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No Place Is 100% Safe. Read How To Manage The Risks Of Your Trip.

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Managing risks is the biggest part of traveling safely.

A vacation in Thailand, hiking the Inca trail or a business trip to Rio: every trip has a different level of risk. Unfortunately, no trip is without risk. Even a short excursion to your local grocery store could end poorly. But, there are ways to manage the risks.

Understanding the Risks of Travel

The first step to planning any trip, whether we are doing it consciously or not, is assessing the risks. Would you think of booking a flight to Damascus for vacation in 2016? Probably not, due to the current risks associated with traveling to Syria.

A recent article in Stratfor looked at the myth of ‘total security,’ or the idea that a location can be totally secure. The author pointed out a key, very interesting fact about travel. People tend to fixate on highly publicized events.

The 2015 and 2016 terrorist attacks in Europe show this to be accurate. Tourism to Europe fell, and many questioned whether it was safe to travel to the continent at all. But, understanding the risk can give us a better idea of the true situation.

Fires, natural disasters, accidents and disease kill far more people each year than terrorist attacks and homicides. One quote from the article sums this up nicely:

The bottom line is that there is no such thing as absolute safety and security. And since more people die from household accidents every year than from terrorism or criminal homicide, holing up inside your home is no guarantee of safety.

Mitigating Travel Risks

Once we understand that there are risks to traveling, we need to find ways to mitigate them. Let’s use Brazil as an example. The primary risks associated with travel to Brazil are:

  • Crime– Petty theft is fairly common in tourist areas, but ‘hard’ crime occurs in many outlying regions.

  • Disease– Zika may have made headlines, but a variety of other infections are present including yellow fever, malaria, dengue fever, typhoid and hepatitis.

  • Political unrest– Protests have become more common in Brazil, especially during important events.

Now that we ‘know’ the risks, how can we mitigate them? The first step would be to learn more. In the case of crime, the U.S. State Department is a good resource as it offers country-specific web pages that discuss what to do in case something happens. It also discusses what to do in case of political unrest.

For disease, Passport Health has a wide range of resources to help educate about the potential risks in Brazil (and other countries) including vaccination pages, Brazil-specific pages and even information on how to get your visa for Brazil. By using these resources, you can learn more about the risks, and then start taking steps to mitigate them.

In the case of crime and political unrest, the key is to avoid potential trouble spots and then take certain precautions, like not wearing flashy clothing. But, you can’t always avoid infection.

This is what vaccinations and other preventative measures are for. Through vaccination and items like antimalarials or mosquito nets, diseases can be often be prevented and trips can become even more enjoyable.

Change Your Mindset

Education and vaccination can only go so far in protecting you from risks. A change of mind needs to happen as well.

You may not be used to putting on mosquito repellent every time you go out, or looking in the opposite direction for a car in England. But, such behavioral changes could save your life.

The Stratfor article told the story of an American teacher in Libya who decided to go running every morning and was killed. While running isn’t usually a risky activity, it can be if you are in an unsafe area. Remember this when you travel.

If you are worried about risks during your trip, do what you can to avoid them. Learn about which risks may be present, take steps to mitigate them, and be sure to keep them in mind as you go. No place is 100 percent safe, not even your home. Do what you can to make your journey as safe as possible.

To learn more about travel medicine and how it can reduce risks and protect you as you travel, see our travel medicine portal.

No matter what stage you are at in your trip planning process, be sure to contact Passport Health about what you need to stay safe. Our travel medicine specialists will make sure you have everything you need to stay safe as you travel. Call or book online to schedule your appointment today.

What do you do to prevent travel risks? Post your answer in the comments below or Facebook or Twitter.

Traveling To Thailand? Find Out Which Vaccines Are Right For You

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The people of Thailand make the country a great place to visit

Thinking of Thailand invokes images of blue waters, sparkling beaches and tropical drinks while watching the sunset. Who doesn’t dream of relaxing on a stunning beach in Thailand and snorkeling through the azure waters? However, make sure you are well protected before your exotic adventure. Vaccinations for Thailand can help ensure your good health during your trip and upon your return home.

Which Vaccines Do I Need for Thailand?

Vaccination recommendations vary based on itinerary. If you are traveling to Thailand for business or pleasure you may need certain vaccinations, but an aid worker, for example, will likely need many more. The Centers for Disease Control and Prevention and World Health Organization recommend you receive these vaccines:

  • Typhoid– Food and water in Thailand have been known to carry typhoid. Be careful with what you eat and drink, and make sure you are vaccinated.

  • Japanese Encephalitis– This vaccine is very important for many travelers to the region. Japanese encephalitis is a mosquito-borne disease, meaning you could catch it at any time. Take proper precautions against mosquitoes in general, and speak with a travel health specialist about the vaccine.

  • Hepatitis A– Another food and waterborne disease, hepatitis A affects many each year. Make sure you are up to date on this immunization.

  • Hepatitis B– Transmitted through contaminated needles, blood products and sex, hepatitis B can be a serious risk. Vaccination is key to preventing the disease.

  • Rabies– While not a common disease in Thailand, the rabies vaccine is recommened for some travelers who may have contact with wild animals.

For more information on these vaccines or to find out where to schedule a travel consultation at your local Passport Health clinic, give us a call at or book online today.

Which Other Diseases Are Present In Thailand?

Sometimes there aren’t vaccinations to protect against some diseases. Though Thailand is a magical place, these diseases can be present:

  • Malaria– The CDC recommends antimalarial medication for some itineraries. Talk with a travel health specialist to learn if this applies to you.

  • Dengue Fever– This mosquito-borne disease is present in Thailand, so be sure to use netting and mosquito repellents when possible.

  • Zika Virus cases have been reported in Thailand. Pregnant women may want to consider postponing a trip. Precautions against mosquitoes are recommended for all travelers.

  • Traveler’s Diarrhea is the most common illness to afflict international travelers, and traveler’s diarrhea can be caused by a variety of factors. To avoid it, be sure to watch what and where you eat, and avoid unfiltered water or ice cubes. Remedies like DiaResQ can help treat diarrhea if it occurs.

  • Bed Bugs– While this may seem odd, bed bugs are in issue in Thailand, according to the CDC. If you suspect there are bed bugs where you are staying, contact the manager or landlord.

To learn more about these infections, see their respective pages. If you are planning a trip to Thailand, schedule your appointment with a Passport Health travel health specialist today by calling or booking online now.

What Else Should I Know Before Leaving For Thailand?

With amazing beaches and fantastic sights like Wat Chaiwatthanaram, Thailand is a ‘must visit’ for many international travelers. But, there is some more prep work need to help you get ready for your trip.

Be sure to have your itinerary finalized before you go. Having this ready will help you be better prepared for what you’re planning on doing and keep you safe. Thailand is a generally safe country, but some places off the beaten path require caution.

Also, don’t forget to have your passport ready. While Thailand doesn’t require a visa for stays under 30 days, you will need to have at least six months’ validity left on your passport. If you need any help or have any questions about renewing your passport, please feel free to reach out to Passport Health’s Passport and Visa Expediting Service for help. Our representatives can be reached by calling 1-844-366-8472 or contact us online now.

Six weeks before your scheduled departure date for Thailand, make a visit to a Passport Health travel health specialist. We will review your medical history, provide the vaccinations and preventive medications you need, and give you advice to help keep you healthy before, during, and after your trip. Call us at or book your appointment online and start protecting yourself today.

Do you have any travel tips for Thailand? Share them with the Passport Health community in the comments below, on Facebook or via Twitter.

What Was The Plague of Justinian? How One Outbreak Killed 10% Of The Population.

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The Justinian Plague killed millions many of them military commanders or soldiers.
A commander from the Justinian era leads his troops against the Goths.

Imagine a plague that infected millions in just a year, killing as many as 5,000 people per day. For the Eastern Roman (Byzantine) Empire, this nightmare was a reality. Beginning in about 541 CE, the Plague of Justinian swept through Europe, killing up to a quarter of the Eastern Mediterranean population and possibly as much as 10 percent of the world’s population.

What Was The Plague of Justinian?

Despite the catchy name, the Plague of Justinian was identified as the bubonic plague, otherwise known for its 14th Century cousin, “The Black Death.” The disease earned its name from Justinian, the ruler of the Byzantine Empire at the time. It also has a double meaning, as Justinian’s handling of the crisis was almost its own form of infection.

As farmers and other workers were dying by the thousands, Justinian was unable to complete many of the projects he had started and began to raise taxes and change the tax code.

Procopius, a scholar of the time, explained:

“When pestilence swept through the whole known world and notably the Roman Empire, wiping out most of the farming community and of necessity leaving a trail of desolation in its wake, Justinian showed no mercy towards the ruined freeholders. Even then, he did not refrain from demanding the annual tax, not only the amount at which he assessed each individual, but also the amount for which his deceased neighbors were liable.”

What Were the Symptoms of the Plague?

We don’t know the exact symptoms of the Plague of Justinian. The current symptoms for bubonic plague include:

  • Fever
  • Headache
  • Chills
  • Swollen or tender lymph nodes
  • Abdominal pain
  • Gangrene

Procopius described victims suffering from these and also other symptoms including:

  • Delusions
  • Nightmares
  • Comas

He even said some would die almost immediately after the onset of symptoms. However, we don’t know how accurate his reporting was. Procopius said the plague was killing 10,000 people every day, but modern estimates put the daily death toll to closer to 5,000.

How and Where Did the Plague Spread?

Like the modern bubonic plague, scientists believe the Plague of Justinian spread through fleas. Studies indicate the plague may have originated in China or India and was then transported to the fertile valleys of Egypt through trade routes. In 541, the Egyptian port of Pelusium was the first city to document cases, and, by 542, cases were seen as far north as England.

Due to the nature of ancient records, we don’t know the full extent of the disease’s spread. We know the Mediterranean region was the hardest hit, but anecdotal evidence indicates some cases occurred in England, Germany and other northern regions.

What Effects Did the Plague Have?

Justinian wasn’t just a leader; he was also a conqueror. By 542, he had reconquered most of the Roman Empire’s previous domain and was hoping to solidify his rule. The plague made this all but impossible as farmers, soldiers and other key members of society fell ill and died from the disease.

By 568, Justinian’s empire began to crumble as the Lombards invaded Northern Italy, and, within a few generations, enemies were at the gates. Byzantium remained a power through 1453, but it would never be as large as it had been before the plague.

Could The Plague of Justinian Resurface?

Just as with many other ancient diseases, this question has been under investigation for years. A study conducted by Northern Arizona University found the Plague of Justinian came from a now extinct form of Y. pestis or bubonic plague. So in short, it is still around. But, we are unlikely to see anything like Justinian’s Plague or the Black Death in modern times.

“We’ve greatly improved hygiene since the times of the great pandemics,” said one researcher. “The other thing is we not have antibiotics, and plague is susceptible to every antibiotic.”

To learn more about bubonic plague, see the CDC portal. To learn more about other eradicated, or nearly eradicated diseases, see our polio and measles, mumps and rubella pages.

If you are planning a trip, especially one where you may come in contact with rodents, book an appointment at your local Passport Health by calling or booking online today.

What are your thoughts on this terrible plague? Let us know in the comments below, on Facebook or Twitter.

Travel Medicine and Travel Vaccines: An Investment with a Healthy Return

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Travel vaccines are key for protecting business travelers' health.

Industry-leading Research
Industry-leading Research
Key Takeaways for Employers:
  • Eradicated or unknown diseases in the U.S. are present in many foreign countries.
  • Employers can protect the health of their business travelers by providing them with a Travel Medicine Program. This includes pre-travel vaccinations, a pre-travel physical exam, and a travel health consultation.
  • A Travel Medicine Program will result in a considerable return on investment from diminished employee medical costs, less absenteeism, and greater productivity.
  • Business travelers are at a higher risk of disease exposure.
  • A single day of missed work abroad costs corporations an average of $1,201.

Your company just landed that hard-won overseas contract. Now, you are preparing to send a team of highly-trained specialists around the globe to implement the deal. Sending employees overseas involves more than securing passports, plane tickets, and hotel reservations. It is also crucial to ensure employees are up-to-date on travel vaccines and knowledgeable about health issues. A Travel Medicine Program is key to protecting your investment – in your people and in your business.

Your company is likely staffed with globe-trotters. Global travel is at all all-time high, and much of that is driven by corporate travel. The latest statistics from the United Nations World Tourism Organization show that 1.035 billion tourists traveled the globe in 2012. Of those billion plus travelers, approximately 27 percent, or 280 million employees, traveled on business.

In 2012, nearly 280 million employees traveled on global business trips. Were your employees part of this figure?

As businesses seek new deals, new markets, and lower production costs, the exposure to risk increases. International business travelers have an increased risk for injury, illness, and exposure to diseases that are unknown at home. This can raise the corporate liability of employers.

One way for employers to protect the health and well-being of employees is preventing disease in the first place. A Travel Medicine Program that includes pre-travel vaccinations, a pre-travel physical exam, and a travel health consultation is the key to doing this.

What Are The Benefits of Vaccination?

The life-saving benefits of immunizations are widely documented. According to the World Health Organization, 2 to 3 million deaths are prevented globally each year as a result of vaccination efforts. Industry-leaders like the Gates Foundation recognize the overwhelmingly positive impact of vaccines. The Foundation has invested $10 billion to strengthen global immunization programs and save 10 million lives by 2020.

Many health risks that come with global travel are not routinely vaccinated against in the U.S. Without guidance, employees may be unaware of the disease risk in their destination country. A Travel Medicine Program will help ensure your employees are aware of, inoculated against, and equipped with a strategy to handle health concerns abroad. It will result in considerable return on investment from diminished employee medical costs, less absenteeism, and greater productivity. More importantly, it may save a life.

Diseases that have been eradicated or are unknown in the US are endemic in many foreign countries. Is your workforce protected?

The Health Risks of International Travel: Disease Exposure

International travel poses some inherent risks. Many countries have disease that are not present in the United States. Because of this, various vaccinations have been recommended by the Centers for Disease Control for travelers:

  • Typhoid– A food and water borne illness, typhoid affects millions of people every year.
  • Yellow Fever– This mosquito-borne in many parts of the world, especially South America and Africa. Some countries require this vaccine in order to enter.
  • Rabies– While not always recommended, the rabies vaccine is something to seriously consider for long-term travelers to certain regions.
  • Polio– This disease is still present in some parts of the world, if you have not already been vaccinated, you may need to be.
  • Japanese Encephalitis– Common throughout Asia, this vaccine is very important for travelers to the region.
  • Hepatitis A– Another foodborne disease, hepatitis A outbreaks have been documented in many countries over the last five years including developed nations.
  • MMR (Measles, Mumps and Rubella)– Most of these diseases have been eliminated in the U.S. but are still common in other nations.

Not all infections can be prevented with vaccination. Some require pills or can only be remedied, not necessarily avoided:

  • Malaria– Some countries are still struggling with malaria. If you plan on traveling to an affected region, antimalarials are a must.
  • Traveler’s Diarrhea– The most common ailment amont travelers. Unfortunately, there is no vaccine to prevent this illness. But, there are many good remedies like DiaResQ.

To learn more about these infections and their vaccines or treatments, see their respective pages.

The risks of disease abroad are not just hypothetical. A recent case study showed just how tragic the lack of pre-travel education and vaccination can be:

When 15-year-old Cara Munn traveled to China for a summer study abroad program with her prep school, no one from the program warned her or her parents about insect-transmitted diseases in China, and no one took steps to ensure the high school students were taking precautions against insect bites during the trip. The result – Cara Munn contracted encephalitis after a tick bite on a school hiking trip near Mount Panshan. Cara’s family arranged for her medical evacuation, but her illness brought with it a host of life-long injuries, including the inability to speak. A jury found her school, which sponsored and led the trip, guilty of negligence. Cara Munn and her family were awarded $41.7 million in damages.

CT Post

With global air travel on the rise, both the CDC and WHO have reported an increased risk of exposure to infectious diseases. Some infections like measles and mumps are passing into the United States through unvaccinated people.

Globalization, co-mingling of populations, and air travel increase the risk of exposure to infectious disease.

Mitigate Health Risks with Travel Medicine

Disease risks can be mitigated by a Travel Medicine program that includes:

  • Travel vaccines – protect against disease
  • Health advice – prepare for health risks in the destination country
  • Pre-travel physical exam – identify latent conditions

These programs protect a company’s investment in its employees and save employees the heartache and hassle of being sick while away from home. By providing protection against diseases and by helping pinpoint health issues, the risk of medical emergencies occurring abroad is greatly mitigated. The risks of travel and resulting need for travel medicine are clear.

What Is A Typical Travel Medicine Appointment Like?

First, an office visit should be scheduled at least six weeks before travel. Some vaccines will take a few weeks to fully protect someone. The appointment will include:

  • A review of prior immunizations to determine whether booster shots are required.
  • Routine vaccinations, against diseases such as polio, measles, or hepatitis B may be given based on medical history.
  • Other, destination-specific vaccinations such as yellow fever, typhoid fever, and rabies, may be given based on a traveler’s itinerary
  • A routine physical exam helps to identify latent health issues.

By scheduling an office visit well in advance of a trip, business travelers and their employers can rest easy, knowing that vaccinations provide crucial protection from foreign diseases.

A typical Travel Medicine appointment only requires about an hour of time. Much less time and money than having a sick employee abroad. The choice is clear: it pays to be prepared.

Decreased Healthcare and Insurance Costs

A Travel Medicine Program does not just save time and protect health. It also saves money through decreased healthcare and insurance costs. According to the U.S. Department of State, most American health plans are not accepted abroad. Employees would have to pay out of pocket for emergency care. In many places, doctors and hospitals still expect payment in cash at the time of service.

Medical coverage from a United States insurer may not cover treatment of complications from a vaccine-preventable disease. If an employee becomes severely ill from a disease, treatment can become an heavy cost burden.

Most insurance plans do not cover travel vaccinations in the first place. If employers do not offer a Travel Medicine Program, it is up to the employee to seek out and pay for Travel Medicine services on his or her own.

Often, employees don’t take that extra precautionary step. They are too busy, uncertain about where to find the services, or unaware of the risks. In the case an employee does have the time, he or she will have to submit expense reports and receipts for pre-travel medical expenses. This can add more paperwork and hassle for human resources managers. Leaving vaccination up to the individual means compliance is likely to be low, sickness is more likely and healthcare costs may rise.

Can Travel Vaccines Save Me Money?

From the standpoint of an employee traveling overseas, the benefits of vaccinations should be obvious. An hour visit with a Travel Medicine Specialist is preferable to even a day of sickness abroad. Travel medicine helps prevent lost workdays on important assignments and reduces the risk of medical evacuation.

If a company does not a have an insurance program in place that covers evacuation, it can be costly. Expenses can range from $10,000 for a last minute commercial plane ticket and travel preparations to $100,000 for a full evacuation with on-board medical assistance. No business wants to spend $100,000 unnecessarily. And in these situations, even a few days of lost employee time overseas represents a significant financial loss.

Business Traveler Statistics:
  • Average Salary: $130,000
  • Travel Days/Year: 19.4
  • Wage Paid while Traveling: $6,910
  • Average Cost of a Business Trip: $4,098
  • Average Trips/Year: 3.8

What does it mean? The average business traveler takes four, five day trips per year.

  • $23,302 = Total business travel wages and expenses per employee/year
  • $1,201 = Business travel wages and expenses per employee/day

A consultation, physical exam, vaccinations, and medications may cost about $550. This represents 2.3% of the total travel investment on an annual basis. However, many travel vaccinations provide immunity for years. The cost of each appointment is likely to go down with time and more travel as many vaccines will already have been administered in the past. Over five years, the average business traveler takes 15.9 trips. Given a likely declining cost per appointment, the travel medicine investment over time becomes just a fraction of a percent.

“Vaccination makes good economic sense,” the WHO said in a recent briefing, “and meets the need to care for the weakest members of societies.” Travel Medicine and vaccinations save your company money and represent an important investment in the health of the traveling employee population.

Conclusion and Implications

Global business travel is on the rise. This makes corporate pre-travel health programs more important than ever. A Travel Medicine Program with pre-travel vaccinations and consultations makes good business sense. The initial investment is small but the savings have the potential to be astronomical.

How can you protect your employees from vaccine-preventable diseases, while also improving your company’s bottom line? A national account with Passport Health, the largest and leading nationwide provider of immunizations for international travel, makes pre-travel vaccination and education simple and easy for your corporate travelers and for your in-house human resources managers.

From yellow fever to rabies, Passport Health offers all of the vaccinations your business travelers need to ensure they are protected from vaccine-preventable diseases. Schedule a Consultation for Travel Vaccinations and Immunizations today.

Which Vaccines Do I Need For Europe?

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Europe is a very common destination, but many travelers forget that they may need vaccines.

One of the most popular travel destinations is Europe. Whether it’s a summer getaway or a winter holiday away from home, Europe has become a premier travel destination for US citizens. But, many travelers don’t realize that they may still need vaccinations before going even to these well-developed countries.

Do I Need Vaccines For Europe?

Travel to Europe is different from trips to places like Africa or South America. European countries are often more developed and have few infectious diseases. Most travelers will only need routine vaccinations, and these include:

But, some regions will require some extra preparation. The CDC and WHO recommend the following for specific nations:

France

  • Hepatitis A Vaccine– This common foodborne disease is a low risk in France, but the vaccine is recommended for adventurous eaters.

  • Hepatitis B Vaccine– Transmitted through sexual contact and contaminated needles, consider this vaccine based on your itinerary.

  • Rabies Vaccine– Rabies is present in France but mostly confined to the bat population. If you plan on being in an area where bats are present, you may consider this vaccine.

Germany

  • MMR Vaccine– Making sure you are up-to-date on this vaccine as it is very important for travel to Germany. The country has been a hotbed of measles activity over the last five years, meaning it could pose a threat to unvaccinated travelers.

Russia

  • Hepatitis A Vaccine– Hepatitis A is more prevalent in Russia than it is in some other European countries. Because of this, the CDC highly recommends the vaccine for travelers to the country.

  • Japanese Encephalitis Vaccine– Depending on when, where and how long you will be traveling to rural areas of Russia, you may need this vaccine.

Turkey

While not technically a European country, Turkey is a prime destination for many travelers who are also visiting Europe, especially those who may be part of cruises or other tour groups that visit multiple countries.

  • Typhoid Vaccine– You can contract typhoid through contaminated food or water in Turkey and many other nations. Consider this vaccine before you travel.

  • Rabies Vaccine– Unlike France, rabies can be a serious issue in Turkey. Anyone planning to be outdoors for a long period of time and may come in contact with stray or wild animals should consider this vaccine.

  • Antimalarial Medication– While malaria risk is low in Turkey, some cases have been detected. Speak with a travel health specialist before you go to learn if antimalarials are right for your trip.

Planning a trip to any of these countries, or Europe in general? Visit with a travel health specialist before you go. Passport Health clinicians are available across North America to serve you. Book online now or call us at .

What Other Health Concerns May Be Present In Europe?

The European continent is generally a safe place, but some additional considerations include:

  • Bringing a diarrhea remedy like DiaResQ- Despite having fewer infectious diseases than some other regions, traveler’s diarrhea is still a threat in Europe. Be prepared before you go with treatments like DiaResQ.

  • Watch for security alerts- In the last year, various security concerns have changed the European travel landscape. Be aware of what is going on, and consider registering your trip with the State Department.

To learn more about various vaccinations you may need before travel, see our travel vaccines page.

Preparing for a trip? Visit with a Passport Health travel specialist before you go. Our staff will provide you with the most up-to-date information on ways to keep you and your family healthy while abroad. Book online today or call us at .

Do you have any tips for travel to Europe? Let us know in the comments below, on Facebook or via Twitter.

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