Illness and injury to travellers on a premium seniors' tour to Indochina

Background: Commercial expeditions and upmarket tours provide an opportunity for travellers to undertake various specialised travel to more adventurous and extreme destinations often in the relative security of accompanying medical cover provided by an expedition physician. There is limited knowledge of the nature of illnesses and injuries occurring on premium seniors' tours to Asia. This present study was designed to investigate the prevalence of injury and illness suffered by travellers on a premium tour to Indochina. Methods: In 2004, the tour expedition physician (MTMS) diagnosed and recorded all illnesses and injuries amongst 23 travellers on a premium seniors' tour to Viet Nam and Cambodia. Information recorded included age, sex, number of days into the tour, the nature of the presenting illness, the assessment of the condition and the treatment employed during the field phase of 14 days. Travel was by air, train and coach, for a total period of 18 days. Results: Nineteen (82%) travellers sought medical advice at least once for a total of 35 consultations. Females presented on 66% of occasions. The mean age of the travellers was 62 years (SD = 13) with males being significantly older (p = 0.002). Primary illnesses diagnosed related to the following systems: gastrointestinal 29%, respiratory 14%, dermatological 14%, cardiovascular 14%, musculoskeletal 9%, central nervous system 6%, ear/nose/throat 6%, dental 6%, and other problems on 3% of occasions. Of the gastrointestinal problems, diarrhoea was the commonest complaint on 17% of occasions, occurring at any stage throughout the journey. There was a mean of 2.5 presentations per day of the field phase of the tour. Presentations were highest on day 12. More than one third of presentations (37%) were handled conservatively without any further need for therapy, 17% requiring dressings, and 46% requiring specific medications. The commonest medications used were: lozenges/gargles (31%), antiemetic (25%), anti-diarrhoeal or other medications (13%). There were six accidents during the journey resulting in minor soft tissue injuries. There were no deaths or other major accidents requiring emergency evacuation or hospitalisation. Conclusions: On this premium seniors' tour, the health problems encountered were largely similar to those reported for other specialised tours, including premium expeditions. The most common medical problems included gastrointestinal, respiratory, dermatological, cardiovascular and musculoskeletal conditions in descending order. One aspect requiring further study is the psychological adjustments made by travellers on group tours and expeditions. As well as being part of the service provided to travellers, the inclusion of an expedition physician on this premium seniors' tour increased the independence of the travel group on this journey