Health Advisories For Travelers: Their Impact On Developing Countries

Reports of health risks associated with travel, whether based on fact or media exaggeration, have consequences beyond that of travelers’ health, says Lancet. Many disease outbreaks - plague in India, for example - is not known to have affected a single traveler. But such reports have a great negative economic impact on countries that desperately need the revenue from tourism.

In 1992, a British traveler acquired malaria in Kenya, and subsequently died. The event received wide publicity in Britain. Kenya is a popular destination for British tourists. They stay an average of 15 days and spend about U.S. $1,012 per visit. As a result of the malaria death, in the period 1992-1994, 101,000 fewer British travelers visited Kenya. This totals about U.S. $104 million, or 18% of the total foreign dollar income and one-third of the country’s annual health budget. Tourism, next to foreign aid, is Kenya’s main source of foreign income.

One of the reasons that travelers to developing countries become ill is that they ask official representatives of that country - at the tourist office, consulate, or embassy - for advice regarding health matters, says Lancet. A study performed ten years ago in the U.S. found that only 28% of official representatives provided correct health advice, especially regarding inoculations and malaria prophylaxis.

The study was recently repeated in Canada. Seventy-seven representatives of African, Asian, and South and Central American countries with offices in Canada were telephoned and asked whether or not "any shots or pills" were recommended for visiting their country.

While the accuracy of the advice dispensed has improved over 10 years, much misinformation is still being issued. Only 30% provided correct information on yellow fever immunization and malaria prophylaxis, as recommended by the U.S. CDC. Thirty-six percent (vs 18% in the older study) referred callers to other sources of likely reliable information - physicians, travel clinics, and Internet sites. Twenty countries had such sites, four of them provided health advice, and all of it was correct.

Thirty nine percent of the representatives indicated that health precautions were unnecessary, even though they were representing countries with a significant risk for malaria. Only 4% indicated a need for hepatitis A vaccination, a disease highly prevalent in all developing countries. Some recommended "malaria shots", which, of course, do not exist. Several representatives said there were no health risks in their countries and wished the caller "bon voyage".