Travel medicine
Authors: David Lalloo
Journal: The Lancet (2003)

Things are changing in UK travel medicine. For some time, travel medicine as a specialty in the UK has sat uneasily between its origins in tropical and infectious diseases and occupational public health and its practice in predominantly primary-care settings. Travel medicine is increasingly recognised as being more than merely the prevention of travel-related infections, since there are many potential hazards that travellers may encounter. The number of overseas trips made by UK citizens continues to increase; there were more than 59 million in 2002, and the consequent demand for high-quality travel services is considerable. In addition to increasing numbers of overseas travellers, the travelling population is changing. Foreign travel is no longer the prerogative of the young; rising numbers of elderly and immuno-compromised people are seeking exotic holidays and increasing the demand for specialised travel-medicine services. The development and expansion of travel medicine as a specialty is also being driven by heightened awareness of the implications of foreign travel for public health. Getting Ahead of the Curve, the 2002 UK strategy for infectious disease, noted the potential population health threats from overseas travel. Interest in biohazards as a result of the anthrax attacks in the USA and the rapid global spread of severe acute respiratory syndrome (SARS) have further highlighted this issue. For once, the UK response to changing circumstances has been fairly rapid. The need for improved travel-medicine services has been recognised with the launch of NaTHNaC—the National Travel Health Network and Centre. NaTHNaC seeks "to protect the health of British travellers" and will develop the evidence base for travel medicine, provide standardised travel advice for health professionals, and improve surveillance of travel-related infections. These are exciting times for travel medicine in the UK, and it might be thought appropriate that a new journal, Travel Medicine and Infectious Disease, was launched in February, 2003. A few good-quality travel medicine journals already exist: the Journal of Travel Medicine, published by the International Society of Travel Medicine, might be thought to be preeminent. Articles that deal with all aspects of travel medicine are also published in infectious disease, tropical medicine, and general-practice journals. How will Travel Medicine and Infectious Disease fit in with established publications? Travel Medicine and Infectious Disease is published by Elsevier, and adds to its ever-increasing number of infection-related journals. On first appearances, the journal is well produced, attractively laid out, and easy to read. It is edited by Jane Zuckerman, a well known UK travel-medicine practitioner, and has an impressive international editorial board with wide ranging interests, although primary practice and nursing are noticeably under-represented. It is always unfair to judge the quality of a new journal on its early issues. The editors clearly had difficulty attracting submissions for the first two issues: more than three-quarters of the articles were written by members of the editorial board, biographies of the board occupy ten pages of the first issue, and a series of long, formulaic book reviews pad out the end of the journal. However, the original articles are generally interesting, well written, and cover a wide spread of subjects in keeping with the journal's stated aim of appealing to an extensive audience of practitioners—18 different categories of which are listed in an editorial, although again there is no mention of nurses. The same editorial lists the topics on which the journal will focus, including "aviation psychological and behavioural issues", implying a move away from the traditionally narrow, heavily infection-biased view of travel medicine. However, you cannot help but feel that in calling the journal Travel Medicine and Infectious Disease, the editorial board are attempting to hedge their bets and appeal as a more general infectious disease journal. It is too early to judge the quality of Travel Medicine and Infectious Disease and I look forward to reading subsequent issues. The timing of its launch could not be better in view of the rapid changes in travel medicine. It remains to be seen whether the heightened international interest in the specialty will translate into a sufficiently increased demand to justify another travel medicine journal, and whether Travel Medicine and Infectious Disease will find its own niche. This journal is published by Elsevier, of which The Lancet is part.