2008年7月26日星期六

Death and international travel--the Canadian experience: 1996 to 2004.

MacPherson DW, Gushulak BD, Sandhu J.
Migration Health Consultants Inc, Cheltenham, Ontario, Canada. douglaswmacpherson@migrationhealth.com
BACKGROUND: Death during international travel concerns several levels of the travel industry. In addition to the immediate effects for the traveler, their family and friends, the nature of travel-related mortality has important implications for pretravel health advisors and providers of medical care services. METHODS: The Consular Affairs Bureau, Foreign Affairs Canada provides information and assistance to Canadian civilians abroad. Beginning in 1995, the Consular Management and Operations System tracked Canadian deaths abroad notifications. The annual data for 1996 to 2004 was extracted for sex, age, and cause of death by location for all reports received. RESULTS: There were 2,410 reported deaths in Canadians abroad; reported sex was 32% female and 68% male, average age of 61.7 and 60.4 years, respectively. Recorded causes of death: natural (1,762), accidental (450), suicide (92), and murder (106). Country of death reflected the pattern of Canadian international travel for recreation, business, and ancestral linkages. Average age of natural death (66 years) distinguished it from all other causes of death: accidental (45), suicide (41), and murder (43). CONCLUSION: Natural causes and suicide deaths may be anticipated or planned to occur abroad. The risk of death may be mitigated through personal knowledge and medical assessment and prevention strategies. Deaths due to vaccine-preventable diseases, exotic and infectious diseases were rare in this population. Consular services may be able to provide various types of support. Local laws and customs, as well as international regulations in health and quarantine govern other responsibilities such as funeral services and repatriation of the deceased to Canada.
PMID: 17367476 [PubMed - indexed for MEDLINE]


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International Travel Clinic: the Latest in Travel Medicine

Abstract: Patients traveling to less developed parts of the world will benefit from an individual assessment at the International Travel Clinic. Expert infectious disease specialists evaluate travelers’ itineraries to provide destination-specific preventive medicine and current health and safety information.
From Clinical Update, Fall 2007
Each year more than 45 million Americans travel abroad. As more and more people travel the world for business and pleasure, an awareness of potential health threats and the measures to prevent them is essential.
An increasing number of these trips are to tropical and less developed countries, and according to the Centers for Disease Control and Prevention, an estimated 10 million people will become ill as a result of their travels.
Travel medicine is a specialized area of health care that is becoming more important as worldwide travel continues to increase. The International Travel Clinic, part of the Section on Infectious Diseases at Wake Forest University Baptist Medical Center, is one of the area’s most comprehensive resources on travel-related health issues.
“Travel medicine is an exciting specialty field of medicine that includes aspects of public health, infectious diseases and tropical medicine,” said infectious diseases specialist and Travel Clinic director Christopher A. Ohl, M.D. “Knowledge, a little forethought and planning can make all the difference between an enjoyable, illness-free trip, or an unpleasant experience for those traveling. Health and safety should be a consideration before, during and after your travels.”
Traditionally, travel medicine focuses on people traveling outside the United States, with services centered on provision of vaccinations and prevention of malaria and traveler’s diarrhea. Ohl’s extensive knowledge and expertise in preventive, military and emerging infectious disease medicine brings an additional layer of specialty patient care to the Travel Clinic.
The International Travel Clinic is a highly specialized, up-to-date information source. The Travel Clinic staff evaluates the traveler’s itinerary and planned activities as well as the traveler’s medical conditions to develop an information packet that includes disease risk summaries, prevention information and vaccinations required for entering foreign countries, following recommendations of the Centers for Disease Control and Prevention, World Health Organization, Infectious Diseases Society of America, and other professional and technical societies.
“I like to learn from each patient about their upcoming travels abroad to individualize their care,” said Ohl, professor of internal medicine–infectious diseases. “Travel advice to a businessman staying at a four-star hotel in Belize would be different from advice to a backpacker traveling in the tropical, rural mountains of Peru.”
In addition to disease assessments and preventive care, the Travel Clinic provides general information about the traveler’s destination that could affect their visit, such as political unrest, crime rates, weather conditions and emergency medical care and prevention.

www.wfubmc.edu

Travel medicine

Travel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers.


Globalization and travel
Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global epidemiology of health risks to the traveler, vaccinology, malaria prevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries.Supercourse on Travel Medicine
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Mortality and morbidity
Mortality studies indicate that the cardiovascular disease accounts for most deaths during travel (50-70%), while injury and accident follow (~25%). Infectious disease accounts for about 2.8-4% of deaths during/from travel. Morbidity studies suggest that about half of the people from a developed country that stay one month in a developing country will get sick.Supercourse on Travel Medicine Traveler's diarrhea is the most common problem encountered.
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Disciplines
The field of travel medicine encompasses a wide variety of disciplines including epidemiology, infectious disease, public health, tropical medicine, high altitude physiology, travel related obstetrics, psychiatry, occupational medicine, military and migration medicine, and environmental health.
Special itineraries and activities include cruise ship travel, diving, mass gatherings (e.g. the Hajj), and wilderness/remote regions travel.
Basically, the travel medicine can divide into 4 main topics: the prevention (vaccination and travel advice), the assistance medicine (dealing with repatriation and medical treatment of travelers), the wilderness medicine (e.g. high-altitude medicine, cruise ship medicine, expedition medicine, etc.) and the insurance medicine.
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Focus
Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself.WHO Travel Information Also, the CDC publishes valuable and up-to-date information. (see external links). Key areas to consider are vaccination and the six I’s:
Insects: repellents, nets, medication
Ingestions: safety of water, food
Indiscretion: HIV, sexually transmitted disease
Injuries: accident avoidance, personal safety
Immersion: schistosomiasis
Insurance: coverage and services during travel, access to care
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Specific disease problems
Yellow fever is endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps. CDC re: Yellow Fever
Meningococcal meningitis is endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to Mecca. Detailed information is available on the CDC site. CDC re: Meningococcal Meningitis
Malaria prevention is done by preventing or deducing exposure to mosquitos (screened rooms, air-conditioning, nets) use of repellents (usually DEET). In addition chemoprophylaxis is started before the travel, during the time of potential exposure, and for 4 weeks (chloroquine, doxycycline, or mefloquine) or 7 days (atovaquone/proguanil or primaquine) after leaving the risk area. See detailed CDC site.CDC re:Malaria
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Medication Kit
The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances it should include also malaria prophylaxis, condoms, and medication to combat traveler's diarrhea. In addition, a basic first aid kit can be of use.
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See also
Tropical medicine
Tropical disease
Montezuma's revenge
Prince Leopold Institute of Tropical Medicine
Royal Society of Tropical Medicine and Hygiene
Carte Jaune
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References

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External links
Countries - World Health Organization - includes information on outbreaks and health information
Travelers' Health - Centers for Disease Control and Prevention - includes information on outbreaks, specific diseases, recommended vaccinations
Traveler's Health - MedlinePlus
Safe Water for International Travelers includes a Worldwide Rating of Drinking Water Safety and waterborne diseases prevention.
Travelan - a natural product that helps reduce the risk of Traveler's Diarrhea
Global Infectious Diseases and Epidemiology Network - a travel medicine resource known as GIDEON.
A Hungarian textbook
The relation between travel and assistance medicine
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Organizations
The International Society of Travel Medicine
Travel Medicine Body of Knowledge
The American Society of Tropical Medicine and Hygiene

International Safe Travel Program

Back ]
This page has one goal, to provide information that can assist you to travel safely and to help keep you healthy during your international travel(s). There are four main areas in this site:
ORED Travel Safely Reference Book (PDF) - This is a collection of information and tips that cover many aspects of your trip from before you leave home to on the plane to back home again. Also included is information on the bad subjects which can turn an enjoyable trip into a nightmare, i.e. crime, accidents, terrorist incidents, and other related incidents.
Listing of Travel Related Web Links (PDF) - This has some of most important information that you should view, one of which is the U.S. Department of State (DOS) link to the Travel Warnings and Announcement site. Two others are the MSU Longest Health Center Travel Clinic and the Center for Disease Control (CDC) sites for health information.
Know Before You Go PowerPoint (PDF) - This is briefing that is presented during the bi-monthly briefings. It does not include the travel warning and announcement information from the Department of State as this information is subject to change sometimes rapidly.
Laptop Loan Program (PDF) - Information concerning the loan of laptops to personnel traveling internationally. The units have PGP full disk encryption software to protect information in the unit.
The "Know Before You Go" travel briefing is presented the first Wednesday of each month at 9:00 AM and the second Tuesday at 2:30 PM at the Institute of Clean Energy Technology (also known as ICE-T) auditorium. The ICE-T building is located in the Thad Cochran Research, Technology & Economic Development Park.
ORED wishes you a safe and enjoyable trip. Bon Voyage!

(THEME MEETING)

Travel Related Information
Dear delegates, This is in continuation of our earlier correspondence regarding your participation at the International workshop (Theme Meeting) on Nanoceramics and Nanocomposites. I hope that you are currently making your travel arrangement for your visit to IIT Kanpur. We also suggest you to carry official invitation letters/e-mail correspondence confirming the acceptance of your abstract for poster presentation. You may like to keep a print out of this document for your convenience. We wish to inform you the following:For delegates from foreign country:1. If you travel from Delhi to Lucknow by air, then you need to transfer from International terminal to Domestic terminal at New Delhi airport. It is likely that a transit vehicle is arranged by the airlines and it takes around 30 minutes to reach domestic terminal from International terminal. If such option is not readily available, please take a pre-paid taxi from the arrival lounge to reach domestic terminal. It is possible to obtain Indian currency at the airport (arrival lounge) in exchange of USD, Euro or GBP. Other currency exchange may not be easy at New Delhi airport, as I understand.
2. In case you take train from Delhi to reach Kanpur and you require transit accommodation (overnight stay) at Delhi, please let us know IMMEDIATELY.3. If you are arriving at Lucknow airport, please come out at the arrival lounge and look for a student volunteer with a placard, bearing your name on it. Your transport from Lucknow airport to IIT-Kanpur will be arranged by us and the travel time will be approximately 2.5 hours. For delegates from India:
4. If you are arriving at Kanpur Railway Station, please exit the railway station from the platform no. 1 side. Your travel time to IIT-Kanpur will be approximately 1 hour.
5. The accommodation of all the Invited speakers and other important guests of the conference has been arranged at the Visitors' Hostel (commonly referred to as VH) of IIT-Kanpur. For other conference delegates, suitable on-campus accommodation has been arranged, either at students' hostel or Girls' hostel or other convenient places inside IIT-Kanpur campus.6. In case of emergency, please contact Dr. Basu (cell phone: 09935202571). Please use a prefix of 91, if you call from outside India. In addition, you can also use the numbers, mentioned towards the end of this document.
7. For frequent update and the conference schedule (subject to minor last minute change), please visit the conference website: http://www.iitk.ac.in/infocell/announce/nanoceram
We look forward to seeing you sooner,Wish you a pleasant flight, Bon Voyage,
With best regardsDr. Bikramjit Basu Indian Institute of Technology, IIT-Kanpur, Kanpur-208016, INDIA. Tel: 0091-512-2597771 (O) / 2598591 (R) Fax: 0091-512-2597505/2590260

Travel Agents

Significant Points
Travel benefits, such as reduced rates for transportation and lodging, attract people to this occupation.
Training at a postsecondary vocational school, college, or university is increasingly important.
Travel agents increasingly specialize in specific destinations or by type of travel or traveler.
Nature of the Work
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Travel agents help travelers sort through vast amounts of information to help them make the best possible travel arrangements. They offer advice on destinations and make arrangements for transportation, hotel accommodations, car rentals, and tours for their clients. They are also the primary source of bookings for most of the major cruise lines. In addition, resorts and specialty travel groups use travel agents to promote travel packages to their clients.
Travel agents are also increasingly expected to know about and be able to advise travelers about their destinations, such as the weather conditions, local ordinances and customs, attractions, and exhibitions. For those traveling internationally, agents also provide information on customs regulations, required papers (passports, visas, and certificates of vaccination), travel advisories, and currency exchange rates. In the event of changes in itinerary in the middle of a trip, travel agents intercede on the traveler’s behalf to make alternate booking arrangements.
Travel agents use a variety of published and computer-based sources for information on departure and arrival times, fares, quality of hotel accommodations, and group discounts. They may also visit hotels, resorts, and restaurants themselves to evaluate the comfort, cleanliness, and the quality of specific hotels and restaurants so that they can base recommendations on their own experiences or those of colleagues or clients.
Travel agents who primarily work for tour operators and other travel arrangers may help develop, arrange, and sell the company’s own package tours and travel services. They may promote these services, using telemarketing, direct mail, and the Internet. They make presentations to social and special-interest groups, arrange advertising displays, and suggest company-sponsored trips to business managers.
Agents face increasing competition from travel and airline websites for low-cost fares, but travelers still prefer using travel agents who can provide customized service and planning for complex itineraries to remote or multiple destinations. To attract these travelers, many travel agents specialize in specific interest destinations, travel to certain regions, or in selling to particular demographic groups.
Work environment. Travel agents spend most of their time behind a desk conferring with clients, completing paperwork, contacting airlines and hotels to make travel arrangements, and promoting tours. Most of their time is spent either on the telephone or on the computer researching travel itineraries or updating reservations and travel documents. Agents may be under a great deal of pressure during travel emergencies or when they need to reschedule missed reservations. Peak vacation times, such as summer and holiday travel periods, also tend to be hectic.
Many agents, especially those who are self-employed, frequently work long hours. Advanced computer systems and telecommunications networks make it possible for a growing number of travel agents to work at home; however, some agents feel a need to have an office presence to attract walk-in business.
Training, Other Qualifications, and Advancement
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A love of travel and knowledge and enthusiasm for advising people about travel destinations and itineraries are important traits for a travel agent to have. Superb communication and computer skills are essential for talking with clients and making travel reservations.
Education and training. The minimum requirement for those interested in becoming a travel agent is a high school diploma or equivalent; although many travel agencies prefer applicants who have a college degree and business or travel experience. Much of the training is provided on the job, a significant part of which consists of instruction on how to use reservation systems.
Training specific to becoming a travel agent is available at the many vocational schools that offer full-time travel agent programs leading to a postsecondary vocational award. Travel agent courses also are offered in public adult education programs, online, and in community colleges. These programs teach students about cruise lines and sales techniques and how to use the reservations systems. They also provide general information about travel destinations. A few colleges offer bachelor’s or master’s degrees in travel and tourism. Some employers prefer agents who have backgrounds in computer science, geography, communication, foreign languages, or world history, because these backgrounds suggest an existing interest in travel and culture and help agents develop a rapport with clients. Courses in accounting and business management also are important, especially for those who expect to manage or start their own travel agencies. Continuing education is critical because the abundance of travel information readily available through the Internet and other sources has resulted in a more informed consumer who wants to deal with an expert when choosing a travel agent.
Other qualifications. Travel agents must be well-organized, accurate, and detail-oriented in order to compile information from various sources and to plan and organize their clients’ travel itineraries. Agents also must be professional and courteous when dealing with travel representatives and clients. Other desirable qualifications include good writing and interpersonal skills and sales abilities.
Personal travel experience is an asset because knowledge about a city or foreign country often helps influence a client’s travel plans. Business experience or training increasingly is important because agents need to know how to run a business profitably. As the Internet has become an important tool for making travel arrangements, more travel agencies use websites to provide their services to clients. This trend has increased the importance of computer skills in this occupation.
Certification and advancement. Some employees start as reservation clerks or receptionists in travel agencies. With experience and some formal training, they can take on greater responsibilities and eventually assume travel agent duties. In agencies with many offices, travel agents may advance to busier offices or to office manager or other managerial position.
Those who start their own agencies generally have experience in an established agency. These agents must gain formal approval from suppliers or corporations, such as airlines, ship lines, or rail lines to extend credit on reservations and ensure payment. The Airlines Reporting Corporation and the International Airlines Travel Agency Network, for example, are the approving bodies for airlines. To gain approval, an agency must be financially sound and employ at least one experienced manager or travel agent.
The National Business Travel Association offers three types of designations for corporate travel professionals—Corporate Travel Expert, Certified Corporate Travel Executive, and Global Leadership Professional.
Experienced travel agents can take advanced self-study or group-study courses from the Travel Institute, leading to the Certified Travel Counselor designation. The Travel Institute also offers marketing and sales skills development programs and destination specialist programs, which provide detailed knowledge of regions such as North America, Western Europe, the Caribbean, and the Pacific Rim. With the trend toward more specialization, these and other destination specialist courses are increasingly important.
Employment
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Travel agents held about 101,000 jobs in May 2006 and are found in every part of the country. Nearly two-thirds worked for travel agencies. Another 13 percent were self-employed. The remainder worked for tour operators, visitor’s bureaus, reservation offices, and other travel arrangers.
Job Outlook
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Employment of travel agents is expected to change little through 2016. Travel agents who specialize in a travel destination, type of traveler, or mode of transportation will have the best chances for success.
Employment change. Employment of travel agents is expected to increase by 1 percent, which is considered little or no growth. As spending on travel and tourism rebound from recent recessionary periods and as more travelers begin taking more exotic and customized trips, the demands for the specialized services offered by travel agents will offset the service lost to Internet bookings for simpler itineraries. The ease of Internet use and the ready availability of travel and airline websites that allow people to research and plan their own trips, make their own reservations, and purchase their own tickets will result in less demand for travel agents for routine travel arrangements. There will be, however, many consumers who still prefer to use a professional travel agent to plan a complete trip; to deal with more complex transactions; to ensure reliability; to suggest excursions or destinations that might otherwise be missed; to save time; or, in some cases, to save money. In addition, higher projected levels of travel, especially from businesses and retiring baby boomers will offset the loss of routine transactions. Furthermore, luxury and specialty travel is expected to increase among the growing number of Americans who are seeking out exotic and unique vacations and a growing part of travel agents’ business is organizing and selling tours for the growing number of international visitors.
Job prospects. Applicants for travel agent jobs should face fair to good job opportunities, depending on one’s qualifications and experience. Opportunities should be better for agents who specialize in specific destinations, luxury travel, or particular types of travelers such as ethnic groups or groups with a special interest or hobby.
The demand for travel is sensitive to economic downturns and international political crises, when travel plans are likely to be deferred. Thus job opportunities for travel agents will fluctuate with changing economic and political times. Many openings, though, are expected to occur as agents leave for other occupations or retire.
Projections Data
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Projections data from the National Employment Matrix
Occupational title
SOC Code
Employment, 2006
Projected employment,2016
Change, 2006-16
Detailed statistics
Number
Percent
Travel agents
41-3041
101,000
102,000
1,000
1
PDF
zipped XLS
NOTE: Data in this table are rounded. See the discussion of the employment projections table in the Handbook introductory chapter on Occupational Information Included in the Handbook.
Earnings
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Experience, sales ability, and the size and location of the agency determine the salary of a travel agent. Median annual earnings of travel agents were $29,210 in May 2006. The middle 50 percent earned between $23,020 and $36,920. The lowest 10 percent earned less than $18,100, while the top 10 percent earned more than $46,270. Median earnings in May 2006 for travel agents employed in the travel arrangement and reservation services industry were $29,160.
Salaried agents usually enjoy standard employer-paid benefits that self-employed agents must provide for themselves. When traveling for personal reasons, agents usually get reduced rates for transportation and accommodations. In addition, agents sometimes take ?familiarization? trips, at lower cost or no cost to themselves, to learn about various vacation sites. These benefits often attract people to this occupation.
Earnings of travel agents who own their agencies depend mainly on commissions from travel-related bookings and service fees they charge clients. Often it takes time to acquire a sufficient number of clients to have adequate earnings, so it is not unusual for new self-employed agents to have low earnings. Established agents may have lower earnings during economic downturns.
For the latest wage information:
The above wage data are from the Occupational Employment Statistics (OES) survey program, unless otherwise noted. For the latest National, State, and local earnings data, visit the following pages:
Travel agents

Related Occupations
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Travel agents organize and schedule business, educational, or recreational travel or activities. Other workers with similar responsibilities include tour guides and escorts, travel guides, reservation and transportation ticket agents and travel clerks, retail salespersons, and hotel, motel, and resort desk clerks.
Sources of Additional Information
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