Global Health Rants Transportation Travel Health

Travelers, Disease Spread and Responsibility

Cvander photo

The world is a big place and most travelers want to see it all.  The double edged sword of travel is that by going to that unique place, you are contaminating it with your culture, ideas and mere presence.  Having a great time somewhere makes you want to go back and tell your friends.  This means more people will be there, when you re-visit.  The “original” place will have adapted to the influx of travelers.  Thus, you’ve helped ruin your own favorite place.

Responsible Travel

There is the concept of “responsible travel”, although I have yet to hear a good definition.  This, to me, is lessening the impact of travel and tourism on a location and local people.  Responsible travel can mean not staying in a hotel that was made by clear cutting rain forest and using services that protect the environment.  I am all for this concept and applaud those who practice it!  I would like to submit another item to the list of “responsible travel”…reduction of disease spread.

Debarka Banik photoInternational travel has increased from 25 million in 1950 to 898 million in 2007.  2% of the world population (more than 200 million) lives outside their country of birth.  Specific reasons for travel also show interesting statistics.  Business travel, VFR (visit friends/relatives), pilgrimage and health care are increasing reasons for crossing borders.

Obviously, as travel methods improve, more people travel.  Larger and faster methods of travel, think jets and boats, now carry more people.  Studies have shown that the risk for a travel acquired infection increases four times, when the aircraft size doubles.  Larger ships carry more ballast water over long distances, transporting water-borne bacteria to new ecosystems.

Photo Mr. ThomasCruise ships are increasing in popularity, with 11.5 million travelers in 2005.  In the past, cruise ships have served as excellent sources of  infection transportation, as well  as source outbreaks.  For more information on cruise ship specific health, visit here.

Recent examples of disease spread has clearly made use of the international traveler as a method of carrying disease.  Legionella outbreaks on cruise ships, Dengue in Hawaii, Meningitis and the Hajj, SARS and Hong Kong, Tuberculosis and the list goes on.  But this idea of travelers spreading diseases is not new, by any means.

Measles is a very old illness and one of the best examples of travelers carrying disease.  As European explorers traveled to the New World, they also brought measles and small pox.  This decimated local people and expedited the collapse of their civilization.  Attempts at measles eradication are working, as is the ability to better track cases and outbreaks.  This ability allows for comparison of different strains and following effects, globally.  For example, in 2008 a Swiss visitor was hospitalized in Arizona for measles.  The traveler acquired the infection in their home country and subsequently infected nine other people through their voyage. 

Photo AugapfelResponsible travel means not harming the place you are going to.  Carrying disease from one place to another can harm others.  One thing I keep reminding myself is that travel is not “point A to point B”.  There is a return trip in there, eventually.  Nobody wants to bring an infection back with them and spread it around town.  If everybody you have been showing your Safari pics to is sick with a rare African virus a few days later, you will have some angry friends.

Practicing Responsible Travel Health

  • The first way travelers can begin practicing responsible travel health is to realize that they are capable of carrying illness to any of their destinations, including back home. 
  • Second should be basic precautions to prevent disease spread, not only for your sake, but others.  This is hand washing and knowing their immunization status. 
  • Third, research your destination (s) and plan ahead for any potential health issues. 
  • Lastly, take a hard look at immunizations and medicines you might need for your trip.  This often involves a re-check of your childhood vaccines, as well.

Vaccine Preventable Infections 

Several infectious diseases are vaccine preventable.  A traveler who is at risk for contracting these “preventable” illnesses can also carry that disease around the world, infecting many others.  By having the traveler properly immunized, the traveler never gets the infection and cannot carry it to others.  Prime examples of these vaccine preventable diseases include Hepatitis A, Influenza, Measles, Mumps and Polio.  These are “childhood immunizations” commonly given in industrialized nations.

Putting it Together

Travelers are some of the most effective ways to share and communicate new ideas, cultures, opinions and understanding.  As a traveler, you are becoming a participant in Global Health, like it or not.  The responsible thing to do is ensure that you are not traveling the world as “typhoid mary“, spreading illness as you go.  This, to me, is responsible travel.

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