Travel Doctor Offers Rx for a Safer World
Dr. Stuart Rose knows a lot about some very strange things. He knows the risk-levels of cutaneous leishmaniasis in the Middle East. He knows which African countries lie within the ‘meningitis belt.’ He knows how to pronounce onchocerciasis – a particularly nasty black-fly borne infection found on three continents.
Rose is internationally known in the world of travel medicine, the specialty of health and safety abroad.
He’s the creator, author and editor of the International Travel Health Guide, a comprehensive wellness resource for all types of travelers now in its 13th edition, and owner of a travel health company that specializes in products for all types of travelers, including those attracted to extreme and alternative trips.
But his mission is not to wow audiences with nine-syllable diseases and factoids about little-known ailments. Rather, Rose is on a life-long quest to make the traveling public more aware of travel medicine, and the often simple ways they can keep themselves healthy and safe in even the most remote of outposts.
Rose said his fascination with travel medicine began in medical school, during an elective course that centered on tropical diseases. He later interned at two African hospitals, in Ethiopia and Tanzania, where he was responsible for treating a number of ailments that otherwise, he likely would have never seen in his career.
“My experiences in Africa definitely whetted my appetite for both travel medicine and travel itself,” said Rose, who has returned to the continent several times, and travels regularly to the ends of the earth for both work and play.
In the mid-’80s, Rose was working as an emergency physician in western Massachusetts, but also started a travel clinic at Hillcrest (which merged with Berkshire Medical Center in 1996), offering immunizations, screenings, and information to patients planning trips of all types.
After leaving the hospital, he continued to work as a consultant with other travel clinics across the country.
Rose noticed that in many ways, however, he stood alone in his field – travel medicine had yet to take on a very visible role in health care and few doctors entered the discipline – most clinics are staffed primarily by registered nurses.
“For a long time, travel medicine wasn’t even a specialty,” Rose explained. “Most general practitioners didn’t even know very much about tropical diseases or medications, and few had access or even certification to administer many vaccines.”
And even as a travel medicine specialist, Rose found early in his career that remaining abreast of current global health information can be a daunting task. Not only do diseases regularly blink on and off of the global radar screen, but governmental and health policies can differ greatly from country to country.
“I had to use several sources just to find out where different diseases were active, like malaria,” he said. “It was difficult for me, and this is my field. I knew travelers in general would have an even harder time. The information was out there, but there is so much thrown at you in text book fashion, it can be hard to digest.”
The frustration Roses felt when trying to glean information led him to self-publish the first International Travel Health Guide in 1989. The book was a small, white paperback geared toward business professionals and adventure travelers visiting remote areas, and included a number of medical concerns, both common and uncommon, as well as ways to prevent or treat illness in specific countries and a list of resources for travelers.
Rose said the guide was a few years ahead of its time, and although it received some positive attention, travel medicine was still a subject that few health care providers or travelers knew much about.
All that began to change gradually in the 1990s, however, as travel became a more varied and more prevalent part of many people’s lives. More tourists were getting interested in alternative travel, Rose said, and in addition, corporations were expanding their reach into global markets, necessitating more frequent trips to exotic locations in Africa, Asia, and South America.
“Travel is now a whole industry that has burgeoned in the last 10 years,” said Rose, referring specifically to some still fledgling sectors of that industry that are seeing brisk business and growth, including travel insurance and overseas medical emergency outfits that operate specifically for travelers.
“Basically, there is an industry forming that is centered on assistance.”
It’s also an industry that Rose has continued to capitalize on. In addition to maintaining executive authorship and editorship of the International Travel Health Guide, Rose founded Travel Medicine Inc.™, a company that originally served as the ‘publisher’ of the health guide, but has since grown to offer information and products for safe, healthy travel.
Based in Northampton, Mass., the company offers products as simple as mosquito netting and as complex as an ‘Adventure Medical’ trauma and suture kit for medically trained travelers online and through a mail order catalog.
“The business complements the book,” he said. “The first part of travel medicine is the actual administration of shots, vaccines, and treatment. The next part is the information, and the third aspect follows suit – the hardware, gadgets, and products.”
He went on to explain that travel medicine is a much wider-ranging field than many people realize. Not only does it encompass immunizations against exotic diseases and the treatment thereof upon exposure, but also serves as an umbrella over several other issues related to safe travel, such as pre-travel health screening.
“Risk assessment is a big part of travel medicine,” he explained. “If you suffer from heart disease, for instance, it’s important to make sure you should even get on a plane, let alone go trekking through the Himalayas.”
A Guided Tour
But education remains the most important aspect of the travel medicine specialty, Rose continued, and while Travel Medicine™ helps people carry out preventative measures with simple products, the crown jewel of his work in this specialized field remains the International Travel Health Guide.
Today, the guide has grown into 762-page paperback book that he and co-editor Dr. Jay Keystone, who joined Rose in completing the current edition, try to keep as manageable – and portable – as possible.
That’s not an easy feat when drafting, for one, the World Medical Guide, which represents about half of the book, and includes information on the health risks and policies of nearly every country in the world.
And in order to maintain an emphasis on safe travel – Rose said more people die in accidents or motor vehicle crashes while traveling than of disease – each country’s profile includes not only entry requirements, information on the availability of hospitals and doctors, current health advisories and ongoing risks, but also information on road safety and animal hazards.
But Rose and Keystone have also continued to expand supplemental chapters in the book ranging in topic from insect-borne disease, jet lag and motion sickness, trip preparation, HIV/AIDS, business travel and health, and traveling with children, just to name a few.
The guide is organized to be accessible to a variety of audiences, from the casual traveler to health care providers working in travel medicine, and serves as the only regularly updated sources of health and wellness information for travelers on the market, providing a snap shot of the global health climate on an annual basis.
“Right now, the avian flu is the bomb that’s ticking for travelers,” he noted. “If it hits, all bets are off.”
But Rose cautioned that there are other health issues of concern now that should also not be overlooked. Polio, for instance, is seeing a resurgence in some areas such as Nigeria, which no longer provides the vaccine to its citizens.
Some countries now require an HIV test for business or long-term travelers prior to entry, and Japanese Encephalitis has been on the upswing in some Asian countries. On a more positive note, new vaccines have been developed recently for meningitis and whooping cough, a fact of which Rose said all travelers should be aware.
Let’s Jet Set
Armed with the right information, Rose said, travelers can significantly reduce their risk for illness – both common ailments such as traveler’s diarrhea, food poisoning, or dehydration, and more serious problems, including malaria, typhoid, or skin infections, the latter of which account for only 1% of travel-related deaths, but are the most common cause of illness.
“The most common ways people get sick overseas are through contaminated food and water or through insect bites, and there are simple ways to lower the risk of getting sick – water purifying tablets, mosquito nets, or avoiding food from street vendors, for instance,” he explained. “People shouldn’t be scared to travel,” Rose was quick to note, “but they should be aware of what risks they might face and how to avoid problems.”
And in part, the International Travel Health Guide helps to put that into perspective. True, the current edition reports that the risk-level for hepatitis is high in the Middle East, but instances of cutaneous leishmaniasis are low. The ‘meningitis belt’ spans over a dozen African countries, but vaccinations are available and tourist accommodations further reduce the risk.
As for the pronunciation of onchocerciasis … Rose recommended just bringing the guide along to the doctor’s office and turning to page 149, if ever you return from the Sahara with a bit more than you bargained for.
Business: Travel Medicine Inc.
Owner: Dr. Stuart Rose
Address: 369 Pleasant St., Northampton, MA 01060
Web site: www.travmed.com
Services: Travel information and products, home of the International Travel Health Guide
Jaclyn C. Stevenson is a full-time writer and photographer based in Massachusetts. Hailing from a long line of adventure-seekers, she specializes in travel, business, pop culture, the arts, and other slices of life. www.writerjax.com.
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