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Jay Keystone of the Tropical Diseases Clinic at Toronto General Hospital says travellers should look into medical precautions. (Aaron Vincent Elkaim/The Canadian Press/Aaron Vincent Elkaim/The Canadian Press)
Jay Keystone of the Tropical Diseases Clinic at Toronto General Hospital says travellers should look into medical precautions. (Aaron Vincent Elkaim/The Canadian Press/Aaron Vincent Elkaim/The Canadian Press)

Booked your tickets? Time to book an appointment with your doctor Add to ...

Canadians going on exotic vacations may be forgetting a key part of their travel preparations: a trip to the doctor.

Experts say less than a third of travellers seek medical advice before taking off, putting them at risk for unpleasant and potentially dangerous illnesses, infections and parasites.

Even those who think to visit a travel clinic often wait until days before their trip and find themselves facing lineups and wait-lists, travel doctors say.

What's more, some treatments and vaccines need to be administered weeks in advance in order to be effective for the time of travel.

Some doctors say the travel industry - particularly websites offering last-minute deals - should be doing more to alert their customers about health risks abroad and encourage them to seek medical advice.

"There is a general reluctance among travel agents to discuss anything that might cause clients to rethink travel plans," Karen McClean, an infectious diseases specialist with the University of Saskatchewan, said in an e-mail.

"I suspect that online may be worse - perhaps because there is not the human contact and ability for the client to ask questions that may trigger the agent to discuss risks."

Last-minute deals also make it harder for travellers to take the necessary precautions, said Jay Keystone, head of the infectious and tropical diseases unit at Toronto General Hospital.

"The problem with last-minute trips is that [travellers]may not be able to find a doctor that can see them," said Dr. Keystone, who also leads the Medisys travel clinic in Toronto.

And in the rush to get ready for their trip, many travellers give up on seeing a doctor rather than wait in line, he added.

Earlier this year, experts in Britain urged travel websites to carry clear warnings about diseases such as malaria, which can be prevented with medication.

Their comments, published in January's British Medical Journal, followed three cases of malaria in U.K. tourists who went on last-minute getaways to Gambia that they booked online.

Kate Wright, 25, says she never thought to see a doctor before heading to Cuba with her boyfriend last year. Neither of them got sick but she says she would have appreciated some advice about how they could have protected themselves.

"We booked our trip online, and never at any point was there any health information or a warning to consult a doctor before making a trip out of the country," the Torontonian said.

"I think having health information online - or at least a warning to consult a physician before travelling abroad - would be a good idea. While some of it may seem like common sense, I think people often forget about their health when they are booking a vacation."

Some travel companies say they discuss health risks with travellers as needed and inform them of any vaccines required for their trip. Many countries, for example, require tourists to carry a certificate of immunization against yellow fever.

"As soon as we start to hear of an adventure trip or they're planning to go into the rainforest … that's when the discussion would come up," said Richard Vanderlubbe, president of Tripcentral, a travel agency that sells trips online, by phone and in retail stores in Ontario, Nova Scotia and New Brunswick.

"But generally speaking, for your typical all-inclusive vacation, we're not really outwardly advising of any health risks to that or advising that they contact a travel doctor."

But staying out of the bush doesn't guarantee a clean bill of health.

"True, if you're going to stay entirely on a resort, by and large, your risks are going to be a little bit lower, but mosquitoes don't respect resort boundaries," and can carry a range of diseases, said David Patrick, director of epidemiology at the B.C. Centre for Disease Control.

Malaria is present in many destinations popular with Canadian tourists, including parts of the Dominican Republic and Jamaica.

According to Health Canada, about 400 Canadian travellers a year catch the deadly flu-like illness, which is caused by parasites and transmitted through mosquito bites. A record 1,036 cases were reported in 1997. The agency estimates only 30 to 50 per cent of cases are reported.

Other conditions Canadians bring back from vacation include dengue and typhoid fevers as well as hepatitis A and B.

All of these can be prevented with vaccines, medication or insect repellent, Dr. Keystone said. Travel clinics can also provide drugs to treat traveller's diarrhea, he added.

It's not just tourists who take chances with their health while abroad. The majority of Dr. Keystone's patients at the tropical diseases clinic are new Canadians who went to visit relatives in their home country and assumed they were immune to local illnesses, he said.

"But after a few months in Canada, they lose their immunity," he said.

Health Canada's website provides tips and disease-specific recommendations for travellers.

The Canadian Press

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