Respiratory Tract Infections in Travellers

Respiratory tract infections (RTI’s) are the 3^rd most common health issue affecting international travellers. Incident rates range from 5% to 40% depending on the region of travel and particular activity. This is likely a gross underestimate given the fact that most RTI’s are annoying rather than life-threatening. Most individuals will manage their own illness and not seek out a primary care practitioner or hospital. Travel activity has a major bearing on level of risk: Cruising has a greater risk than visiting game parks in Africa; and, large group travel poses a greater risk than travelling solo or with family or friends.

Studies rarely note the impact of RTI’s on the enjoyment of a holiday or whether the business trip has been compromised.

Respiratory tract disease should also be considered in any discussion on RTI’s in travel. The impact on the upper airways can be considerable when visiting places with high levels of environmental air pollution such as New Delhi, Ulaanbataar. The cause of the illness may not be a bug but the discomfort from an allergic sinusitis can also be severe.

• Most upper respiratory tract infections are viral.
• Some individuals are at a higher risk of severe disease
• Influenza is the commonest vaccine preventable disease in travellers
• Pneumococcal vaccine is a routine immunization for individuals over 70 years.
• In older travellers, lower respiratory tract disease often complicates an upper respiratory tract infection and antimicrobial treatment is usually required
• Some RTI’s are more likely to be found in particular localities. These are rare.

• Consider a flu vaccine for your trip. For some it will be routine (> 65 years or < 5 years or those with pre-existing health issues). For others, it will be something you might consider because of travel. You might be taking a long overdue holiday or about to make important decisions on a business trip. Why would you risk illness when it could be prevented.
• Carry a course of antiviral flu medications if you are at risk of serious complications from influenza. These can be difficult to access while travelling. A confirmatory diagnosis should be sort at all times.
• Consider taking a course of appropriate chest or sinus antibiotics with you. You may not have easy access to health services, or local medications may not work as well. It may be 3 am in the morning when you start with a productive cough or severe sinus pain.
• Make sure you reduce exposure through regular handwashing and appropriate use of masks in high-risk situations (airports, crowded commuter transport, etc).
• Review the Pocketbook on Healthy Travel. It takes you through the management of RTI’s from the minor URTI to the more serious lower respiratory tract infections.
• Consider booking a Virtual Travel Consult 4-6 weeks before you travel overseas.