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Tropimed® or the art of traveling in complete safety

Translated and adapted version of the article that appeared in the magazine Journal Touristique et Culturel (leisure publication for physicians and pharmacists) No. 11/12 November/December 2007.

Mara Morariu, Pharmacist
 

What if Friday evening, a young couple comes to your office or your neighborhood pharmacy asking for health recommendations for traveling in Brazil. The travel agency advised them to see you for travel recommendations (vaccination plan included). They are planning a trip through the Amazon forest that includes a visit to the Iguaçu waterfalls, the magnificent cascades where water falls from a height of over 970 meters. They plan to leave on this dream vacation in just five weeks and the trip will last for two weeks. Your assistant just left for the day and you are all alone with these patients. You can spend only ten minutes helping them. Your new subscription to Tropimed® will be extremely useful to you now! But do you remember how to use it?

Resolution of this scenario at the end of the article

 

Tips for efficient and rapid use of Tropimed®, a travel medicine software product for health professionals.

A) 

In order to determine the travel medical recommendations and the appropriate Travel Medicine Kit for the trip and create a vaccination plan, you must obtain some basic information.

Here is a review of essential information you need in order to evaluate the travelers' specific needs:

  • Personal data, including departure and return dates
  • Knowledge of specific groups of travelers (e.g., any young children, pregnant or breastfeeding women, elderly)
  • General health information of the travelers (e.g., any current medications, chronic illnesses, allergies, heartburn)
  • Kind of travel planned (e.g., vacation with excursions, business travel, trekking, humanitarian mission)
  • Means of travel (e.g., air travel increases risk of thrombosis in pregnant women)
  • Characteristics of destinations (e.g., sun exposure, insects)
B) 

For vaccinations and disease prevention, it is recommended to consult the Tropimed® database. The ideal solution is to create a Travel Report that you can give directly to the patients and also send to them by e-mail. You can use either:

  • Tropimed® online - preferable because it is regularly updated and provides the most recent epidemiological news
     
  • The most recent version of Tropimed® on CD-ROM installed on your computer

Once you have logged into Tropimed® online, you have direct access to the most recent epidemiological news and information updates.

To create a Travel Report, first click on the icon . Then, follow the five steps for the traveler’s file, clicking on the arrow (on the left side in the "travel report" next to "steps") to move from one step to another:

1.  Itinerary: practical, especially if the trip involves stays in several countries, as you can create a general vaccination plan;
2.  Vaccines-prophylaxis: selection of the necessary vaccinations, vaccine types and special needs;
3. 

Vaccination plan: based on your selection, automatically indicates the recommended intervals for the vaccinations and optimizes the number of medical consultations:

4.  Creation of the Travel Report: allows to add practical information, such as:
  • Location-specific information :
    • Geographical and epidemiological maps
    • Country information (disease-related risks and recommended preventive actions)
    • Useful addresses (embassies, consulates)
    • Climate information
       
  • The checklist, includes all recommendations to follow before, during and after the trip, such as:
    • Advice about disease prevention (AIDS, malaria, hepatitis, etc.)
    • Sun exposure, protection against mosquitoes
    • Food (reminder of basic rules such as: “ Boil it, cook it, peel it - or forget it! ”
       
  • Further information :
    • Recommendations (Medication Certification, malaria Chemoprophylaxis and Self-Treatment, HIV Infection and AIDS, Travelers’ Diarrhea, diving accidents, etc.)
    • Diseases (cholera, malaria, ebola, aids, etc.)
    • Vaccines (information about different diseases and the vaccine types available, travel-related efficacy of vaccinations, Recommended Childhood and Adolescent Immunization Schedule, Vaccines for the Immunocompromised, etc.)
       
  • Handouts for patients, examples:
    • Elderly Travelers
    • Rehydration in cases of diarrhea and/or vomiting
    • Insect bites
    • Medical Kit for Travelers
    • Sexually Transmitted Diseases
    • Jet Lag
Tips: The references for health professionals as well as personal documents if available (certificates, list of chronic medicines, allergies, etc.) can be directly inserted into the Travel Report. You first create the document by clicking the icon Personal document and then import it afterwards.

 

5.  Display information: allows viewing of the Travel Report anytime
 
D)

The Travel Report is created in less than 5 minutes and can be printed or sent by e-mail with only a few mouse clicks.

With Tropimed® you can: Advantages
Create a Travel Report in less than five minutes (vaccination, general advice) Time saving
Create a vaccination plan according to the date of departure and itinerary (to optimize vaccinations and reduce consultations)

Security for Travelers
Improvement of compliance

Deliver the Travel Report directly by e-mail with the references for health professionals Speed
Environmentally friendly (paperless)
Deliver the Handouts for the travelers

Customized information /Handouts, e.g. :
  - Pregnancy and travel
  - Medical Kit for Travelers
  - Sexually Transmitted Diseases-
  - Diabetes and Travel
  - Bringing medication with you

Display the geographical maps and more specifically the maps of endemic areas (malaria, yellow fever, etc.) Efficient and convenient
Directly find the information about vaccination centers, embassies and consulates Time saving
Access the Tropimed® database anytime (even without an internet connection using the CD-ROM) Access reliable information around the clock

The use of the Tropimed® database guarantees safe and official information, thanks to the regular updates of medical recommendations provided by collaborating scientific teams:

  • Recommendations for the United-States by Henry W. Murray, M.D., Professor and Associate Chairman of Medicine at Weill Medical College of Cornell University and Attending Physician at New York Presbyterian Hospital in New York City. Dr. Murray provides consultation services for travelers at Cornell's International Health Care Service.
     
  • Recommendations for Switzerland by the Expert Committee for Travel Medicine, that includes Professor Robert Steffen, author of Tropimed®. Professor Steffen is the Head of the Division of Epidemiology and Communicable Disease Prevention at the Institute of Social and Preventive Medicine at Zurich University, Director of the World Health Organization Collaborating Center for Travel Health and editor of the Journal of Travel Medicine.
     
  • Recommendations for Germany are provided by the Institute of Tropical Medicine and the Charité - University Medicine of Berlin (directed by Mrs. Prof. Dr. Gundel Harms-Zwingenberger) under the coordination of Dr. Christian Schönfeld, Head of Ambulatory Travel Medicine.

The sources of the recommendations are quite diverse and country-specific: from the acclaimed Centers for Disease Control and Prevention (CDC) to the "Office fédéral de la santé publique" (OFSP), the World Health Organization (WHO) and the indispensable "Ständige Impfkommission" (STIKO) at the Robert Koch Institute.

Practical case resolution (recommandations valid for November 2007)

In this practical case, vaccination or chemoprophylaxis against a total of ten diseases is recommended (see chart 1). It should ideally begin five weeks before departure (cf. vaccination plan calculated automatically according to vaccination schedules).

summarised table of prophylactic measures

 

General precautions such as “Peel it, cook it, or forget it !” are advised for the entire trip, in particular to prevent travelers' diarrhea.

In summary, the couple should make sure that they are protected against these diseases or if necessary, immediately start their vaccinations at their doctor’s office or local vaccination center.


References


Mara Morariu, Federal Pharmacist