important questions about where they’re going, what do they anticipate doing? That way, when I come to the visit, I’m prepared to have this discussion with that patient or with the group of individuals who may be going together. And I’ve reviewed the maps. I’ve reviewed what the health advisory may be at that time. Most recently, there was a hepatitis A outbreak in a local region that a traveler was going to that I wouldn’t have been aware of unless I had done a little bit of research right before that visit. And so I think it’s just really important, as a travel medicine or traveler health provider, that with each visit you come in with just a little preparation for that individual’s trip, and that way, you can have, again, some of these conversations that are really important because it’s all about risk mitigation.
Dr. Turck:
And if we turn back to you, Dr. Bittner, for the final word, what impact can prioritizing pretravel consultations have on patients?
Dr. Bittner:
It can really affect how the trip goes. I can tell you about a patient I saw not too long ago who told me about an earlier trip, and he had a terrible problem with traveler’s diarrhea. When I saw that patient, I was able to give some advice about prevention. I was able to provide some prescriptions for managing it if it happened. I was able to give some advice about how to deal with it if it happened. And that advice, where you can make a problem less severe, or ideally, prevent an illness, can make all the difference between a trip with wonderful memories and a trip you wish you never took.
Dr. Turck:
Well, those are some great final comments for us to consider as we come to the end of today’s program. And I want to thank my guests, Drs. Norman Beatty and Marvin Bittner, for joining me to discuss the importance of pretravel consultations and vaccines for patients traveling abroad.
Dr. Beatty, Dr. Bittner, it was great having you both on the program.
Dr. Beatty:
Thanks so much and safe travels everybody.
Dr. Bittner:
Thank you.
Announcer:
This episode of VacciNation was sponsored by Valneva. To access this and other episodes in our series, visit VacciNation on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
