Travel-associated illnesses

Effects of Ill Health on the Service of Scottish Presbyterian Missionaries 1867-1929

The experience of Scottish Presbyterian missionaries serving overseas between 1867 and 1929 was analyzed. Data were compiled during a 4-year postgraduate research program from such sources as the General Assembly Reports of the Foreign Mission Committees of the Church of Scotland, numerous missionary magazines, school records, medical directories, and newspaper and medical journal obituaries. Data show that the year of appointment, the mission station and continent location, and medical knowledge were all influencing factors on the length of missionary service, early retirement on account of ill health, death in service, and age at death. This method of comparative, historical study may have further useful applications in looking at the health experience of other groups who lived and worked abroad at the turn of the century, such as civil servants, the military, or other comparable missionary groups.

A cumulative review of studies on travellers, their experience of illness and the implications of these findings

A cumulative review of illness experienced by 13,816 travellers returning to Scotland since 1977, shows an overall attack rate of 36%. Alimentary complaints predominated; 18% of travellers had these alone and a further 10% had other symptoms as well as their gastro-intestinal disorder. Higher attack rates were noted in those taking package holidays. Inexperience of travel, smoking, more southerly travel and younger age (particularly those between 20- and 29-years-old) were other contributing factors. A similar pattern emerged from a I year study of hospital in-patients with travel related admissions. Serological studies of 470 travellers showed that 20% had incomplete immunity to poliomyelitis; 25% of those tested (312 travellers) had serological evidence of typhoid immunisation, I.9% (of 760 travellers) had antibodies to Legionella pneumophila, 64% (5II travellers tested) had antibodies to hepatitis A, 87% (288 tested) had adequate levels of tetanus antitoxin but only 40% of the 225 travellers tested had adequate levels of diphtheria antitoxin. Amongst a subgroup of 645 travellers the travel agent was the most frequently consulted source of pre-travel health advice. This carries particular significance for the dissemination of relevant advice in view of the inadequacies found from study of the health information in travel brochures. These findings, viewed against the perspective of the continuing growth in international travel, means that travellers, the medical profession, the travel trade, health educators, global health agencies and health authorities in those countries accepting and encouraging tourists, will be required to recognise the health implications of further tourism development if this problem of illness associated with travel is to be brought under control.