Compliance of Austrian tourists with prophylactic measures

Institute of Specific Prophylaxis and Tropical Medicine, University of Vienna, Austria.
European Journal of Epidemiology (Impact Factor: 5.34). 04/1992; 8(2):243-51. DOI: 10.1007/BF00144808
Source: PubMed


Physicians dealing with prophylactic measures for tourists going to developing countries will often not be able to foresee the outcome of their recommendations. Therefore an open study with 2,627 Austrian tourists on their flight home from a tropical destination was carried out to evaluate the behaviour of typical short-term travellers with respect to different kinds of precautionary measures. 94.1% of all tourists informed themselves before travelling abroad, but a high proportion of travellers tends to contact only their travel agency or their personal friends, this leading to inadequate information. Regarding the individual performance of precautionary measures the results indicate a few principal conclusions: Among the recommended inoculations the vaccinations against typhoid fever, poliomyelitis and tetanus are widely underestimated, the latter two in particular for adults, while compliance with the passive immunization against Hepatitis A is generally good (more than 80% of all travellers receive Hepatitis A immunoglobulins prophylactically). The most crucial point seems to be the chemoprophylaxis against malaria in as much as a) there seems to be a considerable lack of information about malaria endemic areas among phycisians, b) tourists tend to use the most simple applicable drug unaware of epidemiological considerations and c) the regular intake of chemoprophylaxis declines significantly with the complexicity of the intake procedure.
In addition, tourists are in general well informed about nutritional risks, but only half of them will receive adequate information on the risk of sexually transmitted diseases and a basic medical travel kit.

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    • "In many cases vaccination is considered essential for specific destination countries. Vaccination criteria are age, sex, underlying pathological diseases as well as the frequency of diseases in the host country (8). "
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    • "Many travelers do not utilize pretravel preventive health strategies, including physician advice and chemoprophylaxes (Crockett and Keystone, 2005; Van Herck et al., 2003). A significant proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses (Lopez-Velez and Bayas, 2007; Prazuck et al., 1998; Schunk et al., 2001; Van Herck et al., 2004), and a majority of these travelers demonstrate poor recall of actual vaccination status (Falvo et al., 1996; Kollaritsch and Wiedermann, 1992; Wilder-Smith et al., 2004). Many do not understand basic risks of infection, nor are able to recognize common sources and causes (Van Herck et al., 2004; Wilder-Smith et al., 2004; Zuckerman and Steffen, 2000). "
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    ABSTRACT: Anthropozoonotic (human to nonhuman animal) transmission of infectious disease poses a significant threat to wildlife. A large proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses, and a majority of these travelers demonstrate poor recall of actual vaccination status. Here we characterize self-perceived vaccination status among a large sample of ecotourists at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. Despite their recognized travel itinerary to view endangered animals, tourists at wildlife sanctuaries are not adequately protected against vaccine-preventable illnesses. Of 633 surveys, over half reported being currently vaccinated against tuberculosis, hepatitis A, hepatitis B, polio, and measles. Fewer participants reported current vaccination status for influenza, rabies, and chickenpox. Despite the fact that the majority of visitors to Sepilok are from temperate regions where influenza is relatively more prevalent, 67.1% of those surveyed with medical-related occupations reported not being currently vaccinated for influenza. Ecotourists concerned about environmental protection are themselves largely unaware of their potential contribution to the spread of diseases to animals. The risks of negatively affecting animal populations must be communicated to all concerned parties, and this may begin by urging travelers to examine their actual vaccination status, particularly as the ecotourism industry continues its rapid expansion, and is seen increasingly as a possible tool to save great ape populations from extinction.
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    • "Among travellers to endemic areas, compliance regarding malaria chemoprophylaxis is generally poor, ranging from 32 to 74% depending on the definitions used (Phillips-Howard et al. 1986; Lobel et al. 1987, 1990; Coole et al. 1989; Steffen et al. 1990; Kollaritsch & Wiedermann 1992; Gyorkos et al. 1995). Malaria chemoprophylaxis has been shown to have a low costto-benefit ratio compared to other prophylactic interventions in travellers (Behrens & Roberts 1994), and several studies suggested increased risks of malaria in non-compliant travellers (Lobel et al. 1987; Gyorkos et al. 1995; Phillips-Howard et al. 1990; Behrens & Curtis 1993). "
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