Bit by a spider in Peru? Suffer from high altitude sickness in Tanzania? Contract a virus during a mass gathering like the Hajj? As globetrotters go to increasingly far-flung destinations, travel physicians like Dr. Lin H. Chen need to keep their pulse on remote destinations and the unique health risks they present. “Travel medicine today is a lot more than just ‘jabs’ from a needle for vaccinations – it’s consulting with patients about health and safety measures and taking precautions that can’t always be neatly packed into a suitcase,” said Chen, 56, director of the Travel Medicine Center at Mount Auburn Hospital. Chen never knows what sort of cases she will see when she walks into the exam room; last year, the infectious disease specialist discovered one of the first cases of Zika in New England. The Globe spoke with Chen about this rapidly evolving field of medicine.
“When I discovered one of the first Zika cases in the state, it was a patient who arrived at the travel clinic after a trip to Costa Rica. He showed symptoms of fever, joint pain, and a dramatic rash. A test came back confirming Zika. Shortly after the diagnosis, the country’s health minister recognized that Zika was indeed spreading throughout the local population. This case was interesting because the traveler was a sentinel for the disease not yet confirmed for that location. Travelers go to such exotic places and do fascinating things, whether backpacking, volunteering or working. Our patients might be running a marathon on every continent; participating in car rallies on the Silk Road; locating human trafficking victims, or observing elections abroad. It’s fascinating to see the global connections, and it’s very satisfying when I confirm a diagnosis – sometimes exotic, sometimes not – in an ill traveler and they improve with treatment. Our travel medicine center is one of the GeoSentinal sites worldwide that participate in surveillance and monitoring of travel-related illnesses. My work is really interesting, intersecting so many different disciplines. Many questions arise that do not have clear-cut answers, and I enjoy the challenge of pulling scientific evidence from the different specialties to synthesize into practical clinical guidance. I got involved with this field because I love to travel and I live vicariously through the travels of my patients. I’ve been to all continents except for Africa and Antarctica, including Mexico, Southeast Asia, and Europe. But even a travel physician’s family can have inadvertent injuries and illness. We still have come down with the ubiquitous travel diarrhea, and one of my children even once fractured his elbow in Mexico. He tripped over a swimming noodle by the pool. So accidents can happen anywhere. It’s good to always be prepared.”