Pre-travel counseling for immunocompromised travelers

A 12-year single-center retrospective review

Eugene M. Tan, Jasmine R Marcelin, Abinash Virk

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Immunocompromised travelers (ICTs) are medically complex and challenging for travel medicine providers. Our study hypothesizes that ICTs have high-risk travel itineraries and do not have adequate immunity against vaccine-preventable infections. Methods: This retrospective review of 321 ICTs from 2004 to 2015 included patients with solid organ transplant (SOT, n = 134), connective tissue disease (CTD, n = 121), inflammatory bowel disease (IBD, n = 46), and human immunodeficiency virus (HIV, n = 20). Variables included immunosuppressive medications, hepatitis A and B vaccination and serology, gamma-globulin use, and antimalarial and antidiarrheal prophylaxis. Chi-square analysis was used for categorical variables and Kruskal–Wallis for continuous variables. Results: Malaria-endemic regions accounted for 38.9% (125/321) of travel destinations. High-risk activities were planned by 37.4% (120/321) of travelers. A significant proportion of HIV patients [70.0% (14/20)] visited friends and relatives, whereas other ICTs traveled for tourism. Hepatitis A and B vaccination rates were 77.3% (248/321) and 72.3% (232/321). Post-vaccination hepatitis A and B serologic testing were completed by 66.1% (41/62) and 61.1% (11/18) of travelers, respectively. Conclusion: ICTs demonstrate differences in travel patterns and risk. Serologic testing was uncommon, and vaccination rates were low. Providers should screen ICTs early for upcoming travel plans and advise vaccine completion prior to departure.

Original languageEnglish (US)
Pages (from-to)13-22
Number of pages10
JournalInfection, Disease and Health
Volume24
Issue number1
DOIs
StatePublished - Feb 1 2019

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compound A 12
Hepatitis A
Counseling
Vaccination
Hepatitis B
HIV
Vaccines
Travel Medicine
Antidiarrheals
Connective Tissue Diseases
gamma-Globulins
Antimalarials
Serology
Immunosuppressive Agents
Inflammatory Bowel Diseases
Malaria
Immunity
Transplants
Infection

Keywords

  • Immunization
  • Immunocompromised host
  • Vaccination

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Pre-travel counseling for immunocompromised travelers : A 12-year single-center retrospective review. / Tan, Eugene M.; Marcelin, Jasmine R; Virk, Abinash.

In: Infection, Disease and Health, Vol. 24, No. 1, 01.02.2019, p. 13-22.

Research output: Contribution to journalArticle

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abstract = "Background: Immunocompromised travelers (ICTs) are medically complex and challenging for travel medicine providers. Our study hypothesizes that ICTs have high-risk travel itineraries and do not have adequate immunity against vaccine-preventable infections. Methods: This retrospective review of 321 ICTs from 2004 to 2015 included patients with solid organ transplant (SOT, n = 134), connective tissue disease (CTD, n = 121), inflammatory bowel disease (IBD, n = 46), and human immunodeficiency virus (HIV, n = 20). Variables included immunosuppressive medications, hepatitis A and B vaccination and serology, gamma-globulin use, and antimalarial and antidiarrheal prophylaxis. Chi-square analysis was used for categorical variables and Kruskal–Wallis for continuous variables. Results: Malaria-endemic regions accounted for 38.9{\%} (125/321) of travel destinations. High-risk activities were planned by 37.4{\%} (120/321) of travelers. A significant proportion of HIV patients [70.0{\%} (14/20)] visited friends and relatives, whereas other ICTs traveled for tourism. Hepatitis A and B vaccination rates were 77.3{\%} (248/321) and 72.3{\%} (232/321). Post-vaccination hepatitis A and B serologic testing were completed by 66.1{\%} (41/62) and 61.1{\%} (11/18) of travelers, respectively. Conclusion: ICTs demonstrate differences in travel patterns and risk. Serologic testing was uncommon, and vaccination rates were low. Providers should screen ICTs early for upcoming travel plans and advise vaccine completion prior to departure.",
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