Summer brings an increased number of international travelers, and physicians are often asked about travel immunizations. Travel Medicine is a specialty dealing with the prevention and management of health issues facing international voyagers. Good health is obviously important for everyone, but it becomes even more relevant when people travel outside our borders.

Increased international travel to Asia, Africa, South America and to areas which were formerly considered inaccessible has increased the need for travel consultations and immunizations throughout the nation. One company has taken the lead: Passport Health (www.passporthealthusa.com) is the largest private provider of immunizations in the U.S. Hundreds of thousands of doctors throughout the United States refer their patients to Passport Health for specialized pre-departure counseling, travel & safety advice and immunizations prior to their international excursion.

In South Florida, Passport Health has a well-represented network of travel clinics that provide all types of vaccinations; and, this is becoming more and more attractive to primary care physicians, ObGyn’s and pediatricians alike. “We have known for a while that the reimbursement schedule for vaccines never benefits the doctor,” said Fran Lessans, Passport Health’s founder and CEO. “You have to consider the time explaining the need for a specific vaccine as well as its side effects, administration, documentation, record keeping and monitored storage. Insurance typically does not cover travel immunizations. Even if insurance does cover a vaccine it is often at or below the actual cost of the vaccine. By the time you are done you lost money,” she added.

In a 2008 survey of pediatricians and primary care physicians, nearly 50% of the 800 doctors who responded said they had delayed buying at least one vaccine because of the cost. About one in five said they felt strongly that reimbursement for the purchase and administration of vaccines was not adequate. ABC News reported on June 16, 2009 of another survey which reveals that one in ten doctors who vaccinate privately insured children are considering dropping that service largely because they are losing money.

“We do not treat or diagnose,” continued Karen Kluge, R.N., Executive Director at Passport Health Boca Raton. “We provide destination-specific counseling and immunizations to travelers and general wellness vaccinations like Hepatitis A & B, Pneumococcal, TDaP and HPV.” After each consultation with the traveler’s permission, Passport Health sends a letter to the patient’s primary care physician advising of all immunizations received. “We do not compete with primary care physicians. We concentrate on immunizations,” she concluded.

Although Passport Health provides a wide array of immunizations, the company focuses on providing education, counseling, vaccinations and medications to international travelers. Kluge stated that even seasoned travelers risk illness if they enter endemic areas where diseases such as Yellow Fever, Malaria and Japanese Encephalitis, thrive.

Travel Medicine, like any other medical specialty, is practiced by medical professionals who have undergone rigorous training and must keep up with ever changing recommendations, outbreaks and pathogen resistance to medications.

Those in practice are trained in global epidemiology of health risks to the traveler. These include tropical diseases, pathology, altitude medicine, and malaria prevention. Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and referral.

“In the United States, there are about 33 million international travelers every year; and this does not include those who are traveling to Mexico or Canada. Most of them unfortunately travel unprepared; some do not even have insurance or emergency evacuation means,” said Claudie Boulay, RN, Executive Director at Passport Health Miami in closing.