title: Effect of maximizing a travel medicine clinic's prevention strategies.
abstract: BACKGROUND
  Even among travelers who undergo evaluation in travel medicine clinics, illnesses develop despite the emphasis placed on prevention. It is possible that travel-associated disease rates may be modified by maximizing access to care and augmenting educational methods of disease prevention. Use of alternative preventive measures such as alcohol hand gel sanitizers may also alter illnesses among travelers.
  
  
  METHODS
  We assessed medical outcomes in a travel population cared for in the setting of free vaccinations, medications, and travel medicine consultation, in which personal preventive measures were presented in numerous formats by a physician specializing in infectious diseases. An initial demographic questionnaire was administered at the time of travel consultation. A post-travel telephone interview conducted 2 weeks after return from travel evaluated illness while abroad, illness upon return, and adherence to travel recommendations. An assessment was also performed regarding the utility of an alcohol hand gel sanitizer.
  
  
  RESULTS
  One hundred fifty-five travelers were evaluated (primarily older, well-educated US-born travelers, on vacation with family or coworkers). Travelers filled their prescriptions 98% of the time; 77% reported adherence to antimalarial chemoprophylaxis. Sixty-four percent of travelers developed illness abroad, and 20% developed illness upon return. The most frequent complaints were diarrhea and upper respiratory illness. Ten percent of travelers altered their itinerary owing to illness. The use of alcohol hand gel sanitizers did not appear to impact the development of diarrhea or respiratory illnesses.
  
  
  CONCLUSIONS
  In this small group of travelers, access to free consultation, vaccinations, and medications along with presentation of personal protective measures in various formats did not seem to influence the development of illnesses among travelers. Although not rigorously analyzed, alcohol hand gel sanitizers did not seem to alter diarrhea or respiratory tract illness rates. These data highlight the need for new or more effective methods to prevent illness among travelers.
authors.affiliation: Department of Clinical Investigation, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Horvath
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: David P
authors.initials: DP
authors.lastname: Dooley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003140:Communicable Disease Control / Q000458:organization & administration*; D003967:Diarrhea / Q000453:epidemiology; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000458:organization & administration*; D011322:Primary Prevention / Q000458:organization & administration*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012871:Skin Diseases / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014195:Travel / Q000706:statistics & numerical data*; D014481:United States