medical tourism risks
How risky is medical tourism? Part 1
May 19, 2016
what to pack for a cosmetic surgery abroad? Beauty Abroad Guide
List of things you should take/consider taking on your cosmetic surgery abroad
June 1, 2016

What are the medical tourism risks and dangers? Part 2.

medical tourism risks. Beauty Abroad Guide

Medical tourism has many benefits, but it is also related to a significant number of risks and dangers. Before you travel abroad for healthcare you should think twice and chose wisely the destination of your medical travel. You have to realize that medical tourism in most cases is not internationally regulated and patients carry a great responsibility for their health and life when they decide to travel for healthcare.[1] In the article: Pros and cons of medical tourism I presented a short overview of medical tourism general advantages and disadvantages. In today’s post I would like to provide you with a detailed information about some medical tourism risks and dangers. Hope it helps.

1. Risk of infection

If you are considering medical procedure you should be aware of the risk of aquiring nosocomial infections caused by eg. blood transfer viruses like hepatitis B (HBV), hepatitis C (HCV) or HIV.[2] If you plan to have a medical procedure (abroad) you should talk to your domestic physician about vaccination against HBV. Before making decision on a travelling abroad for medical care you should also gain knowledge on hygiene, infection control and cleanliness standards in the country where you plan to undergo your medical procedure. It’s one of the most important things to do before medical travel and it should be an immanent element of pre travel research. The risk of aquiring blood transfer viruses in some countries may be higher than in other. Other contagious diseases related to healthcare abroad include- as reported in literature- bacterial infections caused by eg. Staphylococcus aureus, Escherichia coli, Mycobacterium abscessus, Mycobacterium fortuitum, Streptococcus agalactie, Streptococcus anginosus. [3,4,5,6,7] CDC mentioned that there were also cases of medical tourists infected with antibiotic-resistant strains of bacteria never previously seen in USA.[8] Infections are serious complictions after surgeries, especially if caused by antibiotic resistant strains or not/rarely seen in the patient’s place of residence. Medical tourists should do their best to avoid facilities with poor infection control, hygiene and cleanliness standards.

2. Quality of food and water abroad

When you travel abroad you should inform yourself about water and food safety. The list of countries with specific recommendations is available on: http://wwwnc.cdc.gov/travel/ . If you have doubts about high standards of food and water you should stick to these safety habbits:
– don’t buy food from street vendors,
– eat in „classy” restaurants,
– buy food which is cooked/ baked and served hot,
– eat/ drink pasteurized products,
– wash and peel fruit/vegetables yourself (avoid eg. fresh juices),
– drink bottled water (avoid tap water) or hot coffee/tee.[9]
Tourists who are ignoring food and water safety standards are at risk of gastrointestinal problems caused by Escherichia coli, norovirus, hepatitis A virus (HAV- you can vaccinate against it) and many more infectious agents.
Note: You should be in really good health before/ after a surgery. Food posioning before the surgery may cause rescheduling of the procedure, so it may be a problem when you are abroad. After the surgery, when you are in pain, it is the last thing you want to experience…

3. Quality of drugs and blood products abroad

When you travel abroad for healthcare you should also inform yourself about safety of drugs and blood products. During and after the surgery you will be given medicines. You have to be aware that in some countries (being popular medical tourism destinations) there is a big problem with fake or counterfeit drugs. Taking counterfeit drugs may lead to poisoning or even death because of bad ingredients used (poor quality, not treating the illness etc.). [10] If you undergo the surgery abroad you may also need blood products. In developed countries blood donors and blood products are meticulously tested against eg. blood transfer viruses and blood products are generally considered safe. Access to blood products is also much better in high- income countries in comparison to low- income countries (36.8 donations per 1000 population vs. 3.9 donations per 1000, respectively). Another problem is that in developing countries quality of blood products is lower and patients are more often exposed to bloodborne pathogens: HBV, HCV, HIV. The incidence of transmission of these viruses in blood donations in high-income countries is considerably lower than in low- and middle-income countries. [11,12]

This post is a continuation of a series of articles dedicated to medical tourism safety. If you haven’t read part 1, I encourage you to do so- How risky is medical tourism? In the next post, I will continue this topic and I will explain to you medical tourism risks associated mostly with legal, ethical issues etc.

 


References:
1. European Hospital and Healthcare Federation. Medical tourism. http://www.hope.be/05eventsandpublications/docpublications/98_medical_tourism/98_HOPE_Medical-Tourism_September_2015.pdf
2. CDC. Medical tourism http://www.cdc.gov/features/medicaltourism/
3. Kendall BA, Barker AP, Hadley JC, Florell SR, Winthrop KL.Disseminated Mycobacterial Infection After International Medical Tourism.Open Forum Infect Dis. 2015 Apr 17;2(2):ofv054. doi: 10.1093/ofid/ofv054. ECollection 2015.
4. Hui SH, Noonan L, Chavada R. Post Liposuction Mycobacterium Abscessus Surgical Site Infection in a Returned Medical tourist Complicated by a Paradoxical Reaction During Treatment.Infect Dis Rep. 2015 Dec 22;7(4):6304. doi: 10.4081/idr.2015.6304. eCollection 2015 Dec 22.
5. Schlarb D, Idelevich EA, Krause-Bergmann A, Stollwerck P. Successful interdisciplinary radical treatment of Mycobacterium fortuitum infection in a lipotourist from Germany after abdominoplasty in Turkey.New Microbes New Infect. 2015 Sep 10;8:21-3. doi: 10.1016/j.nmni.2015.09.003. ECollection 2015
6. Livingston R, Berlund P, Eccles-Smith J, Sawhney R.The Real Cost of “Cosmetic Tourism” Cost Analysis Study of “Cosmetic Tourism” Complications Presenting to a Public Hospital.Eplasty. 2015 Jul 28;15:e34. ECollection 2015.
7. Chan HL, Poon LM, Chan SG, Teo JW. The perils of medical tourism: NDM-1-positive Escherichia coli causing febrile neutropenia in a medical tourist.Singapore Med J. 2011 Apr;52(4):299-302.
8. CDC. Yellowbook http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/medical-tourism
9. CDC. Destinations http://wwwnc.cdc.gov/travel/destinations/traveler/none/india?s_cid=ncezid-dgmq-travel-single-001#stay-healthy-and-safe

10. World Health Professions Alliance. Background Document on Counterfeit Medicines in Asia http://www.whpa.org/background_document_counterfeit_medicines_in_asia.pdf
11. WHO. Availability, safety and quality of blood products. http://www.who.int/bloodproducts/norms/WHA63-12_REC1-P2-en.pdf
12. WHO. Blood safety and availability. http://www.who.int/mediacentre/factsheets/fs279/en/

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