Burlington Travel Clinic

EXPATRIATES

After You Return

Expatriates

Have a placement in Nigeria drilling for oil? Have you been chosen by your organization to install a new power plant in rural Iraq? Doing humanitarian aid work in the Philippines to help the typhoon victims?

These are examples of when you would be an expatriate. In Latin, an “expatriate” means “out of country”. The name is commonly shortened to simply, ‘expats’.

Large numbers of professional and skilled employees are selected by their employers and organizations to go overseas on missions of varying nature to spend extended periods of time.

To accomplish the mission safely and successfully, preparation is key.

Destination specific vaccination, chemoprophylaxis and advice are the responsibility of both the expat traveller and the organization sending them.

Due to the long duration of stay, expats have more exposure to whatever their new surrounding environment will offer and hence, more risk. Thus, pre-travel consult is an imperative part of the their mission.

In this special sector of travellers, infectious and physical ailments are not the only risk. Psychological problems and stress are very common with expats, as they often experience culture shock when becoming acclimatized to their new environment. When expats are accompanied by their families, it’s common for the culture shock that their spouse and children experience raise their stress levels that much higher.

Part of the pre-travel consult will be to address all the psychological issues expats may face and how to implement stress-relieving measures and coping mechanisms.

A lot of expats terminate their missions because of lack of pre-travel preparation and medical advice.

Please Note:

  1. The information in this page is for educational purposes only. It is not to substitute for a formal travel consult with your travel doctor.
  2. Always seek immediate medical advice if you get sick abroad.

Visiting Relatives and Friends (VFRs)

VFRs are travellers visiting their friends and relatives in the country of their cultural and ethnic background.

Due to the cultural diversity that resulted from immigration to Canada during the last few decades, millions of Canadians visit their home country every year.

This considerably big sector of travellers is very important to address due to many reasons:

VFRs think they are immune to infectious diseases present in their country of origin, like malaria for example, and don’t realize that they might have lost this immunity over the years due to decreased exposure to those disease threats.

Furthermore, children of VFRs are not immune to diseases their parents are immune to, since the were never exposed like their parents were at a young age. This is particularly true for Hepatitis A. Most adult VFRs become immune to Hepatitis A before they immigrate to Canada so they may assume their children are as well.

The high prevalence of certain diseases in most VFRs’ countries of origin, namely malaria and typhoid fever, are both very serious and preventable. For example, Indian-Canadian VFRs are at considerable risk of acquiring typhoid fever or malaria during a trip to the Indian subcontinent.
This may result in exportation of numerous cases of malaria and typhoid fever, which pose risk not only to the VFR travellers themselves but to the public as well.
It is highly recommended that all VFRs seek a pre-travel consult before visiting their countries of origin.

Please Note:

  1. The information in this page is for educational purposes only. It is not to substitute for a formal travel consult with your travel doctor.
  2. Always seek immediate medical advice if you get sick abroad.

Pregnant and Breast-Feeding

Pregnant and breast-feeding travellers represent a challenge. Certain vaccines and medications cannot be given safely to this group of travellers.

The pregnant traveller is more prone to adverse events and travel-related risks rather than a non-pregnant traveller.

It’s always advisable for pregnant travellers to see their obstetrician and their travel doctor before departure.

Before the use of DEET and other insect repellents during pregnancy and breast-feeding, ask your travel doctor.

Please Note:

  1. The information in this page is for educational purposes only. It is not to substitute for a formal travel consult with your travel doctor.
  2. Always seek immediate medical advice if you get sick abroad.
Breastfeeding, EXPATRIATES

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Children and Infants

Whether going for a safari family vacation, accompanying family to visit friends and relatives, or relocating with an expatriate parent, these little travellers need extra care from both the parents and a travel doctor.

Children and infants are more prone to travel-related risks and complications than adults.

Injury is at the top of the list and should be avoided by all possible measures. Special attention should be paid to drowning and motor vehicle accidents. Children should always be supervised by an adult around recreational water outlets such as swimming pools, water parks and the ocean.

Let the kid have fun, they are on vacation, but you should not ignore safety! Floating devices should be used all the times. A very good idea is to bring flotation devices from home in case they are not available at your destination.

Some developing countries vehicles are not equipped with seat belts or child seats. The latter should also be brought from home.

The most important advice to parents is be extremely careful walking children in the streets in developing countries where drivers may not abide by the traffic laws, resulting in devastating pedestrian accidents. Parents should assume there is no speed limit in developing countries until proven otherwise.

Risk is the highest among children and infant VFR travellers, especially malaria, typhoid fever and Hepatitis A.

Malaria is among the most serious and life-threatening disease that can be acquired by pediatric international travellers. Pediatric VFR travellers are at particularly high risk for acquiring malaria if they do not receive chemoprophylaxis.*

Appropriate antimalarial medications are required for all pediatric travellers going to endemic areas.

Children and infants are more prone to malaria complications, thus mosquito safety and measures should be always implemented, especially insecticide-treated bed nets and DEET. DEET is safe for children and infants older than 2 months if used properly (See: Mosquito Safety).

All pediatric travellers to malarial zones should be on antimalarial medication. Ask your travel doctor for the appropriated antimalarial vaccines for your children.

Although typhoid fever can occur worldwide, especially in developing countries, a VFR traveller to the Indian subcontinent or Southeast Asia should be extremely cautious about practicing food and water safety (See: Food and Water Safety). An effective typhoid fever vaccine is available for children 2 years of age and older (See: Vaccines).

North American infants and children are not immune to Hepatitis A which is endemic in many destinations worldwide like the Caribbean, Africa, Asia and South America. A very effective vaccine against Hepatitis A is available.

Diarrhea and associated gastrointestinal illness are amongst the most common travel-related problems affecting children. Infants and children with diarrhea can become dehydrated more quickly than adults.*

Food and water safety is the most important preventative measure (See: Food and Water Safety).

A valuable tip to parents when their child is experiencing diarrhea and/or vomiting: Don’t use over the counter antimotility and antiemetic medications.

As mentioned earlier, children become dehydrated quickly, so ORS should be used. Commercially available ORS packets should be on the packing list in case they are not available at your destination.
For more information on ORS, please visit:

http://travel.gc.ca/travelling/health-safety/rehydration 

Protection against the sun should be also be implemented by parents (See: While You’re There).

For more tips about healthy travel with children, please visit:

http://travel.gc.ca/travelling/health-safety/children

Please Note:

  1. The information in this page is for educational purposes only. It is not to substitute for a formal travel consult with your travel doctor.
  2. Always seek immediate medical advice if your child gets sick abroad.

*Centers for Disease Control and Prevention. CDC Health Information for International Travel 2014. New York: Oxford University Press; 2014.