Preparing for travel of any kind can always bring a headache. You have to make sure the necessary charging cables are packed, figure out which clothes you need to wear, double-check your reservations. And with enough planning on your own, you can foresee most of what needs to be resolved ahead of time to ensure a happy and safe journey.
Depending on where you’re going or on your health history, however, some expert advice can also be critical in the planning process. Dr. Judy Streit, Clinical Associate Professor of Infectious Diseases and Director of the UIHC’s Travel Medicine Clinic (TMC), is one of those experts. Since getting its start nearly 20 years ago, the TMC has offered counseling, vaccinations, and medications to help travelers stay healthy during their trip.
“It’s a unique clinic because people are generally well, so our work is preventative most of the time,” Dr. Streit says. These travelers—“I don’t like to call them patients”—come to the TMC from around the state. “Sometimes it’s someone going to Indonesia to purchase exotic tea; other times it’s someone entering the Peace Corps with plans to live in a hut for a couple of years. But I almost always get that sense of vicarious adventure, which makes it an enjoyable clinic.”
One of the most important activities providers in the clinic must do is stay aware of emerging as well as existing infections. Although the Zika virus in the Caribbean and Latin America is grabbing headlines, a few years ago it was dengue fever or chikungunya, which still require discussion, or there are malaria and yellow fever, which always require a risk assessment. The best resource available for education, Dr. Streit says, is the Centers for Disease Control and Prevention, which publishes guidance to prepare for travel to most destinations. There are also subscription websites for clinic staff that provide expert advice and updates that can be “more granular and nearly real-time.” These resources, combined with staying in contact with other Travel Medicine providers around the country, help Dr. Streit and her colleagues give their travelers as accurate as possible a picture before they set off.
The clinic itself is staffed by five providers—three physicians, an ARNP, and a PA—and sees about 60 travelers a month. They expanded the number of clinic visits five or six years ago, Dr. Streit reports, and TMC has kept those new slots and their existing ones almost continuously full. Additionally, they have now established services at the Iowa River Landing location, as Dr. Todd Wiblin has added travel medicine to his general medicine clinic there. TMC has also begun to explore the opportunities afforded by technological advances and the nature of their practice, such as telehealth for consultations with travelers or with other providers.
As smoothly as Dr. Streit and her colleagues have engineered their clinic, there are still the occasional bumps, from vaccine and medication shortages, which can force some logistical juggling, to the seasonality of travel, when TMC could use some additional slots. “The conversations we have in clinic adapt to the specific circumstances of the traveler, their itinerary, and infectious disease current events,” Dr. Streit says. Ultimately, though, the clinic’s goal is to provide the traveler with a comprehensive picture of what he or she may encounter and guidance to make informed decisions before and during their trip. “As much information as we can provide so that they can make the best decision for themselves.”
And though the international health threats may change and the clinic’s providers now prescribe antibiotics in more considered ways due to resistance concerns or evolving knowledge of drug interactions, TMC’s consistency of excellence continues. “Our primary success,” Dr. Streit says, “isn’t readily measured.” If they have done their job correctly, she explains, of properly preparing a traveler to visit a far-flung part of the world, they expect to never hear from or about that person again. “It’s the proverbial ‘no news is good news.’” Until the next trip.
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