Over the years, the global tourism industry has experienced an incessant growth. In fact, international tourist arrivals in 2015 more than doubled compared to figures recorded in 2005. In 2016 alone, more than 16.4 million tourists visited Singapore – up 7.7 percent from the previous year, according to the Singapore Tourism Board.

While these numbers indicate a positive economic impact, the continuous flow of tourists – country  to country – also pose a threat to the health and well-being of locals and travellers.

Dr Nieh Chih Chiang, part-time tutor at National University of Singapore and instructor for Advanced Cardiovascular Life Support (ACLS) and Basic Cardiac Life Support (BCLS), shared some of the most common travel-related diseases one may be infected of. “Individuals who are travelling or are working in the travel industry are prone to contacting infectious diseases such as the yellow fever, hepatitis A-G, meningitis and cholera,” he said.

Unrecorded cases of influenza


“In my practice, I have observed that Singaporeans are more likely to be infected with malaria, typhoid, and influenza,” said Dr Nieh.

According to the statistics from the Ministry of Health (MOH), malaria and typhoid are among the top infectious diseases in the country in 2016, with 31 and 51 recorded cases, respectively.

Influenza cases tell a different story, said Nieh.

“Cases of influenza are harder to track because many patients do not go on follow-up appointments with their doctors,” Nieh laments. Failing to follow through may elevate the patient’s risks of developing respiratory diseases.

He advised physicians and patients alike to be vigilant of various symptoms to prevent the worsened effect of influenza. This includes cough, fever, sore throat, coryza, fatigue, headache, red eyes, and rashes.

Pre- and post-travel consultations


Tests for pre- and post-travel management differ on which countries they are going, Nieh explained.

“There is a list of the countries being grouped into various groups which the disease are endemic—hence, these will require respective blood test to check their immunity, and to see if there's a need for booster or any other vaccinations.”

The following are some of the information physicians must look into during pre-travel consultations:
  • Medical history (age, sex, allergies, medications patients are currently taking)
  • Health conditions (recent surgery, pregnancy, seizure disorder)
  • Immunisation (if there are any)
  • Reason for travelling Travel style (engaging in adventurous activities, eating exotic foods)
Below are the components of post-travel care:
  • Travel history (activities involved, sexual history)
  • Symptoms screening (fever, diarrhoea, rashes)
  • Check for possible injuries
Nieh highlighted that post-travel health investigation following the incubation period is important as acquired diseases or injuries may be life-threatening, and/or a threat to public health. MIMS

References:
  1. https://www.statista.com/topics/962/global-tourism/
  2. http://www.straitstimes.com/singapore/tourists-spent-record-248b-in-singapore-in-2016-arrivals-also-hit-record-high-of-164m
  3. https://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/weekly_infectiousdiseasesbulletin.html?year=2016
  4. http://www.channelnewsasia.com/news/singapore/increase-in-number-of-flu-cases-at-polyclinics-moh-7919872
  5. http://www.straitstimes.com/opinion/herd-immunity-and-how-health-choices-affect-those-around-you
  6. https://wwwnc.cdc.gov/travel/yellowbook/2018/the-pre-travel-consultation/the-pre-travel-consultation
  7. www.pitt.edu/~super7/19011-20001/19351.ppt